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PT623 Exam 2 Questions And 100% Correct Answers
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PT623 Exam 2 Questions And 100% Correct AnswersWhat is the function of the thoracic spine? - ANSWER - protection of the vital organs and
the spinal cord
- provides stability via passive structures over mobility
What is the structure of the thoracic spine? - ANSWER - vertebral body height smaller in
the front and larger in the back to support kyphotic curve
- long, down sloping spinous processes
- small disc height meaning much less motion available
- facets lie largely in the frontal plane for side bending
What are the rib articulations? - ANSWER - articulate anteriorly with the sternum and
posteriorly with the thoracic spine via vertebral body and transverse process
- costochondral joint
- costovertebral joint
- costotransverse joint
How do you assess thoracic joint play? - ANSWER - when assessing a motion segment,
push on the transverse process of the vertebrae below
- example: assessing mobility of T5 segment, push transverse process of T6 away from
T5
What happens with flexion at the thoracic spine? - ANSWER - anterior tip and anterior
glide of interbody joint
- bilateral upglide of facet joints
- all posterior ligaments (interspinous, supraspinous, posterior longitudinal), posterior
aspect of disc, muscles, and facet joint capsule under tension
,What happens with extension at the thoracic spine? - ANSWER - posterior tip and
posterior glide of interbody joint
- bilateral downglide of facet joints
- anterior ligaments, muscles, capsule, and disc under tension
What happens with side bending at the thoracic spine? - ANSWER - ipsilateral tip and
glide at interbody joint
- ipsilateral downglide and contralateral upglide of the facets
What happens with rotation at the thoracic spine? - ANSWER - pure rotation with sliding
of the facet joints
What is upper rib motion? - ANSWER - pump handle motion
- increased anterior posterior diameter
What is lower rib motion? - ANSWER - bucket handle motion
- increased medial lateral diameter
What is the action of serratus anterior? - ANSWER - scapular protraction and upward
rotation
What is the action of levator scapulae? - ANSWER - elevation of scapula
What is the action of the rhomboids? - ANSWER - scapular retraction, elevation, and
downward rotation
What are the primary causes of thoracic / rib pain? - ANSWER - mechanical thorax pain
via thoracic or rib hypomobility, joint locking, or synovitis
,- thoracic disc disease
- contractile or mechanical (movement based problem)
What is regional independence? - ANSWER - when thoracic hypomobility is associated
with: neck pain, shoulder pain, lateral elbow pain, carpal tunnel syndrome,
costochondritis, etc
- thoracic / rib region pathology linked to pain in other musculoskeletal regions (neck,
shoulder, elbow, low back)
What is the epidemiology of primary thoracic pain? - ANSWER - associated with
adolescence, posture, and backpack use
- backpack use: perceived heaviness
What outcomes should you use for thoracic / rib pain? - ANSWER - PSFS
- FABQ
- NPRS
- GROC
- NDI if movement at the head / neck elicits pain (reading, typing, etc)
- ODI
Mechanical thoracic / rib pain - ANSWER - joint dysfunction: thoracic z joints,
costovertebral and costotransverse joints, costochondral / chondrosternal joints
- muscle strains via repetitive stress (pain reproduced with palpation, contraction, or
stretch)
Thoracic pain with mobility deficits key examination findings? - ANSWER - Pain
associated with movement or position of the thorax
- Restricted AROM
- Restricted segmental mobility
- No UE radicular symptoms
, - Postural dysfunction
- Muscular imbalance
Thoracic pain with mobility deficits intervention? - ANSWER - Thoracic mobilization /
manipulation
- Rib mobilization / manipulation
- AROM exercises
- Address muscular imbalances
- Postural exercises
Effectiveness of thoracic spine manipulation for thoracic pain? - ANSWER - Schiller
2001
- short term decrease in NPRS score and increase in side bend range of motion
- some support for thoracic spine manipulation for people with primarily thoracic spine
pain
What are the contraindications to thoracic spine manipulation? - ANSWER - Fracture
- Osteoporosis
- Cord compression (UMN signs)
- Active infection
- Demyelinating disorders
- Inflammatory arthritis conditions in an active stage
What is the epidemiology of thoracic disc disease? - ANSWER - disc herniation most
often central
- T1 or T2 - feel pain in arm (dermatome)
- Middle thoracic spine - feel pain wraps around to the front unilaterally (dermatome)
- Most often found in 4th-6th decades
- Most cases occur T8 - T12
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