T4 Thoracic Spine

Question 1

What is the most common disease affecting the thoracic spine?

Answer 1

Osteoporosis

Question 2

The upper thoracic spine refers to ____
The lower thoracic spine refers to ____

Answer 2

-T1-T2
- T3 - T12

Question 3

T1 (cervicothoracic junction) and T12 (thoracolumbar junction) are considered…

Answer 3

Transitional vertebrae, therefore they can begin to move in unison w/ their articulating vertebrae

Question 4

The ribs contribute to…

Answer 4

Spinal stability, restricting forward bending, side bending, and rotation, protect viscera

Question 5

Which are the atypical ribs and what does this mean?

Answer 5

Ribs 1,11 & 12
This means they articulate with one vertebral body are not united to a disc and articulate with the numerically corresponding vertebral body only

Question 6

Define typical ribs

Answer 6

Typical ribs, articulate with two vertebral bodies to the numerically corresponding vertebral body and the IVD and the vertebral body above. They have a head with two facets on either side of a tiny crest.

Question 7

Ribs 11 & 12 are…

Answer 7

Floating ribs

Question 8

Ribs 1 & 2 articulate with the ___
Ribs 3-7 articulate with the ___

Answer 8

• manubrium
• sternum

Question 9

When the mid thoracic spine (T3 - T9)
Flexes the ribs roll…
Extends …
Laterally flexes…
Rotates…

Answer 9

• flexion: the ribs roll anteriorly and glide superiorly
  -Extension: the ribs roll posterior and glide inferiorly
• Lateral flexion: the ribs approximate ipsilaterally and separate contralateral
• rotation: the ipsilateral rib will posteriorly rotate. The contralateral rib will anteriorly rotate.

Question 10

How many joints are there in the thorax?

Answer 10

136

Question 11

How do we generate our core power?

Answer 11

With thoracopelvic rotation

Question 12

What are the primary muscles of respiration during inspiration?

Answer 12

Diaphragm, levator costorum, external intercostals, internal intercostals

Question 13

What are the secondary muscles of respiration during inspiration?

Answer 13

Scaleni
SCM
Trapezius
Serratus anterior and posterior
Pectoralis major and minor
Subclavius
Latissimus Dorsi
Serratus posterior superior
QL
Iliocostalis lumborum

Question 14

What are the primary muscles of respiration during expiration?

Answer 14

Internal obliques
External obliques
Rectus abdominis
Transversus abdominis
Transverses Thoracis
Transverse intercostals
Internal intercostals

Question 15

What is the primary muscle of respiration?

Answer 15

The diaphragm

Question 16

The diaphragm is innervated by

Answer 16

C 3,4 and 5 phrenic nerve

Question 17

During inspiration the volume is ____ and pressure is ____ in the abdominal cavity,

the volume is _____ and pressure is _____ in the thoracic cavity

Answer 17

• decreased, increased
• Increased, decreased

Question 18

The “bucket handle” action of the ribs happens mainly at ribs ___

Answer 18

7 through 10

Question 19

With the bucket handle action of the ribs, movement at the costovertebral jt happens around which axis?

Answer 19

AP axis

Question 20

With the “pump handle” action, movement at the costovertebral jt happens around which axis?

Answer 20

ML axis

Question 21

When we inhale the spine ____, the ribs _____ & rotate ______ and glide _____ where they meet the spine

Answer 21

• Extends
• Expands
• Posteriorly
• Inferiorly

Question 22

When we exhale the spine ____, the ribs rotate ____ and glide ____ where they meet the spine

Answer 22

• flexes
• anteriorly
• superiorly

Question 23

Where is veryebral compression fracture common?

Answer 23

• In the lower thoracic region

Question 24

Vibra compression fracture occurs in older patients with the main cause being…

Answer 24

Osteoporosis

Question 25

What is the presentation of vertebral compression fracture?

Answer 25

Sudden onset of acute pain after minor trauma in older people for example, stepping off a curb, sudden movement, sneezing

Question 26

What are some signs and symptoms of scoliosis?

Answer 26

- typically asymptomatic - Rib prominence, elevated shoulder and or prominent shoulder blade - Uneven, hip arm or leg lengths - Uneven musculature, impaired mobility, and muscle performance - Back pain is not usually considered a scoliosis symptom

Question 27

What are some complications of scoliosis?

