Thoracic Spine

Question 1

cervical spine

Answer 1

lordotic curve

Question 2

thoracic spine

Answer 2

kyphotic curve

Question 3

lumbar spine

Answer 3

lordotic curve

Question 4

intervertebral disks:

Answer 4

-annulus fibrous: multilayered fibers, thiner poseriotly
-nucleus pulpous: 60-70% water, compression and dehydration, high elastic and semigelatinous substance
-23 IV disks: no disk between C0-C1 and C1-C2

Question 5

clinical anatomy: articulations and ligamentous anatomy

Answer 5

-anterior and posterior longitudinal ligaments
-supraspinatus ligament
-interspinous ligaments
-ligamentum flavum

Question 6

extrinsic muscles

Answer 6

respiration and movement with the UE and scapula

Question 7

intrinsic muscles

Answer 7

close to the spinal cord and directly influence its motion

Question 8

past medical history

Answer 8

hisory of spinal cord, general health, changes in activity, mental health status

Question 9

history of the present conditions

Answer 9

location of the pain and referred or radicular symptoms, onset of the pain, severity of the pain, MOI, consistency fo the pain: constant of intermittent, bowel or bladder control, disability associated with low back pain-sleeping pattern

Question 10

functional assesment

Answer 10

-gait
general movement and posture (scoliosis?)

Question 11

general inspection

Answer 11

frontal curvature, sagittal curvature, skin markings

Question 12

scoliosis:

Answer 12

lateral bending of the spinal column in the frontal plane

Question 13

inspection of the thoracic spine

Answer 13

bretahing patterns, bilateral comparison of skin folds, shape of chest

Question 14

inspetion of the lumbar spine

Answer 14

lordotic curve, standing posture, erector muscle tone.
-compensatory posture for nerve root impingement.

Question 15

active range of motion

Answer 15

flexion and extension, lateral bending, rotation

Question 16

passive range of motion

Answer 16

flexion, extension, rotation

Question 17

joint play tests

Answer 17

assessing for hypomobility, hypermobility, pain.
caused by: facet joint pathology, degenerative changes, spondylitic defects

Question 18

tests for lower motor neuron lesions:

Answer 18

-hyporeflexia: flacidity of the muscles
-upper and lower quarter screen: muslce testing (myotomes), sensory testing (dermatomes), deep tendon reflexes

Question 19

spinal stenosis:

Answer 19

-narrowing of the spinal canal or intervertebral foramen
-compresses the contents within the canal
-50-60 year olds
-pain during walking, numbness/tinglgling, weakness, radiating pain

Question 20

intervertebral disk lesions

Answer 20

loss of water, decreasede protein, altering of chemical structure

Question 21

disk herniation

Answer 21

extrusion of the nucleus pulpous through the annulus fibrosus

Question 22

errector spinae muscle strain

Answer 22

self-limiting conditions, MOI usually from heavy or repetitive lifting, aching increases with flexion, pain increases with flexion and resisted extension

Question 23

facet joint dysfunction

Answer 23

-dislocation, subluxation, or degeneration of the facet
-localized pain over the facet
-decrease in symptoms with an increase in activity
-facetectomy: surgical restriction of a vertebral facet

Question 24

spondylosis:

Answer 24

defect in the pars interarticularis. collared scooty dog. localazied low back paun restricts extension

Question 25

sopndylolisthesis:

Answer 25

can be a progression of spondylolysis. seperation of vertebrae. decapitated scotty dog.

Question 26

thoracic spine

Answer 26

-cann affect respiration -cancer, gall bladder, gastroesophageal conditions

Question 27

scheumanns disease

Answer 27

juvenille kyphosis. 13-16 year olds, more boys than girls -schmorls node is often associated,. herniation of the nucleus pulpous throught the vertebral endplate.

Question 28

on field history

Answer 28

location of pain, peripheral symtoms: pain, numbness, weakness. MOI: rotation of eccentric contratcions

Question 29

on field inspection:

Answer 29

position of te athlete- prone or supine. posture-flexion or extensino, flaccidity of the muscles willingness to move-motionlless assume unconcious

Question 30

on field neurologic tests:

Answer 30

-sensory: bilateral extremity checks: anterior, posterioir, medial, lateral -motor tests: wiggle the feet and hands and bend knees and elbows

Question 31

on field palpation:

Answer 31

bony palpation: spinous and transverse processes paraspinal muscles: spasm? MOI trauma.

Question 32

management of suspected fracture

Answer 32

spine boarded, transported to hospital, radiographs

Question 33

lumbar spine:

Answer 33

-bilateral symptoms: spinal cord injury -pain spinous processes: compression or burst fracture -management of suspected fracture or spinal cord: spine board and transport to hospital

Question 34

posterior anterior vertebral joint play

Answer 34

prone push spinous processes anteriorly and feel for springing vertebrae. positive test is if vertebrae moves excessively and pain is elicted

Question 35

scoliosis test

Answer 35

stand wwith hand held in front with arms straight. have patient bend forward sliding hands down to toes. posiitve test when an asymmetrical hump is observed along lateral aspect fo the thoracolumbar spine and ribcage.

Question 36

hoovers test

Answer 36

supine. cup the heels of the patient. patient attempts to raise one leg on involved side. posiitve test: the patient does not attempt to lift leg and no pressure on examiners hand.

Question 37

valsalva test:

Answer 37

sitting. pateint holds a deep breath while bearing down similar to performing a bowel movement. posiitve is increase spinal or radicular pain.

Question 38

milgram test:

Answer 38

supine. pateint performs a bilateral straight leg to raist to the height of 2-6 inces and hold for 30 seconds. posiitve test: patient is unable to hold positiion, cannot lift leg, has pain.

Question 39

kernig'stest/ brudzinski test

Answer 39

supine. pateint performs a unilateral straight leg raise with the knee extended until pain occurs. when pain occurs flex the knee. posiitve: pain experienced in the spine and possibly radiating into the lower extremity. pain releived when knee is flexed.

Question 40

straight leg raise

Answer 40

supine. hold under heel and anterior knee to keep leg in full extension. examiner raises the leg by flexing hte hip until discomfort in experuenced or full ROM obtained. positve: patient compains of pain before end of normal ROM. pain may raidate distally along tested leg, usually in psterior thight radiatin ginto the claf and maybe the foot.

Question 41

well (cross) straight leg test

Answer 41

supine. onehand under heel other paced anterior thigh superior to the knee. raise the leg by flexing th rhi[ until discomfort reported. posiitve if pain experienced on side opposit being raised.

Question 42

slump test

Answer 42

sitting over the edge of the table. stand at the side of the patient. slump forward rounding shoulders and keep cervical spine neutral, flex cervical spine by bringing chin to the chest examiner holds patient in thisd position. then extend one knee and dorsiflex the ankle. repeat on other side. follow all steps until symptoms are provoked. positive if sciatic pain or other neurologic symptoms arise.

Question 43

quadrant test

Answer 43

stand with feet shoudler width apart. examiner stands behind patient holding their shoulders. patient extend spine then side bends and rotates to affected side. positive if reproduction of symptoms

Question 44

single led stance test

Answer 44

pateint stands evenly distributing body weight across two feet. examiner stands behind. patient lifts one leg, places the trunk in hyperextension. examiner may need to assist . repeat other side. positive: pain noted in lumbar spine of SI area.