Intro to Thoracic Examination Flashcards
Week 1 (24 cards)
Why is differential diagnosis of thoracic pain difficult?
The thoracic region has complex biomechanics, proximity to vital organs, and numerous articulations.
What does it indicate if thoracic symptoms occur w/ breathing?
usually rib dysfunction; deep breathing or arm elevation aggravate rib dysfunction
What activities tend to aggravate thoracic spine problems?
thoracic movement - esp. rotation/extension
upper limb movements - esp. elevation
sustained postural load (sitting)
cerv. motion
coughing/sneezing/deep inspiration
What symptoms indicate thoracic nerve root pain?
sharp, stabbing, aching, burning pain
Where should the spine of the scapula line up with the thoracic vertebrae?
spinous process of T3
Where should the inferior angle of the scapula line up with the thoracic vertebrae?
spinous processes of T7-9
What is a Dowager hump?
Severely kyphotic upper posterior (dorsal) region, which may result from multiple
anterior wedge compression fractures in several vertebrae of the middle to upper
thoracic spine
What is a Hump back?
Localized, sharp, posterior angulation, called gibbus, produced by an anterior
wedging of one of the two thoracic vertebrae as a result of infection (tuberculosis),
fracture, or a congenital bony anomaly of the spine
What is a Round Back?
Decreased pelvic inclination and excessive kyphosis
What is a Flat Back?
Decreased pelvic inclination, increased kyphosis, and a mobile thoracic spine.
What can affect pelvic heights?
significant leg length discrepancy greater than 1/2”
can alter the lateral curvature of the spine
What is a Barrel Chest and what does it result in?
forward/upward projecting sternum
results in breathing difficulty, stretching the intercostal/anterior chest muscles, shortening of scapular adductor muscles
What is Pigeon Chest and what does it result in?
forward/downward projecting sternum
results in lengthing of upper ab muscles and adaptive shortening of upper intercostal muscles
What is Funnel Chest and what does it result in?
posterior-projecting sternum occurs secondary to an outgrowth of the ribs
results in adaptive shortening of upper abs, shoulder adductors, pec minor, intercostals. lengthening of thoracic extensors and middle/upper trap
where should most movement on inspiration occur?
lower lateral rib cage w/ concurrent movement of upper abd
**most commonly lost in patients with thoracic dysfunction
What is Lhermitte’s Symptom and what is it associated with?
electric shock-like sensation into spinal cord/limbs during neck flexion
associated w/ demyelination, prolapsed cervical disk, neck trauma, or subacute combined degeneration of the cord
What nerve does ULNT 1 test?
Median nerve
anterior interosseous nerve
C5, C6, C7
What nerve does ULNT 2 test?
Median nerve
musculocutaneous
axillary
What nerve does ULNT 3 test?
Radial nerve
What nerve does ULNT 4 test?
Ulnar nerve
C8 and T1
What three levels are used for respiratory excursion measurement?
Axilla, xiphoid level, 10th rib level.
What is the normal difference between inspiration and expiration?
3–7.5 cm (1–3 inches).
What is the Rule of Threes in thoracic spine assessment?
A method used to estimate transverse process location based on spinous process levels.
Why is the Rule of Threes controversial?
Recent research suggests it lacks accuracy due to variability in vertebral alignment.
