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Intro Thoracic Spine Flashcards

(60 cards)

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1
Q

The average thoracic kyphosis ranges from what to what degrees?

A

20 - 40 degrees

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2
Q

The apex of thoracic kyphosis is usually at what level

A

T7 - T8

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3
Q

What thoracic spine level is there a significant decrease in movement of the spinal cord leading to a tension point

A

T6

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4
Q

What are the thoracic rule of threes

A

T1 - T3: SPs level with their own body
T4 - T6: SPs level with inferior disc
T7 - T9: SPs one segment below corresponding TPs
T10 - T12: SPs and TPs on same horiz plane

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5
Q

What kind of joint is the costovertebral joint

A

Compound synovial joint

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6
Q

The costovertebral joint is strengthened by what ligament

A

Radiate ligament

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7
Q

The costotransverse joint is a joint between the what and what

A

Facets of TPs and rib tubercle

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8
Q

The sternocostal joint between sternum and cartilage of first rib is what kind of joint

A

Synchondrosis

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9
Q

If you get L sided chest pain in OSCE, what do you need to rule out first or automatic fail?

A

Cardiac involvement

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10
Q

T spine coupling

A

Upper T spine: SB and rot same
Mid/lower: follows L spine usually, so opposite

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11
Q

Inspiration muscles

A

Diaphragm, external intercostals

Accessory: scalenes, SCM, UT, pec major/minor

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12
Q

Expiration muscles

A

Abdominals and internal intercostals

Accessory: lats, QL

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13
Q

Idiopathic scoliosis cause

A

Obscure

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14
Q

What percentage of idiopathic scoliosis is genetic?

A

90%

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15
Q

Idiopathic scoliosiis more common in male or female

A

Female

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16
Q

3 types of idiopathic scolisos

A

Infant
Adolescent
Jeuvenille

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17
Q

Scoliosis can continue after maturity due to

A
  • strong genetic dose
  • curve throws off balance of body
  • poor muscle tone
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18
Q

Lateral shift in thoracic spine is sign of

A

Serious pathology

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19
Q

5 causes of kyphosis

A

Genetic, osteoporosis, spondylosis, pathologic fractures, Scheuermann’s

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20
Q

Scheuermanns is what

A

Osteochondrosis of the vertebrae

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21
Q

Age for scheuermanns

A

10-20

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22
Q

Problem occurs where for scheumernnsn

A

Where disc and vertebrae connect

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23
Q

Schuermanns affects end plate?

A

Yes

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24
Q

Scheumernns end plate dysfunction causes

A

Collapse of vertebrae anteriorly

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25
Scheumeranns pain sx
Pain slowly increasing as day goes on by heavy labor, never severe
26
Scheumanns diagnosis
X ray 3 adj vertebrae showing minimum 5 degrees wedging and kyphosis angle >45
27
Clinical sx AS
Mid low back pain/stiff > 3 mos Worse in AM lasting more than 1 hr Chest expansion < 2cm on full inhalation Pain better with activity, not rest Psoriasis, uveitis, iritis, chrons, colitis
28
AS diagnosis
HLA-B27 positive X ray and MRI with fused spine LBP>3mos Limited chest expansion
29
T spine disc issues Age Area of disc Worse than L/C spine? Chest pain PT t/x
40-60 Posterior or posterolateral Better because IV foramen bigger Anterior chest pain (rule out cardio) Extension based
30
Costochondral conditions Caused by Pain and swelling where Acute costochondrosis aka
Trauma Bone/cartilage junction, 1in lat sternum Tietz’s syndrome
31
Thoracic facet dysfunction Sx
Unilateral limitation and pain in rotation Asymmetrical segmental mobility and palpatory findings
32
Costovertebral joint dysfunctions Main sx Restricted mainly in Pain with
Intense sharp pain unilaterally Side bend Deep breathing, sneezing, cough
33
Diff diagnosis costovertebral jt dysfunction
Cardiac Pneumonia Pleuritis Rib fracture Herpes zooster Long thoracic nerve ANNT
34
1st rib dysfunction Due to Need to rule out How to confirm Neuro sx
Trauma Presence of cervical rib X ray None
35
How to confirm presence of cervical rib
If 1st rib higher up to 1cm = joint dysfunction 1st rib higher up to 2+cm = cervical rib
36
C6-T3 (cervicothoracic region) coupling
Same
37
Cervicothoracic region dysfunction Sx and motion
Pain and limitation with flx,ext, SB/rot to same side
38
CTJ region levels
C6-T3
39
CTJ orientation
Goes from oblique to frontal plane
40
Why is t spine overall more stiff and less mobile
Presence of rib cage
41
Why is there kyphosis in t spine
Wedge shape of discs, less anterior height of vertebral bodies
42
T spine anterior is cave or vex
Concave
43
What are the atypical vertebral bodies
T1 and T12
44
Superior articular facets face Inferior face
Post, lat, sup Ant, med, inf
45
Angle of facets
20-30 degree away from frontal plane
46
T12 facet differences
Sup art facets in frontal plane but inf art facets in Sagittal
47
Thoracic spine Typical vs atypical segment articulation
Typical (2-10) articulate with 2 adjacent vertebra and disc at cost vertebral joint Atypical (1,11,12) articulate only with their own vertebrae
48
The superior and inferior components of CV joint is divided by what
Intra articular ligament
49
Intra articular ligament connects
Head of rib with disc
50
CV joint is strengthened by what lig
Radiate
51
Ribs 1-2 connect where 3-6 7
1-2: manubrium 3-6: sternum: 7: xyphoid process
52
What lig strengthens ant part of facets
Lig flavum
53
T spine lig flavum elastic to collagen ratio
2:1
54
Most common t spine disc issue spot
T7-T8
55
Most common Sx of disc issue in t spine
Ant chest pain, need to rule out cardiac
56
1st rib orientation and articulation
Inferiorly, most curved, T1
57
T spine arthros
Flx: inf facet of superior vertebra glides up and tilt forward on superior facet of inf vertebra Sb to R: down and back on R Rot to R: down and back on R
58
Rib motions in upper vs lower thoracic spine
Upper: parallel to frontal plane so motion will increase AP diameter, pump handle Lower: parallel to Sagittal plane, increase transverse diameter, bucket handle
59
Compression fx usually in what area of t spine
Lower thoracic
60
Sternomanibrial moi
Hyper flexion or sternal split

Intro Thoracic Spine (1 decks)

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