Answer 27

- pulmonary/cardiac risks - Neurological complications in severe and progressive curves - Gastrointestinal disturbances - Intermittent back ache may occur

Question 28

True or false: radiating leg pain night pain or systemic complaints are normal symptoms of scoliosis

Answer 28

False: these are not normal symptoms of scoliosis, and require further investigation by medical doctor

Question 29

The curve labeling of scoliosis is dictated by the ____ side

Answer 29

Convex

Question 30

Scoliosis curve can have which shapes?

Answer 30

C curve or S curve

Question 31

What are transitional vertebrae when it comes to scoliosis?

Answer 31

Vertebrae between the curves

Question 32

What is the span of scoliosis?

Answer 32

The anatomical start, and end points of curve

Question 33

What is the apex of scoliosis?

Answer 33

Vertebra furthest from midline

Question 34

Scoliosis severity: 10° is… 10°-20° is … 20°-50° is… 50° is …

Answer 34

10° is normal 10°-20° is mild 20°-50° is moderate 50° is severe

Question 35

What are the labelling components of scoliosis

Answer 35

Right or left curve Curve shape Major and minor curves Transitional vertebra Span Apex Cob method Severity

Question 36

With scoliosis, the vertebral bodies rotate to the ____ of the curve

Answer 36

Convexity

Question 37

True or false: Functional scoliosis is reversible and can be altered with forward or side, bending, and positional changes

Answer 37

True. Proper and consistent treatment may include therapeutic exercise, positional changes, and correction of contributing causes.

Question 38

To test for functional scoliosis we can use…

Answer 38

Adams forward Bend test

Question 39

Which type of scoliosis is a fixed deformity

Answer 39

Structural scoliosis

Question 40

What are the three types of structural scoliosis?

Answer 40

Idiopathic, congenital, neuromuscular

Question 41

What is the most common type of scoliosis?

Answer 41

Idiopathic

Question 42

What is congenital scoliosis caused by?

Answer 42

Disturbances in vertebral development, failures of formation or failures of segmentation of the vertebral bodies

Question 43

When does congenital scoliosis usually occur?

Answer 43

During the first six weeks of embryonic formation

Question 44

True or false: Neurological complications are common with congential scoliosis

Answer 44

False. Neurological complications may present but are not common.

Question 45

Neuromuscular scoliosis often presents as…

Answer 45

a long c-shaped curve from cervical to sacral region

Question 46

With children and adolescents what is a key component to the plan of care

Answer 46

Consistent monitoring of the curve progression

Question 47

In adults scoliosis treatment is usually focused on…

Answer 47

Releiving Pain

Question 48

True or false: Idiopathic scoliosis can be fixed or corrected.

Answer 48

False: This type of scoliosis is progressive and cannot be fixed or corrected

Question 49

Congenital scoliosis may be a progressive disorder in which usually involves…

Answer 49

Surgical intervention

Question 50

Forms of treatment and intervention are considered when the curve is between… Bracing is considered when the curve is between… Surgical interventions are considered when the curve is between…

Answer 50

- 20° - 30° - 30° - 40° - 40°- 45°

Question 51

What will rib fractures present with…

Answer 51

will present with acute pain with all motions of the spine

Question 52

Rib dysfunction may present as…

Answer 52

atypical interscapular, chest, sternum, or arm pain

Question 53

What is the clinical presentation of rib dysfunction?

Answer 53

- sharp pain (sometimes described as stabbing) - aggravated by specific movements - upper ribs aggravated by reaching - lower ribs aggravated with bending/twisting - pain will increase w/ sneezing, coughing, deep breaths - paraspinal tenderness/hyperalgesis

Question 54

Describe exhalation dysfunction…

Answer 54

A rib that fails to move fully into its inhalation position. This can be described as being “locked in exhalation”, exhalation restriction, limited in inhalation, or depressed.

Question 55

Describe inhalation dysfunction

Answer 55

A rib that fails to move fully into its exhalation position. This can be described as being locked in inhalation, an inhalation restriction, limited in exhalation or elevated.

Question 56

What is the most common cause of intercostal neuralgia?

Answer 56

Herpes zoster virus (shingles)

Question 57

What are the symptoms of intercostal neuralgia?

Answer 57

- unilateral neurogenic pain that radiates around towards the sternum in the associated dermatome - sporadic episodes of acute pain or constant dull ache - pain can be stabbing, sharp, spasm-like, gnawing - pain increases with certain mevements, actions, activities (coughing, sneezing, laughing

Question 58

Costochondritis is relatively common as a primary condition and in combination with…

Answer 58

Coronary heart disease

Question 59

What does costochondritis (a.k.a tietze’s syndrome) present as?

Answer 59

- pain and tenderness of the costochondral junctions - diffuse tenderness and multiple lesions