Thoracic Spine and Ribs Review

Question 1

What structures are included in the Thorax?

Answer 1

Thoracic Spine
Sternum
Ribs (7 true, 5 False, 2 Floating)
122 Joints

Question 2

What is included in ONE spinal level?

Answer 2

Intervertebral Joint
2 Facet Joints
2 Costotransverse Joints
4 Costovertebral Joints
*Most vertebra articulate with 2 ribs on each side

Question 3

Where there is a joint, there is the possibility of ________________?

Answer 3

Movement Dysfunction

Question 4

Main muscles of the erector spinae group

Answer 4

Spinalis
Longissimus
Iliocostalis

Question 5

What are the two posterior deep muscles of the neck for extension, Lateral flexion and rotation?

Answer 5

Splenius Capitus
Splenius Cervicis

Question 6

What muscles elevate and retract the scapula?

Answer 6

Rhomboid Major and Minor
(Dorsalscapular N)

Question 7

How many planes of motion does the T Spine have?

Answer 7

All 3 planes of motion

Question 8

What are the normal ranges of motion in the T-spine?

Answer 8

Flexion/Extension= 20-45
Sidebending= 20-45
Rotation= 35-50

Question 9

What is the movement of “pump handle”

Answer 9

Superior and Anterior movement of the sternum

Question 10

What is the movement of “Bucket Handle”

Answer 10

Elevation of later shaft of the rib

Question 11

Primary Inspiratory muscles

Answer 11

Diaphragm and External Intercostal muscles

Question 12

What are the accessory inspiratory muscles?

Answer 12

SCM
Scalenes
Pec Minor
Serratus Anterior

Question 13

What are the Accessory Expiratory muscles?

Answer 13

Internal Intercostals
Transversus Thoracis
External Oblique
Rectus Abdominus
Internal Oblique

Question 14

What happens during “Quiet Breathing”

Answer 14

expiration occurs due to recoil of lungs and rib cage

Question 15

What is structural scoliosis?

Answer 15

Affects primarily infants/Children/teens
and is thought to be from disease, heredity, or idiopathic

Question 16

What is functional scoliosis?

Answer 16

smaller rotational component and does not have structural change
Usually results from Muscle spasms, leg length discrepancy, poor posture habits, or pain
Responds to conservative treatment

Question 17

What shape can scoliosis curves look like?

Answer 17

C or S shaped
Thoracic Curves
Lumbar Curves
Thoracolumbar Curves

Question 18

How is scoliosis diagnosed?

Answer 18

Xray and Cobb Angle
Min Angle= 10 degrees

Question 19

Cobb Angle 10-20 Degrees=

Answer 19

pt monitored to see if angle is progressing and is usually treated conservatively with PT

Question 20

Cobb Angle 20-40 Degrees=

Answer 20

pt may have a back brace and has more intense physical therapy

Question 21

Cobb Angle over 40 degrees=

Answer 21

They will have to brace, and surgery is needed

Question 22

What are the 3 physical therapy treatment goals for scoliosis?

Answer 22

1. Improve hypomobile areas for improved alignment through stretching concave side and STM, Joint Mob and stretch
2. Strengthening and Stabilizing to restore balance to strengthen convex side
3. Posture Education

Question 23

What are 2 main dysfunctions in postural dysfunction?

Answer 23

Dowager’s Hump
Increased Kyphosis

Question 24

What is the treatment for Postural Dysfunction?

Answer 24

involves cessations and reversal of deformity to the extent possible treatment for pain, patient education for posture, and HEP

Question 25

What is the result of compression fracture?

Answer 25

Trauma or Osteoperosis T-spine most vulnerable and women are at higher risk

Question 26

What is the medical management for compression fracture?

Answer 26

Bracing, Vertebroplasty and Kyphoplasty

Question 27

Treatment for Compression Fractures

Answer 27

Reduce pain and muscle spasms with exercises in spinal stabilization and flexibility to reduce compression from tight muscles. Patient education should be in body mechanics

Question 28

Why should compression fracture patients avoid flexion exercises?

Answer 28

Compression fracture patients should avoid flexion exercises because of increased compression on the vertebral body with spinal flexion

Question 29

What is ankylosing spondylitis?

Answer 29

an auto-immune disease that primarily affects the spine an causes chronic inflammation. The cause is unknown but may have a genetic component and has no known cure

Question 30

What are the symptoms for Ankylosing Spondylitis?

Answer 30

Pain or Stiffness in the lower back, buttocks and hips As it progresses, it may spread to upper spine, rib cage, and SI Joint, Vertebral bones; compromising respiratory function and overall mobility

Question 31

Why should there be extreme caution for joint mobs in ankylosing spondylitis patients?

Answer 31

due to joint fusion or osteopenia (low bone density)

Question 32

What is costochondritis?

Answer 32

Inflammation of the cartilage in the rib cage where it attaches to ribs or sternum (costosternal joint)

Question 33

What causes costochondritis?

Answer 33

Trauma, repetitive strain, respiratory Condition, or pathogens that cause inflammation

Question 34

How does Costochondritis present?

Answer 34

TTP Pain with deep breathing certain torso movements coughing and/or exertion

Question 35

What is the early tx for costochondritis?

Answer 35

Reduce inflammation with modalities, manual tx, KT tape, posture education and activity modifications Therex should include stretching trunk/rib mobility, postural alignment, and muscles that attach ribs

Question 36

What is segmental dysfunction? (misaligned vertebrae, restricted joint in the back)

Answer 36

improper movement or trauma that allows vertebral segments to get stuck segmental dysfunction or somatic dysfunction

Question 37

How is normal range of motion lost during segmental dysfunction?

Answer 37

Hypertonic muscles are preventing the segment from moving properly

Question 38

What treatment should be performed on segmental dysfunction patients?

Answer 38

Manual to decrease hypertonic muscles and indirect treatments to move away from restrictive barriers to try to reset muscle proprioceptors and muscle control (positional release and strain counterstain