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CATA 437 > thoracic spine > Flashcards

thoracic spine Flashcards

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1
Q

T/S compression fx % and TP %

A

compression: 52%
TP fracture: 37%

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2
Q

T/S is important for what with scapula

A

scapular mvt

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3
Q

can be complex areas to assess why

A

both musculoskeletal injuries but also referred pain from viscera

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4
Q

Pain referred from visceral areas is usually what

A

Pain referred from visceral areas (lungs, heart and intestines) is usually poorly localized and vaguely delineated and is referred to as a segmental or multi segmental distribution

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5
Q

pain from lesion to MSK structure is brought on by what and why can influence visceral pain

A

Pain from lesions to MSK structures is brought on by posture and movement
However a cough, deep breath, PA or posture may influence visceral pain…

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6
Q

Subjective History Thoracic Spine

A
  • red flag from systemic problem
  • age/occupation: scheurmann’s (13-16) and idiopathic scoliosis ado female
  • boundaries of pain/pain presentation
  • pain with breathing
  • pain deep, superficial, shooting, burning, aching
  • coughing, sneezing straining
  • pain into leg, arm,head neck,
  • digestive problem
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7
Q

origin of ANS found where

A

between T1 and L2

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8
Q

ANS is responsible for

A

innervation of smooth muscle, cardiac muscle, glands, and blood vessels

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9
Q

Sympathetic and parasympathetic systems – have _ effect

A

opposite

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10
Q

SNS increase with what

A

Fight or Flight
Increase in stress, danger, physical activity, pain

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11
Q

SNS involve what activities

A

Involves E activities
Exercise, Excitement, Emergency, and Embarrassment

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12
Q

SNS reduce what

A

non essential activities
-> urinary and GI tract

Blood flow to organ is reduced, muscle is increased

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13
Q

T1-T5 innervate what

A

heart lung

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14
Q

T5-L2 innervate what

A

innervates stomach, intestines (up to distal ½ of large intestines), spleen and liver, pancreas

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15
Q

T10-L2 innervate what

A

distal half of large intestine, reproductive organs, urinary bladder, kidney

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16
Q

role of PNS

A

Stimulates activity to conserve and restore body resources
Concerned with keeping body energy use low

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17
Q

PNS is most active when

A

Most active in non stressful situations

SLUDD- salivation, lacrimation (tears), urination, digestion, defecation

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18
Q

what happen physiological after a meal and which system is actif

A

PNS
HR and BP and respiratory rates are low
GI tract activity high
Warm skin, pupils constricted

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19
Q

what is chest binding

A

Technique used to compress breast tissue in order to create a flatter appearance of the chest

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20
Q

in one Australian study _% of respondents had used binding

A

87

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21
Q

used of chest binding

A

For many transmasculine people, chest binding is considered a necessary rather than elective daily activity due to associated mental and emotional health
For some, it may be used as an interim measure before surgery can be obtained

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22
Q

concern with the use of binder

A

Rib fractures, back pain, chest pain, rib or spine changes, bad posture, shoulder pain, shoulder joint ‘popping’, muscle wasting, numbness, headache, overheating, fatigue, weakness, lightheadedness or dizziness, cough, respiratory infections, shortness of breath, heartburn, abdominal pain, digestive issues, breast changes, breast tenderness, scarring, swelling, acne, itch, skin changes, and skin infections

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23
Q

% of negative outcome from binder reported

A

97% of people reported at least 1 negative outcome (53% backpain, 53% overheating, 48.8% chest pain, 40% bad posture, 38.9% shoulder pain, 46.% SOB)

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24
Q

Common Thoracic Spine Pathologies

A

Scoliosis
Kyphosis
Scheurmann’s disease
Thoracic outlet syndrome
Rib fracture
Muscle strains- intercostals, scapular muscles, abdominals
Costochondral and chrondrosternal joint sprain
Manubriosternal and sternoclavicular joint sprain
Intervertebral facet joint sprain
Costovertebral and costotransverse joint sprain

