Podcast
Questions and Answers
During a subjective exam for thoracic spine pain, what information is crucial to gather regarding the patient's pain experience?
During a subjective exam for thoracic spine pain, what information is crucial to gather regarding the patient's pain experience?
- The patient's favorite color and hobbies.
- The patient's dietary preferences and sleep schedule.
- The exact location of the pain, what makes it better or worse, and history of the injury. (correct)
- The patient's shoe size and preferred brand of clothing.
Which of the following outcome measures is specifically designed to assess functional limitations related to neck pain, rather than thoracic pain?
Which of the following outcome measures is specifically designed to assess functional limitations related to neck pain, rather than thoracic pain?
- Oswestry Disability Index (ODI).
- Neck Disability Index (NDI). (correct)
- Numeric Pain Rating Scale (NPRS).
- Patient Specific Functional Scale (PSFS).
When assessing thoracic spine Range of Motion (ROM), what key instruction should be given to the patient to isolate the movement to the thoracic region?
When assessing thoracic spine Range of Motion (ROM), what key instruction should be given to the patient to isolate the movement to the thoracic region?
- Perform rapid, ballistic movements to reach end range.
- Lock out the lumbar spine. (correct)
- Hold their breath during the movement.
- Actively extend the cervical spine throughout the movement.
During thoracic ROM assessment, when is it most appropriate to apply overpressure?
During thoracic ROM assessment, when is it most appropriate to apply overpressure?
When performing palpation of the posterior thoracic spine, which of the following anatomical landmarks is typically located at the level of T7?
When performing palpation of the posterior thoracic spine, which of the following anatomical landmarks is typically located at the level of T7?
During palpation of the anterior and lateral thorax, which of the following structures should be assessed?
During palpation of the anterior and lateral thorax, which of the following structures should be assessed?
In the context of thoracic spine muscle strength testing, which muscle group is primarily being assessed when evaluating 'thoracic paraspinals'?
In the context of thoracic spine muscle strength testing, which muscle group is primarily being assessed when evaluating 'thoracic paraspinals'?
When performing a central posterior-anterior (PA) joint mobilization on the thoracic spine, what anatomical structure is directly contacted by the 'dummy' hand?
When performing a central posterior-anterior (PA) joint mobilization on the thoracic spine, what anatomical structure is directly contacted by the 'dummy' hand?
During unilateral PA joint mobilization, the force is applied with either opposite heel of the hand or opposite thumb directly anterior on which structure?
During unilateral PA joint mobilization, the force is applied with either opposite heel of the hand or opposite thumb directly anterior on which structure?
What is the direction of force applied during a first rib inferior glide mobilization technique?
What is the direction of force applied during a first rib inferior glide mobilization technique?
A patient reports experiencing pain along the medial border of their scapula. Which muscle would the therapist suspect to be a source of pain?
A patient reports experiencing pain along the medial border of their scapula. Which muscle would the therapist suspect to be a source of pain?
A patient presents with decreased shoulder flexion range of motion and reports tightness in the anterior chest wall. Which muscle is most likely contributing to the range of motion limitation?
A patient presents with decreased shoulder flexion range of motion and reports tightness in the anterior chest wall. Which muscle is most likely contributing to the range of motion limitation?
A therapist is assessing a patient with suspected thoracic outlet syndrome. Which of the following muscles would MOST likely be palpated to assess for hypertrophy or tenderness?
A therapist is assessing a patient with suspected thoracic outlet syndrome. Which of the following muscles would MOST likely be palpated to assess for hypertrophy or tenderness?
Which of the following instructions is MOST appropriate when assessing thoracic rotation range of motion?
Which of the following instructions is MOST appropriate when assessing thoracic rotation range of motion?
When performing palpation of the spinous processes in the thoracic spine, what is the appropriate positioning for the patient?
When performing palpation of the spinous processes in the thoracic spine, what is the appropriate positioning for the patient?
When assessing accessory motion of the thoracic spine, which of the following techniques involves applying a posterior-to-anterior force on the spinous process to assess joint play?
When assessing accessory motion of the thoracic spine, which of the following techniques involves applying a posterior-to-anterior force on the spinous process to assess joint play?
During an interview a patient reports their pain is intermittent and is located near the spine of the scapula. Which thoracic level would you suspect the pain referral is coming from?
During an interview a patient reports their pain is intermittent and is located near the spine of the scapula. Which thoracic level would you suspect the pain referral is coming from?
What specific information would you gather during a subjective exam with the patient completing a body chart?
What specific information would you gather during a subjective exam with the patient completing a body chart?
Which of the following objective measures can be used in the thoracic spine to determine changes to the patient's functional status?
Which of the following objective measures can be used in the thoracic spine to determine changes to the patient's functional status?
A patient presents to your clinic and during the objective examination you note the patient is unable to fully extend their thoracic spine. Which of the following do you perform with your measurement?
A patient presents to your clinic and during the objective examination you note the patient is unable to fully extend their thoracic spine. Which of the following do you perform with your measurement?
A patient is complaining of anterior rib pain. Which of the following areas are appropriate to palpate in order to determine the source of their pain?
A patient is complaining of anterior rib pain. Which of the following areas are appropriate to palpate in order to determine the source of their pain?
Which of the following is a muscle that can be tested to see the strength of the muscles acting on the thoracic spine?
Which of the following is a muscle that can be tested to see the strength of the muscles acting on the thoracic spine?
