Thoracic Spine

Question 1

What is Scheuermann’s Disease?

Answer 1

Uneven growth of vertebrae, leading to anterior wedging of three or more consecutive vertebrae by at least 5 degrees

Question 2

At what age does Scheuermann’s Disease typically present?

Answer 2

Between ages 12 and 17

Question 3

What are the early symptoms of Scheuermann’s Disease?

Answer 3

Subacute thoracic pain, often exacerbated by physical activity and prolonged standing or sitting

Question 4

What is the typical presentation of a rib fracture?

Answer 4

Sharp, localized pain that worsens with deep breathing, coughing, or movement

Question 5

What are the common causes of rib fractures?

Answer 5

Trauma (e.g., motor vehicle accidents, falls, sports injuries), severe coughing.

Question 6

What is a common complication of untreated rib fractures?

Answer 6

Pneumonia

Question 7

Fill in the blank: The risk factors for compression fractures include _______ and _______.

Answer 7

[advanced age], [female gender]

Question 8

What is the typical appearance of a patient with emphysema?

Answer 8

Thin and has a pink complexion

Question 9

What is the purpose of the pump handle motion during respiration?

Answer 9

To increase the anteroposterior diameter of the thoracic cavity

Question 10

What condition is characterized by the breastbone protruding outward?

Answer 10

Pectus carinatum (Pigeon Chest)

Question 11

What age group is most at risk for thoracic outlet syndrome (TOS)?

Answer 11

Young adults

Question 12

What is the most common type of scoliosis?

Answer 12

Idiopathic scoliosis

Question 13

What Cobb angle range indicates mild scoliosis?

Answer 13

10 to 24 degrees

Question 14

What are the components of the Schroth Method for scoliosis treatment?

Answer 14

Muscular symmetry and alignment

Question 15

What is the primary goal of physical therapy management for Scheuermann’s Disease?

Answer 15

Prevent progression of the disease

Question 16

What are the risk factors for developing compression fractures?

Answer 16

Low bone density, advanced age, female gender, prior fracture after age 50

Question 17

What are the three sections of the thoracic spine?

Answer 17

1) Upper: CT Junction & Upper 3-4 Ribs
2) Middle: Mid scapular to around T8
3) Lower: Thoraco-Lumbar Junction

Question 18

What is the significance of the rib articulations during respiration?

Answer 18

They allow for expansion and contraction of the thoracic cavity during breathing

Question 19

True or False: Rib 11 and 12 are considered true ribs.

Answer 19

False

Question 20

What is the typical treatment strategy for rib fractures in physical therapy?

Answer 20

Encourage mobility, teach splinting, and breathing exercises

Question 21

Fill in the blank: The thoracic flexion range of motion is _______.

Answer 21

[20-45 degrees]

Question 22

What are the key symptoms of thoracic outlet syndrome?

Answer 22

Radicular type of shoulder/arm pain with diminished radial pulse

Question 23

What differentiates structural scoliosis from functional scoliosis?

Answer 23

Structural scoliosis involves permanent spinal changes, while functional scoliosis can occur from repetitive movements

Question 24

What does the term ‘Blue Bloater’ refer to in the context of COPD?

Answer 24

Advanced COPD characterized by a bluish tint to the skin and lips due to low oxygen levels

Question 25

What are the initial stabilization exercises recommended for scoliosis?

Answer 25

Plank, side plank, and bridging.

Question 26

What is the primary focus when stabilizing the pelvis/lumbar region in scoliosis treatment?

Answer 26

To stretch out the thoracic curves.

Question 27

What is the Schroth Method?

Answer 27

A specific scoliosis treatment designed for each patient's spinal curvature.

Question 28

What is the first key component of the Schroth Method?

Answer 28

Muscular Symmetry.

Question 29

What does the Muscular Symmetry component emphasize?

Answer 29

Alignment of the pelvis and elongation stretching of the concave side of the curve.

Question 30

What is Rotational Angular Breathing (RAB)?

Answer 30

A breathing technique that helps rotate the spine and reshape the rib cage.