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25
spinous process position
Positioned obliquely downwards
26
explain the rule of 3
T1-T3: TP at level of SP-same vertebrae T4-T6: TP ½ vertebral body above SP T7-T9 TP at level of SP of vertebrae above T10 Rules of T7-9 T11 Rules of T4-6 T12 Rules of T1-3
27
tubercle and head of ribs articulate with
with the vertebral and transverse costal facets on the thoracic vertebrae
28
posterior aspect of ribs articulate with
with the sternum via with the costocartilage
29
true ribs: false ribs: floating ribs:
true: 1-7 false: 8-10 floating ribs: T11-T12
30
which ribs is difficult to palpate
rib 1 , small broad and flat
31
rib one align with and which muscle primary attach to it
apex of right lunges, anterior scalene
32
costotransverse and Costovertebral joint refere pain where
along the ribs
33
which ligament attach to sternoclavicular and sternocostal joint
radiate ligament interchondral ligament
34
what is the role of pump handle movement
elevation of ribs, increase in anterior-posterior diameter of thoracic cavity
35
role of bucket handle movement
elevation of rib, increase in lateral diameter of thoracic cavity
36
ribs that primarily do bucket handle movement ribs that primarily do pump handle movement
bucket: false ribs 8-10 pump: true ribs: 1-7 combination of both ribs: 11-12
37
ribs movement with rotation to the right
Look at posterior aspect of ribs for direction of movement Right ribs= external rotation Left ribs= internal rotation
38
what are the respiratory muscle
diaphgram, serratus posterior/inf/sup, external intercostal, internal intercostal
39
muscle involve primary in force expiration
internal intercostal diaphgram
40
muscle involve in inspiration
external intercostal diaphgram
41
role of serratus post inf in respiration
aids in respiration and lower the ribs
42
role of serratus post super in respiration
elevated the ribs
43
action of thoracic diagram during inspiration and expiration
During inspiration lowers and flattens During expiration it relaxes and ascends
44
what is attach to diaphgram
Pleural tissue and pericardium are attached to the diaphragm
45
which nerve run between pericardial sac and diaphgram
phrenic nerve
46
fascial connection of diaphgram connected with
psoas major and QL
47
Esophagus pierces diaphragm at
T10
48
if you have a problem at T10 which disease could you also have
Gastroesophageal reflex disease
49
if you have T8 compression what could be affected
Inferior Vena Cava T8, compression will affect drainage 2/3 blood exits lower body via inferior vena cava 1/3 exits lymphatic system
50
thoracolumbar fascia attached where and merges with
Attaches medially to thoracic and lumbar spine and laterally to costal angles, 12th rib Merges with lats, glute med, glute max, T.A and int/ext obliques
51
muscle strain of thoracic spine commonly occurs with
with coughing, twisting/rotation activities and heavy lifting Acute with high energy mechanism or chronic overuse high rep mechanisms
52
muscle strain of thoracic spine will display pain where
along the muscle with palpation, possible pain with deep breaths, movement of the spine that stretches or contracts the affected muscles
53
rib stress fracture are common with which type of athlete
rower from continuous repetitive movement
54
which part of ribs is commonly affect
Posterior ribs most commonly affects due to the pull of SA Occurs most frequently after time off when endurance is not optimal
55
which level of T/S is most susceptible to stress fracture
Level of T4-T7 is most susceptible to stress fractures and strains Rhomboids, lats, ES
56
which dynamic is affected with rib fracture
T/S, rib cage and shoulder
57
Incidence of symptomatic disc herniation is low/high
low
57
disc herniation in T/S is more common in what age and which gender is more affected
40s-50s and male
58
75% of T-spine herniation reported to be where
below T8
59
60
Disc herniation in T/S is associated with which type of pain
axial pain (localized to middle or low thoracic region near level of injury), radiculopathy
61
scoliosis follow which law
1 -> SB and rotation are opposite
62
non-structural scoliosis only have SB or rotation element
only SB
63
how a scoliosis is named
Named for the point of the apex of the curve and the side of the convexity ex: L T7 scoliosis
64
explain the convex side of rib with scoliosis
ribs pushed posteriorly, angle gets sharper and overall volume is decreased
65
explain the concave side of ribs with scoliosis
Concave side – ribs pushed anteriorly, widens the angle
66
spinous process deviated toward which side with scoliosis
concave side,
67
what is costochondritis