When attempting to improve joint mobility of the thoracic spine, which of the following would you choose to perform?
When attempting to improve joint mobility of the thoracic spine, which of the following would you choose to perform?
During a central PA to the thoracic spine, your dummy hand should contact what?
During a central PA to the thoracic spine, your dummy hand should contact what?
When performing an inferior glide of the first rib, you should apply the force through which structure?
When performing an inferior glide of the first rib, you should apply the force through which structure?
If a patient presents with limited range of motion primarily with flexion of their thoracic spine, which of tests and measures would NOT be appropriate to assess?
If a patient presents with limited range of motion primarily with flexion of their thoracic spine, which of tests and measures would NOT be appropriate to assess?
If you want to isolate movement of the thoracic spine during range of motion, what is the best instruction cue to provide to the patient?
If you want to isolate movement of the thoracic spine during range of motion, what is the best instruction cue to provide to the patient?
In which position does the patient lie when performing a Central PA of their thoracic spine?
In which position does the patient lie when performing a Central PA of their thoracic spine?
Which of the following is NOT part of the physical exam for the thoracic spine?
Which of the following is NOT part of the physical exam for the thoracic spine?
Flashcards
How do you document pain?
How do you document pain?
Fill out a body chart and create an initial hypothesis.
What does a subjective exam involve?
What does a subjective exam involve?
A subjective exam involves understanding what makes the pain worse and better, and the history of the pain.
What is the Patient Specific Functional Score (PSFS)?
What is the Patient Specific Functional Score (PSFS)?
PSFS involves patient rating of functional activities
What is the Numeric Pain Rating Scale (NPRS)?
What is the Numeric Pain Rating Scale (NPRS)?
Signup and view all the flashcards
What does a physical exam for the thoracic spine involve?
What does a physical exam for the thoracic spine involve?
Signup and view all the flashcards
What does ROM testing of the thoracic spine involve?
What does ROM testing of the thoracic spine involve?
Signup and view all the flashcards
Why use overpressure during ROM?
Why use overpressure during ROM?
Signup and view all the flashcards
What structures are palpated during a thoracic spine exam?
What structures are palpated during a thoracic spine exam?
Signup and view all the flashcards
Which muscles are tested during strength testing of the thoracic spine?
Which muscles are tested during strength testing of the thoracic spine?
Signup and view all the flashcards
What is Central PA?
What is Central PA?
Signup and view all the flashcards
What is Unilateral PA?
What is Unilateral PA?
Signup and view all the flashcards
How do you perform First Rib Inferior Glide?
How do you perform First Rib Inferior Glide?
Signup and view all the flashcards
Study Notes
- The Thoracic Spine Exam notes are presented by Adam Squires PT, DPT, Cert SMT, Cert DN - Board Certified Specialist in Orthopedic Physical Therapy
Objectives of the Exam
- Understand and demonstrate techniques for assessing thoracic spine mobility.
- Understand and demonstrate techniques for assessing the strength of thoracic musculature.
- Understand and demonstrate techniques for assessing thoracic spine joint accessory motion.
Subjective Exam Components
- Identify where the pain is located, and fill it out on a body chart with an initial hypothesis
- Determine what makes the pain worse, what is it, and how much does it take
- Determine what makes the pain better, what is it, and how much does it take
- Consider patient history, including MOI and timeframe
Outcome Measures
- Patient Specific Functional Score (PSFS)
- Numeric Pain Rating Scale (NPRS)
- Oswestry Disability Index (ODI) measure
- Neck Disability Index (NDI) measure, covered in the Cervical section
- Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) covered in UE course
Physical Exam Overview
- Range of Motion (ROM): Active with overpressure
- Palpation
- Strength Testing
- Joint accessory movement assessment
Range of Motion (ROM) Details
- Patient should be seated and the lumbar spine locked out
- Assess Flexion, Extension, Rotation, and Lateral Flexion
- Apply overpressure if movements are not full or are not symptom-provoking
Palpation Areas - Posterior
- Palpate the spinous processes:
- Spine of scapula at T3/T4
- Inferior angle at T7
- Last rib at T12
- Check rib angle
- Palpate the posterior musculature
- Middle trap, lower trap, rhomboids, and latissimus dorsi
- Palpate the 1st rib
Palpation Areas - Anterior/Lateral
- Rib angles
- Sternum
- Sternoclavicular joint
- Sternocostal joints
- Pectoralis major
- Pectoralis minor
Strength Testing Focus
- Thoracic Paraspinals, specifically the Extensors
- Middle Trap
- Lower Trap
- Rhomboids
Central PA
- Administer with patient prone and the therapist standing on one side.
- Use the hypothenar eminence to contact the spinous process where the force is applied with opposite hand directly anterior, similar to lumbar CPA
- Peace sign: Place "dummy" fingers on either side of the spinous process. Force applied with opposite hand directly anterior
Unilateral PA
- Administer with patient prone and the therapist standing on one side.
- Use the "dummy" thumb, placed thumb chosen side at the desired level. Force applied with either the opposite heel of the hand or opposite thumb directly anterior.
- Use the Hypothenar eminence same as CPA but off the one side and not as specific
First Rib Inferior Glide
- Technique performed with the patient seated, and the therapist positioned behind them
- Support the opposite side of the head
- Apply force through the lateral MCP toward the opposite hip
- Keep the elbow lined up with the direction of force
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
