Card Set Information
Thoracic Spine PTA202 PTA 202
PP and class notes for thoracic spine
Vertebrae differ by
Longer spinous processs
How many degrees of flexion and extension
What happens to mobility in the lower thoracic
More mobility due to lack of rib articulation
Anterior lung expansion
Pulls down lungs
- transverse, rotates ribs outward
Spine segments most to least mobile
What prevents rotation
What prevents flexion
Facet orientation in frontal plane
What prevents extension
Amount of lateral side bend
Amount of rotation
Per segment thoracic has more or less mobility than lumbar?
As a whole lumber and thoracic have more, less, or equal mobility
Which test is more effective for thoracic? MMT or functional?
Most common hypomobility?
Uniside bend or limited extension
What motion in thoracic tends to occur with side bend?
Rotation to other side
T/F can have hypo and hyper mobility combination.
Ie functional scoliosis
: L side could be hypomobile while right hyper
If both hyper and hypo mobile what would you do to fix?
Stabilize hypermobile motion
Mobilize the hypomobile motion
If a joint is hypo or hyper mobile what you might see else where?
If joint is hypo you'd find a hyper mobile joint that accommodates it and vice versa
Easiest to hardest planes for trunk exercises
An elongated muscle is best trained in what position?
Exaggerated kyphosis can lead to the rib cage to rest on what?
Anterior iliac crest.
Severe kyphosis can shorten or lengthen the appendicular skeleton?
What is the only type of stretching an osteoporosis patient should receive?
Idiopathic vs acquired scoliosis
Structural vs functional
Swayback is due to..
Common population for osteoporosis
Post menopausal women
Decreased calcium or vitamin D
What progresses osteoporosis?
Osteopor clinical findings
Pain in bones, back, and muscle spasm
Kyphosis and scoliosos
Usually unable to restore to normal, just prevention of progression
Hi Ca++ diet, vitamin D, protein
Foasmax to inhibit osteoclast activity
Weight bearing exercises
Greater than 45-50 degrees
Excessive thoracic associated with anterior wedging of thoracic vert
Juvenile- Occuring in kids
Younger children with mild deform
-Spinal extensor strengthening
-Stretching hams, pec major, superior abs
Bracing in adolescents until maturity
Spinal fusion surgery in curves greater than 70
Freezing of the joints of the spine with inflammation
Affects SI, intervert and costovert spaces
Remissions and exacerbations
Possible autoimmune disorder, genetic basis
Ankylosing Spondylitis Pathology
Starts as inflam of the vertebral joints
Fibrosis then calcification (loss of ROM)
Initially LB and SI
Kyphosis develops from lack of ROM
Osteoporosis with possible patho fractures
Limited lung expansion due to calficiation of costovertebral joints
Ankylosing Spondylitis SnS
: LBP and morning stiffness
Discomfort relieved by walking and mild EX
May develop radicular pain
1/3rd develop system signs
-fatigue, fever, iritis, weight loss
Ankylosing Spondylitis Tx
Maintain joint mob
Possible joint replacement
Which side has a visible posterior rib hump in a structural scoliosis?
Which side can you see anterior rib flare
Excessively large thoracic kyphosis
How does LLD relate to scoliosis (does it always occur?)
Could be a compensation for scoliosis
Not always a result of scolosis
T/F Positive Adam's test shows functional scoliosis
Positive Adam's test shows structural. If scoliosis disappears during Adam's test it means its a functional Scoliosis.
Functional scoliosis is usually secondary to..
Spasm/pain in LW or midback musculature.
ie always standing on one leg
Severe scoliosis curves may effect
cardio pulmonary due to limited lung expansions
: <20 degrees
: 20-50 degrees
: >50 degrees
Etiology of structural scoliosis
F>M 10-15 y/o
Muscle imbalance, postural control, or bone malformation
Neuromuscular Structural Scoliosis
Osteopathic structural scoliosis
Non-structural scoliosis types
Dislocated hip (possible LLD)
LB spasms and/or disc protrusions
-Gives a posture to avoid pain; results in functional scoliosis
Habitual posture changes
-Standing on one hip
Clinical findings Scoliosis
Scap winging (on convexity of curve)
Pelvic obliquity (crest not level)
Waist angle changes
Curve increases or stays with forward bending
Exercise with cast/brace
-Stretch and strengthen
Spinal bracing (boston, milwaukee)
-On convex side to strengthen and realign spine upright
-Spinal fusion with Harrington rod >40degrees
What side do you strengthen, which do you stretch