Thoracic Flashcards
Pain referral gallbladder
Right mid epigastric region T8-9. Pain referred between R upper trap, between scapulae, and R subscapular area; jaundice; fevers, chills; indigestion; vomiting/nausea; intolerance to fatty foods
Renal pain referral
Ipsilateral sub costal and costovetebral region at the level of T10-12. Pain is typically dull and aching. Increased urinary output or frequency
Rule of 3’s for thoracic spine
Spinous processes of T1 through T3 are at the same
level as the transverse processes, the spinous processes
of T4 through T6 are one half vertebral level below the
transverse processes, the spinous processes of T7 through
T9 are one full vertebral level below the transverse processes, the spinous processes of T10 through T12 are at the same vertebral level to which they are attached
True ribs
1-7
False ribs
8-12
Costotransverse joint
1-10 attach to corresponding transverse process. Ribs 11-12 do not attach to transverse process and do not have costotransverse joint.
Critical zone in thoracic spine
T4-9 due to small diameter of spinal canal and reduced blood supply
Motion of ribs during inspiration
Pump handle action. Ribs move laterally and superiorly.
Rub motion during expiration
Ribs move inferiorly in anterior and lateral aspects.
Rib motion of upper vs lower thoracic spine
Pump handle: upper
Buckle-handle: lower
Rib motion of 11-12
Caliper motion. Move posterior and lateral during inspiration and anterior and medial during expiration
Motion of thoracic spine during inspiration
Extension
Motion of thoracic spine during expiration
Return to neutral
T4 syndrome
Stiffness to upper to mid thoracic spine.
Signs and symptoms: headaches, neck pain, UE pain, boost stocking glove paresthesias.
CPR coronary artery disease
- age/sex (females>65, males >55
- known clinical vascular disease
- pain worse during exercise
- pain not reproduced during palpation
- pt assumes pain is of cardiac origin
