Thoracic Spine and Cervical Spine Flashcards Preview

KNSS 220 Athletic Therapy > Thoracic Spine and Cervical Spine > Flashcards

Flashcards in Thoracic Spine and Cervical Spine Deck (75):
1

How many thoracic spine vertebrae are there?

12

2

What area does the thoracic spine cover?

area that has ribs

3

What is the costovertebral joint?

ribs + vertebrae

4

Facet joints are in between...

each vertebrae

5

Name the deep muscles of the thoracic spine.

erector spine runs from iliac crest to cervical spine

6

Name the intermediate muscles of the thoracic spine.

- serratus (anterior and posterior)
- rhomboid

7

Name the superficial muscles of the thoracic spine.

- trapezius muscle (lower)
- mid trapezius
- latissimus dorsi

8

What do we ask for history of thoracic spine and rib cage?

pain with breathing

9

What are the movements of the thoracic spine?

- flexion and extension (fairly limited in tsp)
- lateral flexion (big movement in tsp)
- rotation (big movement in tsp)

10

Rib fractures and costal cartilage separations occur the most where?

in collision sports

11

What is the MOI for rib fractures?

generally only occur with a direct blow

12

What is the MOI for costal cartilage separations?

- can be from direct impact (can be at site or somewhere else and bending)
- violent contraction (could be coughing or sneezing)

13

Where is the costal cartilage line?

where rib attaches to cartilage and to the sternum

14

In what area of the ribs are fractures and separations most common? Why is this?

- ribs 5-9 (bottom half)
- tend to have more blows in that area
- generally less protected

15

What are the signs and symptoms for rib fractures and costal cartilage separations?

- severe pain with breathing
- pain is local to where they have the injury
- point tender from palpation
- crepitis (grinding)

16

Name a complication from rib fractures and costal cartilage separations.

flail chest

17

Describe flail chest and why it is potentially dangerous.

- multiple fractures can cause a loose section in rib cage
- compromises breathing
- need to get to hospital (EMS)
- can become life threatening
- shallow respiration, lots of pain
- fractured pieces can float around and damage organs, vessels, and muscles

18

Why won't they do surgery for rib fractures or costal cartilage separations?

they don't want to affect your breathing system

19

How do we manage rib fractures or costal cartilage separations?

- can't tape or brace
- can't help breathing
- round about braces
- like to hug pillows
- up to 6 weeks of doing nothing

20

Name 3 special tests for rib fractures or costal cartilage separations.

- deep breaths
- rib springing
- crepitis

21

Describe the deep breath test.

rib fracture would cause pain at the site

22

Describe rib springing.

- hands on either side of rib cage, push in and let it bounce back
- pain
- only done from the side

23

Describe the crepitis test.

- feeling for crepitis at the area they have pain
- grinding, clicking, not attached = positive test

24

Where are rib heads? What can happen to them?

- Rib​ ​heads​ ​sit​ ​on/next​ ​to​ ​the​ ​vertebrae
- Capsule​ ​and​ ​ligaments​ ​that​ ​hold​ ​them
- Can​ ​be​ ​sprained/subluxed

25

Rib head subluxations generally only occur where?

in the back

26

What is the MOI for rib head subluxations? Give examples.

- typically from violent ROM
- ex. wrestling, football tackles

27

What are the signs and symptoms of rib head subluxations?

- inch out from the spine, very local pain in the back
- they felt some sort of pop or snap
- will not like breathing deeply

28

Why could people with rib head subluxations get referred pain?

- can if where rib head is sitting is aggravating a nerve root
- most nerve roots come around the rib cage

29

What is the comfort position for people with rib head subluxations?

- like to rest back against something (muscles of spine aren't working)
- like to lie down

30

What is the special test for rib head subluxations?

no specific special test

31

How do we manage rib head subluxations?

- Calm​ ​down​ ​pain
- Calm​ ​down​ ​inflammation
- Calm​ ​down​ ​muscle​ ​spasm
- Use​ ​modalities
- Most​ ​go​ ​back​ ​into​ ​place​ ​after​ ​muscle​ ​spasm​ ​goes​ ​down
- Can​ ​do​ ​manual​ ​therapy​ ​if​ ​they’re​ ​stuck​ ​out​ ​of​ ​place

32

What is chronic rib head subluxation?

always come out of place

33

What kind of exercises should people with rib head subluxations (esp. chronic) be doing?

- symmetrical right to left
- Rows
- Bench​ ​press
- Lat​ ​pull​ ​downs
- Breaststroke​ ​(in​ ​pool​ ​or​ ​mimicking​ ​movement​ ​with​ ​tube​ ​or machine)

34

Describe facet joints.