Inflammation of the cartilage that connects rib to sternum worse with coughing and deep breathing sharp, achy or pressure like pain improve on its own
68
TOS is more common in M or W
W
69
common MOI of TOS
Common MOI Repetitive OH movement Faulty posture Improper breathing Traumatic=whiplash/falls
70
common entrapment sites of TOS
between scalene’s (ant/mid), 1st rib and clavicle, pec minor…
71
what is ATOS and history finding
arterial TOS claudication/rest pain of upper limb, excluding shoulder/neck, numbness, coolness,palor
72
which test is positive with ATOs
EAST, ULTT, adsons test
73
VTOS history finding and which test is positif
deep pain on movement or rest pain in upper limb, chest, shoulder swelling and cyanotic discolouration +Ve: EAST, ULTT, adson
74
NTOS history
pain in neck, trapezius, shoulder, arm, chest, occipital headache variable pattern upper limb weakness, numbness, paraesthesias
75
which muscle is tender on palpation with NTOS
scalene triangle, subcoracoid space
76
s/s with upper plexus NTOS (C5-C7)
sensory disturbance of arm, weakness/atrophy of deltoid, bicep and brachialis
77
s/s with lower plexus NTOS (C8-T1)
sensory disturbance ulnar forearm and hand, weakness/atrophy of small muscle of hand, weak wrist and finger flexion
78
normal kyphosis and what is considered abnormal
20-40 degree abdnormal: 40-45 +
79
scheuermann kyphosis occurs at what age and what is it
Can occur in young age (13-16) Vertebrae grow at different rates during child’s growth spurt
80
symptom of scheuermann kyphosis
Pain to follow after periods of exertion or long periods of inactivity
81
what is dowager hump
increased kyphosis, from stress fracture of postmenopausal osteoporosis
82
what is chest breathing
Whole body moves up Tension through the neck musculature Use of SCM, scalene, UFT to assist in inhalation Abdomen moves up and in Rib flare
82
proper breathing mechanic
- inhale through the nose - expansion of the abdomen- 360º (like a balloon) - slight anterior tilt of pelvis with inhalation -pump and bucket handle movement of the chest - no shoulder movement toward the ears - relaxation of neck musculature
83
what is collapsed breathing
Whole body moves down Shoulder’s hunched Compression to the heart, lungs and organs Chest and rib cage compress inferior Belly projected forward and down like dead weight Common in obese individuals and individuals suffering from depression
84
what is frozen breathing
Entire outer layer of body contracts to constrict and suppress the rising movements of breath Breath holding and tension Stressful situations and cold environment
85
what is reverse breathing
Abdomen contracts in on inspiration and out on expiration Confusing to the body Affects muscle movement and coordination patterns
86
non emergency signs of dysfunctional breathing
Cranial movement of rib cage Inward movement of abdomen Movement of spine (flexion/ext)
87
Signs of improper activation of core-stabilization during movements
1. Elevation of the chest - brings the diaphragm away from ideal position for maximal activation 2. Breath holding when performing tasks 3. The inability to maintain the intra-abdominal pressure during the normal respiratory cycle 4. Imbalanced abdominal activity with excessive contraction of the rectus abdominis, and lack of activity of the lateral and posterior parts of the abdominal wall 5. Belly breathing pattern where only the front of the abdomen expands 6. Concavities at the lower lateral abdomen
88
what can compromised breathing
Position of chest and pelvis affect synchronization of diaphragm and pelvic floor Elevated chest impairs the contraction of costal part of diaphragm
89
how should chest and pelvis be during breathing
parallel
90
finding with anterior subluxation of ribs
rib angle = less prominent and tender anterior rib= more prominent motion: restriction in inhalation and exhalation
91
finding with posterior subluxation of rib
rib angle = more prominent and tender anterior rib: less prominent motion: restriction in inhalation and exhalation
92
finding with sup first rib subluxation
rib angle: Superior aspect of first rib elevated (5mm) anterior to UFT ant rib: Marked tenderness of superior aspect motion: Restriction primarily in exhalation (scalene hypertonicity)
93
ant-post rib compression finding
shaft: Less prominent ant and post convexities mid-axillary lines: More prominent discomfort: Tenderness and tension of intercostal space above and below motion: Restriction of respiratory activity
94
lateral rib compression finding
rib shaft: More prominent ant and post mid-axillary lines: Less prominent discomfort: Tenderness and tension of intercostal space above and below motion: Restriction of respiratory activity

CATA 437 (12 decks)

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