Thoracic Spine Flashcards
Spinous Percussion Test
In thoracic region, same as cervical test
Test for: fracture, metastasis (breast cancer), nerve root lesions.
All 12 thoracic SPs
Adam’s Test: Forward bending test
Patient forward trunk flexion. To determine structural or functional changes.
Structural: bones “fused” - no movement between them. Rib hump.
Functional: symmetrical when bent
Upper Limb Tension Test
How to perform: Patient supine, brace patients arm against thigh. Depress shoulder and sustain during test. Abduct shoulder, externally rotate it, supinate forearm, extend wrist and fingers, extend elbow. Then contralateral cervical lateral rotation and then ipsilateral cervical lateral flexion.
The last 2 steps differentiate nervous from local tissue.
Test for: median nerve radiculopathy
Positive: Pain shooting along the course of the peripheral nerve.
Findings mean: excessive nerve tension or impingement./adhesion or impingement near the spine
Scalene Syndrome
Tight scalene are an issue. The neuromuscular bundle goes through here and can be occluded. Nerve compression can lead to tingling, numbness, and paresthesia. Vascular issues would be throbbing, blue. Cervical rib can also compress area (it would be surgically removed).
Adson’s Test/Reverse Adson’s
How to perform: Hold patients affected arm out to the side while palpating pulse and have them hold their breath and look at the affected hand.
Positive: loss of the radial pulse or paresthesia
Finding: For vascular impingement in the thoracic outlet area.
A negative test is followed by a reverse Adson’s test. Same test but patients looks over shoulder to non-affected arm.
Adson’s INDICATES FINDING OF ANTERIOR SCALENE SYNDROME.
Reverse Adson’s INDICATES FINDING OF MIDDLE SCALENE SYNDROME
Allen Test
Positive Finding: >15 second refill considered abnormal
Eden’s Test
How to perform: Bilateral, hold arms extended back, palpate pulses and have patient take deep breath - hold and tuck chin, bear down.
Positive: loss of pulses
Testing the subclavius muscle and costoclavicular syndrome.
Roo’s Test - EAST
How to perform: Have patients hold their arms up and open and close their hands 2 beats per second for 3 minutes
Positive: inability to keep up the pace of hand flexion and extension, downward drift of arms, pain in the hands, paresthesia.
Findings suggest costoclavicular thoracic outlet syndrome
Wright’s Test
How to perform: Palpate pulses, lift arms up and back, at tightness pulses diminish. Uni or bilateral.
Positive: loss of pulse at 90 degree - premature loss. Symptoms of pain reduced.
Findings suggests the pec minor is compressing area.
Hyperabduction syndrome
Breathing Pattern
Diaphragm respiration and circulatory muscles.
How to perform: patient supine, patients hands on chest and abdomen and doctors hands on top. Abdomen should move before chest.
Forced breathing: accessory muscles are involved.