- Joints​ ​that​ ​occur​ ​between​ ​2​ ​vertebrae​ ​on​ ​top​ ​of​ ​each​ ​other​ ​throughout​ ​the​ ​spine
- Vertebrae​ ​below​ ​has​ ​bone​ ​coming​ ​up​ ​from​ ​either​ ​side
- Vertebrae​ ​on​ ​top​ ​has​ ​bone​ ​that​ ​comes​ ​down​ ​that​ ​meets​ ​these​ ​2​ ​bones
- Very​ ​specific​ ​alignment​ ​that​ ​determines​ ​movement​ ​at​ ​the​ ​area
- *One​ ​on​ ​top​ ​is​ ​facing​ ​upwards,​ ​backwards,​ ​out​ ​to​ ​the​ ​side (allows side flexion, rotation, not a lot of flexion and extension)
- has fluid

35

Facet irritations tend to happen with irritations more in the _____ _______.

thoracic spine

36

What is happening if you have facet irritations?

Part​ ​of​ ​capsule​ ​(soft​ ​tissue)​ ​is​ ​stuck​ ​between​ ​2​ ​pieces​ ​of​ ​bone

37

What is the MOI for facet irritations?

- Caused​ ​by​ ​extreme​ ​ROM
- Can​ ​be​ ​1​ ​extreme​ ​motion​ ​or​ ​long​ ​sustained​ ​ROM
- Ex.​ ​fell​ ​asleep​ ​in​ ​awkward​ ​position

38

What are the signs and symptoms of facet irritations?

- Extreme​ ​pain​ ​closer​ ​to​ ​the​ ​spine​ ​(1⁄2​ ​inch)
- Muscle​ ​spasm​ ​and​ ​inflammation
- Will​ ​not​ ​be​ ​a​ ​pop​ ​or​ ​snap
- Breathing​ ​will​ ​not​ ​make​ ​their​ ​pain​ ​better​ ​or​ ​worse

39

People with facet irritations will like what position and dislike what position?

- like flexion: opens up the joint space, not squishing capsule as much
- do not like leaning backwards

40

How do we manage facet irritations?

- Decreasing​ ​spasm​ ​and​ ​inflammation​ ​typically​ ​brings​ ​capsule​ ​out​ ​of​ ​the​ ​space
- Tend​ ​to​ ​not​ ​become​ ​chronic​ ​issue

41

Most problems with posture occurs in the _____ _____.

thoracic spine

42

Variations in posture can be due to _______ or _______ reasons.

- structural
- functional

43

What are we looking for in posture from the front?

Looking​ ​for​ ​nose​ ​lining​ ​up​ ​with​ ​sternum​ ​lining​ ​up​ ​with​ ​belly​ ​button​ ​creating​ ​a​ ​line all​ ​the​ ​way​ ​down​ ​to​ ​floor​ ​right​ ​between​ ​their​ ​feet

44

What are we looking for in posture from the back?

Straight​ ​line​ ​down​ ​spinous​ ​processes​ ​then​ ​straight​ ​line​ ​down​ ​to​ ​floor

45

What are we looking for in posture from the side?

- Hole​ ​in​ ​ear​ ​lines​ ​up​ ​with​ ​AC​ ​joint​ ​(top​ ​of​ ​shoulder)
- AC​ ​joint​ ​lines​ ​up​ ​with​ ​greater​ ​trochanter
- Greater​ ​trochanter​ ​lines​ ​up​ ​somewhere​ ​along​ ​the​ ​joint​ ​line​ ​of​ ​the​ ​knee
- Lines​ ​up​ ​with​ ​lateral​ ​malleolus

46

Anything falling off the line when looking at posture means...

incorrect posture

47

What does it mean for posture to be incorrect due to structure?

bones​ ​are​ ​physically​ ​formed​ ​that​ ​way,​ ​can’t​ ​fix​ ​it

48

What does it mean for posture to be incorrect due to function?

muscles/activities​ ​creating​ ​problem,​ ​can​ ​fix​ ​it

49

Name and describe the 3 normal curvatures to the spine.

- Cervical:​ ​lordosis​ ​(curve​ ​forward)
- Thorasic:​ ​kyphosis​ ​(curve​ ​back)
- Lumbar:​ ​lordosis​ ​(curve​ ​forward)

50

What are abnormalities in posture?

