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

Thoracic Spine and Cervical Spine Flashcards

1
Q

How many thoracic spine vertebrae are there?

A

12

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2
Q

What area does the thoracic spine cover?

A

area that has ribs

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3
Q

What is the costovertebral joint?

A

ribs + vertebrae

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4
Q

Facet joints are in between…

A

each vertebrae

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5
Q

Name the deep muscles of the thoracic spine.

A

erector spine runs from iliac crest to cervical spine

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6
Q

Name the intermediate muscles of the thoracic spine.

A
  • serratus (anterior and posterior)

- rhomboid

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7
Q

Name the superficial muscles of the thoracic spine.

A
  • trapezius muscle (lower)
  • mid trapezius
  • latissimus dorsi
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8
Q

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

A

pain with breathing

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9
Q

What are the movements of the thoracic spine?

A
  • flexion and extension (fairly limited in tsp)
  • lateral flexion (big movement in tsp)
  • rotation (big movement in tsp)
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10
Q

Rib fractures and costal cartilage separations occur the most where?

A

in collision sports

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11
Q

What is the MOI for rib fractures?

A

generally only occur with a direct blow

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12
Q

What is the MOI for costal cartilage separations?

A
  • can be from direct impact (can be at site or somewhere else and bending)
  • violent contraction (could be coughing or sneezing)
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13
Q

Where is the costal cartilage line?

A

where rib attaches to cartilage and to the sternum

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14
Q

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

A
  • ribs 5-9 (bottom half)
  • tend to have more blows in that area
  • generally less protected
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15
Q

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

A
  • severe pain with breathing
  • pain is local to where they have the injury
  • point tender from palpation
  • crepitis (grinding)
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16
Q

Name a complication from rib fractures and costal cartilage separations.

A

flail chest

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17
Q

Describe flail chest and why it is potentially dangerous.

A
  • 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
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18
Q

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

A

they don’t want to affect your breathing system

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19
Q

How do we manage rib fractures or costal cartilage separations?

A
  • can’t tape or brace
  • can’t help breathing
  • round about braces
  • like to hug pillows
  • up to 6 weeks of doing nothing
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20
Q

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

A
  • deep breaths
  • rib springing
  • crepitis
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21
Q

Describe the deep breath test.

A

rib fracture would cause pain at the site

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22
Q

Describe rib springing.

A
  • hands on either side of rib cage, push in and let it bounce back
  • pain
  • only done from the side
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23
Q

Describe the crepitis test.

A
  • feeling for crepitis at the area they have pain

- grinding, clicking, not attached = positive test

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24
Q

Where are rib heads? What can happen to them?

A
  • Rib​ ​heads​ ​sit​ ​on/next​ ​to​ ​the​ ​vertebrae
  • Capsule​ ​and​ ​ligaments​ ​that​ ​hold​ ​them
  • Can​ ​be​ ​sprained/subluxed
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25
Q

Rib head subluxations generally only occur where?

A

in the back

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26
Q

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

A
  • typically from violent ROM

- ex. wrestling, football tackles

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27
Q

What are the signs and symptoms of rib head subluxations?

A
  • inch out from the spine, very local pain in the back
  • they felt some sort of pop or snap
  • will not like breathing deeply
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28
Q

Why could people with rib head subluxations get referred pain?

A
  • can if where rib head is sitting is aggravating a nerve root
  • most nerve roots come around the rib cage
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29
Q

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

A
  • like to rest back against something (muscles of spine aren’t working)
  • like to lie down
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30
Q

What is the special test for rib head subluxations?

A

no specific special test

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31
Q

How do we manage rib head subluxations?

A
  • 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
Q

What is chronic rib head subluxation?

A

always come out of place

33
Q

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

A
  • symmetrical right to left
  • Rows
  • Bench​ ​press
  • Lat​ ​pull​ ​downs
  • Breaststroke​ ​(in​ ​pool​ ​or​ ​mimicking​ ​movement​ ​with​ ​tube​ ​or machine)
34
Q

Describe facet joints.

A
  • 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
Q

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

A

thoracic spine

36
Q

What is happening if you have facet irritations?

A

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

37
Q

What is the MOI for facet irritations?

A
  • Caused​ ​by​ ​extreme​ ​ROM
  • Can​ ​be​ ​1​ ​extreme​ ​motion​ ​or​ ​long​ ​sustained​ ​ROM
  • Ex.​ ​fell​ ​asleep​ ​in​ ​awkward​ ​position
38
Q

What are the signs and symptoms of facet irritations?

