TEST 3: Thoracic Spine Dx OSCE Flashcards Preview

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Flashcards in TEST 3: Thoracic Spine Dx OSCE Deck (16)
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1

what is an important bony landmark of the thoracic spine?

C7 and T1:
-C7 is vertebra prominent and may be used to help locate T1

2

what is located at T3?

spine of scapula

3

where is the inferior angle of the scapula located?

-spinous process of T7 and transverse process of T8

4

explain the Rule of 3s

-T1-3: SP in the same plane as the TP of the same numbered vertebra
-T4-6: SP halfway between the TP of the same numbered vertebra and the vertebra one inferior
-T7-9: SP at the level of the TP of one vertebra inferior
-T10: same as T7-9
-T11: same as T4-6
-T12: same as T1-3

5

what is the rotation and side bending of the thoracic spine?

rotation is up to 90 deg
side bending is up to 40 deg

6

Type I Spinal Mechanics

TONGO:
-type one neutral group opposite
-typically > or = 3 segments
-neither flexed or extended (in neutral)
-sidebending of spine in one direction results in rotation of the thoracic vertebrae in the direction opposite to sidebending

7

Type II Spinal Mechanics

"Non-Neutral"
-typically involves a single vertebral unit
-flexion or extension of thoracic spine
-sidebending of spine in one direction results in rotation of thoracic vertebrae in the same direction

8

how to assess R and L rotation in neutral?

-pt in prone with examiner at side of table
-palpate the TP with the pads of thumbs
-examiner alternately presses on R and L TP of T7 (load and spring) evaluating for ease of motion/hard end feels
-if the R TP moves anteriorly easier, that segment is rotating L more freely

9

how to assess R and L side bending in neutral?

-inferred by spinal mechanics after flexion and extension assessment as well as rotation assessment

10

how to assess for flexion in prone?

-have pt in cat back position
-palpate the TP with the pads of thumbs
-examiner alternately presses on R and L TP of T7 (load and spring) evaluating for ease of motion/hard end feels

11

how to assess for extension in prone?

-have pt in TV watching position
-palpate the TP with the pads of thumbs
-examiner alternately presses on R and L TP of T7 (load and spring) evaluating for ease of motion/hard end feels

12

how to assess R and L rotation in a seated position?

-segmental motion testing can be assessed doing seated loading and springing (R and L rotation)
-examiner should be behind pt and load and spring from T1-12
-assess in active flexion and extension

13

how to assess for passive side bending and passive rotation?

-passive sidebending: in seated position, examiner pushes down on pt's ipsilateral shoulder and monitor ipsilateral TP for hard end feel
-passive rotation: in seated position, examiner contacts front of pt's ipsilateral shoulder and induces rotation while monitoring ipsilateral TP for hard end feel

14

evaluation of findings

-always evaluate in flexion/extension: repeat loading and springing thru F, E, N
-if improves/becomes more symmetric in flexion, then we have a flexion dysfunction--restricted to/becomes asymmetric in extension
-if improves/becomes more symmetric in extension, then we have an extension dysfunction--restricted to/becomes asymmetric in flexion

15

if F or E component exists, you can assume...

Type II Mechanics/Dysfunction

16

if no change in F/E (doesn't prefer F/E), you can assume...

Type I Mechanics/Dysfunction