- Look​ ​for​ ​everything​ ​lining​ ​up,​ ​something​ ​off​ ​the​ ​line
- Abnormality​ ​away​ ​from​ ​the​ ​midline​ ​(one​ ​of​ ​the shoulders/hips​ ​higher,​ ​one​ ​leg turns​ ​out​ ​on​ ​one​ ​side​ ​etc.)

51

What is righting reflex?

- You​ ​have​ ​no​ ​control​ ​over​ ​it
- Regardless​ ​of​ ​what​ ​is​ ​going​ ​on​ ​in​ ​your​ ​body,​ ​everything​ ​will​ ​do​ ​what​ ​it​ ​can​ ​for​ ​the eyes​ ​to​ ​be​ ​level​ ​with​ ​horizon
- To​ ​create​ ​easiest​ ​image​ ​for​ ​your​ ​brain​ ​to​ ​interpret

52

What 5 postural deviations can be seen from the side?

- kyphosis
- forward head
- flatback
- swayback
- lordosis

53

Describe kyphosis.

- excessive hunch back
- bigger hump in tsp than you would expect

54

Describe forward head.

- can occur by itself or with kyphosis
- most common due to computers
- sitting in a car

55

Describe flatback.

- Decreased​ ​lordosis​ ​curve​ ​in​ ​lumbar
- Line​ ​goes​ ​through​ ​greater​ ​trochanter

56

Describe swayback.

- Lumbar​ ​curve​ ​exists​ ​but​ ​whole​ ​pelvis​ ​is​ ​moved​ ​forward
- Line​ ​does​ ​not​ ​go​ ​through​ ​greater​ ​trochanter

57

Describe lordosis.

- Excessive​ ​lordosis
- Can​ ​also​ ​have​ ​pelvis​ ​forward,​ ​head​ ​forward,​ ​kyphosis

58

What is scoliosis?

- spine is curving
- C curve: one curve that comes through the spine
- S curve: 2 curves that come through the spine

59

Why is scoliosis generally very damaging?

- Ribs​ ​on​ ​the​ ​side​ ​pushed​ ​out​ ​will​ ​also​ ​push​ ​out​ ​further​ ​(protruding​ ​out​ ​the​ ​back), ribs​ ​on​ ​the​ ​other​ ​side​ ​will​ ​look​ ​sunken​ ​or​ ​flat
- Muscles​ ​or​ ​internal​ ​organs​ ​will​ ​contract/lengthen​ ​according​ ​to​ ​how​ ​much​ ​space they​ ​have

60

For scoliosis, the ______ the deviation, the _______ the problem.

bigger, bigger

61

Where does scoliosis happen?

- can happen only in csp, only in tsp, or only in lsp
- can see ribs higher on one side by up to 2-3 inches

62

Scoliosis can be either ______ or _______.

functional or structural

63

Which type of scoliosis is more violent, can't fix it?

structural

64

What do we do for people with structural scoliosis?

- ​try​ ​to​ ​create​ ​best​ ​scenario​ ​possible​ ​for​ ​them
- Give​ ​them​ ​symmetrical​ ​exercises
- Ex.​ ​gymnastics
- Swimming
- Body​ ​building

65

What do they do in extreme cases for people with structural scoliosis?

​break​ ​their​ ​spine​ ​and​ ​put​ ​rods​ ​in​ ​them​ ​(limited in​ ​everything​ ​they​ ​can​ ​do)

66

How does functional scoliosis develop? Give an example.

- ​muscle​ ​tissue​ ​on​ ​one​ ​side​ ​is​ ​very​ ​developed​ ​while​ ​the other​ ​side​ ​is​ ​not​ ​developed​ ​at​ ​all
- ex. fencing

67

What does whiplash consist of? Which comes first?

- sprains and strains
- sprains first, strains second (muscles have more ROM)

68

What are the 2 types of collars for whiplash?

- hard collars: support head more
- soft collars: keep muscles warm

69

Describe torticollis.

- facet joint irritation
- head stuck to the side
- stayed in position too long
- ex. Air plane ride

70

How do we manage torticollis?

calm down muscle spasm

71

What is the one sport that burners are most common in?

football

72

Describe burner/brachial plexus neuroplaxia.

- stretched brachial plexus
- muscles go into spasm
- pins and needles in neck and down arm
- can become permanent if always having burners

73

Impact to where results in the worst injury?

- top of the head
- blowout fracture of C1 and C2

74

What are some of the rule changes made to avoid damaging injury?

- football: no leading with the head
- hockey: no hits from behind

75

What is the special test for csp?

- myotomes and dermatomes
- resisted ROM will show strains