A
  • 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
Q

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

A
  • like flexion: opens up the joint space, not squishing capsule as much
  • do not like leaning backwards
40
Q

How do we manage facet irritations?

A
  • Decreasing​ ​spasm​ ​and​ ​inflammation​ ​typically​ ​brings​ ​capsule​ ​out​ ​of​ ​the​ ​space
  • Tend​ ​to​ ​not​ ​become​ ​chronic​ ​issue
41
Q

Most problems with posture occurs in the _____ _____.

A

thoracic spine

42
Q

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

A
  • structural

- functional

43
Q

What are we looking for in posture from the front?

A

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
Q

What are we looking for in posture from the back?

A

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

45
Q

What are we looking for in posture from the side?

A
  • 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
Q

Anything falling off the line when looking at posture means…

A

incorrect posture

47
Q

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

A

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

48
Q

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

A

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

49
Q

Name and describe the 3 normal curvatures to the spine.

A
  • Cervical:​ ​lordosis​ ​(curve​ ​forward)
  • Thorasic:​ ​kyphosis​ ​(curve​ ​back)
  • Lumbar:​ ​lordosis​ ​(curve​ ​forward)
50
Q

What are abnormalities in posture?

A
  • 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
Q

What is righting reflex?

A
  • 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
Q

What 5 postural deviations can be seen from the side?

A
  • kyphosis
  • forward head
  • flatback
  • swayback
  • lordosis
53
Q

Describe kyphosis.

A
  • excessive hunch back

- bigger hump in tsp than you would expect

54
Q

Describe forward head.

A
  • can occur by itself or with kyphosis
  • most common due to computers
  • sitting in a car
55
Q

Describe flatback.

A
  • Decreased​ ​lordosis​ ​curve​ ​in​ ​lumbar

- Line​ ​goes​ ​through​ ​greater​ ​trochanter

56
Q

Describe swayback.

A
  • Lumbar​ ​curve​ ​exists​ ​but​ ​whole​ ​pelvis​ ​is​ ​moved​ ​forward
  • Line​ ​does​ ​not​ ​go​ ​through​ ​greater​ ​trochanter
57
Q

Describe lordosis.

A
  • Excessive​ ​lordosis

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

58
Q

What is scoliosis?

A
  • spine is curving
  • C curve: one curve that comes through the spine
  • S curve: 2 curves that come through the spine
59
Q

Why is scoliosis generally very damaging?

A
  • 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
Q

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

A

bigger, bigger

61
Q

Where does scoliosis happen?

A
  • 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
Q

Scoliosis can be either ______ or _______.

A

functional or structural

63
Q

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

A

structural

64
Q

What do we do for people with structural scoliosis?

A
  • ​try​ ​to​ ​create​ ​best​ ​scenario​ ​possible​ ​for​ ​them
  • Give​ ​them​ ​symmetrical​ ​exercises
  • Ex.​ ​gymnastics
  • Swimming
  • Body​ ​building
65
Q

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

A

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

66
Q

How does functional scoliosis develop? Give an example.

A
  • ​muscle​ ​tissue​ ​on​ ​one​ ​side​ ​is​ ​very​ ​developed​ ​while​ ​the other​ ​side​ ​is​ ​not​ ​developed​ ​at​ ​all
  • ex. fencing
67
Q

What does whiplash consist of? Which comes first?

A
  • sprains and strains

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

68
Q

What are the 2 types of collars for whiplash?

A
  • hard collars: support head more

- soft collars: keep muscles warm

69
Q

Describe torticollis.

A
  • facet joint irritation
  • head stuck to the side
  • stayed in position too long
  • ex. Air plane ride
70
Q

How do we manage torticollis?

A

calm down muscle spasm

71
Q

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

A

football

72
Q

Describe burner/brachial plexus neuroplaxia.

A
  • stretched brachial plexus
  • muscles go into spasm
  • pins and needles in neck and down arm
  • can become permanent if always having burners
73
Q

Impact to where results in the worst injury?

A
  • top of the head

- blowout fracture of C1 and C2

74
Q

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

A
  • football: no leading with the head

- hockey: no hits from behind

75
Q

What is the special test for csp?

A
  • myotomes and dermatomes

- resisted ROM will show strains

KNSS 220 Athletic Therapy (14 decks)

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