Thoracic/Rib Conditions Flashcards
(29 cards)
thoracic outlet syndrome
neurovascular compression syndromes can involve either neural or vascular elements that supply the upper extremity
neurologic TOS
brachial plexus compression
vascular TOS
subclavian artery/vein compression or thrombosis
nonspecific TOS
patient has symptoms but no abnormal nerve conduction or angiography tests
clinical presentation of TOS
diffuse arm pain/numbness/tingling often into the 4th and 5th digit that is worse with overhead activity; neck or shoulder pain, thenar atrophy, diminished grip strength, hand/arm swelling. cold distal extremity, pallor or discoloration of the hand
Subscapular Crepitus
Snapping Scapula
Scapulothoracic Bursitis
local pain at the superior medial angle of the scapula, audible or palpatory crepitus, patient reports feeling a catch in the upper back, restricted scapular motion
clinical presentation of thoracocostal facet sprain
difficulty breathing, feels as if a rib is out of place, shallow breathing due to pain, local sharp pain over the joint
clinical presentation of costochondritis
moderate to severe sharp/shooting anterior chest wall pain, insidious onset, pain usually unilateral, localized but can radiate to chest, upper abdomen, or back; pain worse with coughing, sneezing, or deep inspiration, decreased with rest or ice
clinical presentation of costocartilaginous injury tietze syndrome
insidious, over-use, coughing; typically benign, self-limiting, non-suppurative in swelling of the chest wall, onset may be sudden or gradual; pain resolves in days to weeks but swelling may be present for months to years; pain with taking deep breaths, coughing, or difficulty breathing
clinical presentation of scoliosis
progressive: adolescent, idiopathic
acute: tumor, fracture, disc disease
loss of balance, falls, asymmetric stress on lower limbs, low body image
functional scoliosis
compensatory, postural, can usually be corrected with stretching, joint mobilization, strengthening, and postural training
structural scoliosis
idiopathic, congenital, mesenchymal disorder, trauma, vertebral neoplasm, metabolic
clinical presentation of postural syndrome
gradual onset of dull and achy upper back pain secondary to poor postural habits or prior neck/upper back injuries; better w stretching, LAD, worse w prolonged sitting or standing, difficulty sleeping, headaches, carpal tunnel, or TOS syndromes
thoracic radiculopathy
symptoms follow a dermatomal distribution and can cause pain and numbness that wraps around the front of your body; sharp pain in back that may worsen with coughing or sneezing
clinical presentation of thoracic myelopathy
difficulty walking, loss of urinary or bowl control, issues with balance and coordination, increased reflexes in the extremities or development of abnormal reflexes
clinical presentation of intercostal neuralgia
burning, sharp, or shooting pain; squeezing pressure sensation that wraps around the chest causing tingling or numbness; pain worse with physical activity, breathing, stretching, laughing, coughing, and sneezing; referred pain to shoulder blade or lower pelvis
clinical presentation of rib fracture
pain with inspiration and dyspnea, reported after coughing spells, athletes with high force
radiculopathy
condition involving nerve root
myelopathy
condition involving spinal cord
non-accidental rib fractures
osteoporosis in elderly; in pediatric patients, take appropriate clinical history
where is most common location for Tietze syndrome?
2nd, 3rd, and 4th costosternal articulations
possible surgery for TOS
1st rib removed
if patient breaks out in rash
intercostal neuralgia: viral infection (shingles)
if patient does NOT break out in rash
intercostal neuralgia: nerve entrapment