Question 31

How does Rotational Angular Breathing (RAB) benefit scoliosis patients?

Answer 31

It teaches the patient to breathe into the concave side of the body to expand and strengthen.

Question 32

What is the importance of awareness of posture in scoliosis treatment?

Answer 32

To develop postural awareness and strengthen muscles on the convex side of the curve.

Question 33

Fill in the blank: The pelvis/lumbar region must be stabilized in order to stretch out the _______.

Answer 33

thoracic curves.

Question 34

True or False: The Schroth Method is a one-size-fits-all approach to treating scoliosis.

Answer 34

False.

Question 35

What are the later symptoms of Scheuermann's Disease?

Answer 35

Visible kyphosis, often rigid and not correctable by posture adjustment; exaggerated kyphotic curvature of the thoracic spine between 45 and 75 degrees ## Footnote This kyphosis is often noticeable.

Question 36

How does Scheuermann's Disease typically present?

Answer 36

Pain with physical activity that creates stress through the thoracic spine; notable kyphosis or 'hunchback' appearance ## Footnote This is particularly observed in the thoracic or thoracolumbar spine.

Question 37

What treatment options are available for managing symptoms of Scheuermann's Disease?

Answer 37

Symptom modulation, reduced load, stretching, postural correction, muscle energy techniques, and breathing exercises ## Footnote These are aimed at managing the painful stage and prevention.

Question 38

Fill in the blank: Scheuermann's Disease leads to anterior wedging of _______ or more consecutive vertebrae by at least 5 degrees.

Answer 38

three

Question 39

Name a medical history factor that increases the risk of compression fractures.

Answer 39

Previous fractures, long-term use of corticosteroids, hyperparathyroidism, chronic renal failure ## Footnote These conditions can weaken bones and increase fracture susceptibility.

Question 40

What is a common early symptom of compression fractures?

Answer 40

Sudden onset can occur in the absence of trauma, such as coughing, bending, lifting, or twisting ## Footnote These activities can lead to fractures even without significant load.

Question 41

What are chronic symptoms of compression fractures?

Answer 41

Chronic pain and spinal deformity, specifically kyphosis (dowager's hump) ## Footnote Kyphosis results from the structural changes in the spine due to fractures.

Question 42

What characterizes the pain associated with compression fractures?

Answer 42

Sudden onset of fracture pain, worse with movements, less with rest ## Footnote Pain is often localized and can be aggravated by physical activity.

Question 43

How is pain assessed in compression fractures?

Answer 43

Pain with palpation or percussion tapping ## Footnote These methods help determine the location and severity of the fracture pain.

Question 44

What deformity is caused by compression fractures?

Answer 44

Wedge deformity and reduced mobility ## Footnote This deformity results from the vertebrae collapsing, affecting posture and movement.

Question 45

What is the first step in physical therapy management for compression fractures?

Answer 45

Symptom modulation – modalities and relative rest advice ## Footnote This helps manage acute pain before progressing to more active rehabilitation.

Question 46

What is important in the later stages of physical therapy for compression fractures?

Answer 46

Strengthening and flexibility exercises, along with advice to stay active ## Footnote These activities help restore function and prevent further injury.

Question 47

What happens to the diaphragm during inhalation?

Answer 47

Diaphragm contracts and lowers, ribs expand

Question 48

What is De Kleyn's test?

Answer 48

For VBI, patient lies supine with head on edge of table, PT rotates head to one side, take it into extension, hold for 30 seconds. Ask for any DANS

Question 49

What are the symptoms to Chronic Bronchitis (Blue Bloater)?

Answer 49

chronic, productive cough, cyanosis, mild dyspnea initially, crackles, wheezing, peripheral edema

Question 50

What are the symptoms to Emphysema (Pink Puffer)

Answer 50

Dyspnea, minimal cough, tachypnea, accessory muscle use, decreased breath sounds

Question 51

List the 3 steps of the scroth method

Answer 51

1. Muscular Symmetry 2.Rotational Angular Breathing 3. Isometric (develop postural awareness by strengthening the muscles on the convex side of the curve