Podcast
Questions and Answers
During a subjective examination for thoracic spine pain, which of the following is the MOST relevant reason for asking the patient to fill out a body chart?
During a subjective examination for thoracic spine pain, which of the following is the MOST relevant reason for asking the patient to fill out a body chart?
- To precisely locate and map the distribution of the patient's pain. (correct)
- To quantify the intensity of the pain using a visual analog scale.
- To compare the patient's pain pattern with typical referred pain charts.
- To assess the patient's understanding of their own anatomy.
When taking a history for thoracic spine pain, asking 'What makes your pain worse?' is MOST important for:
When taking a history for thoracic spine pain, asking 'What makes your pain worse?' is MOST important for:
- Identifying aggravating factors and potential pain mechanisms. (correct)
- Establishing the patient's baseline pain level for comparison.
- Determining the patient's emotional response to pain.
- Assessing the patient's coping strategies for pain management.
Which of the following outcome measures is specifically designed to assess functional limitations across various activities chosen by the patient?
Which of the following outcome measures is specifically designed to assess functional limitations across various activities chosen by the patient?
- Neck Disability Index (NDI)
- Numeric Pain Rating Scale (NPRS)
- Patient Specific Functional Score (PSFS) (correct)
- Oswestry Disability Index (ODI)
A physical therapist is evaluating a patient with mid-thoracic pain. If using the Numeric Pain Rating Scale (NPRS), what aspect of the patient's pain is being MOST directly measured?
A physical therapist is evaluating a patient with mid-thoracic pain. If using the Numeric Pain Rating Scale (NPRS), what aspect of the patient's pain is being MOST directly measured?
Which of the following is the MOST appropriate initial step when starting the physical examination of the thoracic spine?
Which of the following is the MOST appropriate initial step when starting the physical examination of the thoracic spine?
When assessing thoracic spine Range of Motion (ROM), what is the purpose of instructing the patient to 'lock out the lumbar spine'?
When assessing thoracic spine Range of Motion (ROM), what is the purpose of instructing the patient to 'lock out the lumbar spine'?
During active thoracic spine ROM assessment, in which direction of movement is 'curling from the mid-spine' primarily intended to assess?
During active thoracic spine ROM assessment, in which direction of movement is 'curling from the mid-spine' primarily intended to assess?
In thoracic spine ROM assessment, when is it MOST appropriate to apply overpressure at the end range of motion?
In thoracic spine ROM assessment, when is it MOST appropriate to apply overpressure at the end range of motion?
When performing posterior palpation of the thoracic spine, which anatomical landmark is typically located at the level of the T7 vertebra?
When performing posterior palpation of the thoracic spine, which anatomical landmark is typically located at the level of the T7 vertebra?
During posterior palpation, the spine of the scapula is a key landmark for locating which thoracic vertebral level(s)?
During posterior palpation, the spine of the scapula is a key landmark for locating which thoracic vertebral level(s)?
Palpation of the 'rib angle' in the thoracic region is BEST performed:
Palpation of the 'rib angle' in the thoracic region is BEST performed:
Which muscle group is NOT typically assessed during posterior palpation of the thoracic musculature?
Which muscle group is NOT typically assessed during posterior palpation of the thoracic musculature?
Anterior palpation in the thoracic region commonly includes assessment of the:
Anterior palpation in the thoracic region commonly includes assessment of the:
Palpation of the sternoclavicular joint is categorized under which type of thoracic spine examination?
Palpation of the sternoclavicular joint is categorized under which type of thoracic spine examination?
Which of the following muscle groups is primarily tested when assessing 'Thoracic Paraspinals - Extensors' strength?
Which of the following muscle groups is primarily tested when assessing 'Thoracic Paraspinals - Extensors' strength?
During strength testing of the middle trapezius, the patient is typically positioned in:
During strength testing of the middle trapezius, the patient is typically positioned in:
The primary action assessed during strength testing of the rhomboids is:
The primary action assessed during strength testing of the rhomboids is:
Joint accessory motion assessment in the thoracic spine primarily evaluates:
Joint accessory motion assessment in the thoracic spine primarily evaluates:
In a Central Posterior-Anterior (PA) joint mobilization of the thoracic spine, the therapist applies force in which direction?
In a Central Posterior-Anterior (PA) joint mobilization of the thoracic spine, the therapist applies force in which direction?
When performing a Central PA mobilization using the 'hypothenar eminence' technique, what part of the therapist's hand is in contact with the patient's spinous process?
When performing a Central PA mobilization using the 'hypothenar eminence' technique, what part of the therapist's hand is in contact with the patient's spinous process?
For a Unilateral PA mobilization technique in the thoracic spine, the force is applied:
For a Unilateral PA mobilization technique in the thoracic spine, the force is applied:
What is the primary difference between a Central PA and a Unilateral PA mobilization technique?
What is the primary difference between a Central PA and a Unilateral PA mobilization technique?
In performing a First Rib Inferior Glide mobilization, the therapist typically stands in which position relative to the seated patient?
In performing a First Rib Inferior Glide mobilization, the therapist typically stands in which position relative to the seated patient?
During a First Rib Inferior Glide mobilization, where is the force primarily directed?
During a First Rib Inferior Glide mobilization, where is the force primarily directed?
What part of the therapist's hand is typically used to apply the mobilizing force during a First Rib Inferior Glide technique?
What part of the therapist's hand is typically used to apply the mobilizing force during a First Rib Inferior Glide technique?
Which of the following is NOT a primary objective when assessing thoracic spine mobility?
Which of the following is NOT a primary objective when assessing thoracic spine mobility?
Assessing the strength of thoracic musculature is important for understanding its role in:
Assessing the strength of thoracic musculature is important for understanding its role in:
Understanding thoracic spine joint accessory motion is MOST relevant for addressing:
Understanding thoracic spine joint accessory motion is MOST relevant for addressing:
Which of the following best describes the sequence of a comprehensive thoracic spine examination?
Which of the following best describes the sequence of a comprehensive thoracic spine examination?
If a patient presents with limited thoracic extension ROM, which muscle group is MOST likely to be weak and require strengthening?
If a patient presents with limited thoracic extension ROM, which muscle group is MOST likely to be weak and require strengthening?
A therapist notes restricted joint accessory motion in thoracic flexion at T5/T6. Which mobilization technique would be MOST directly aimed at improving this restriction?
A therapist notes restricted joint accessory motion in thoracic flexion at T5/T6. Which mobilization technique would be MOST directly aimed at improving this restriction?
Which of the following outcome measures would be LEAST appropriate for assessing functional limitations specifically related to thoracic spine pain?
Which of the following outcome measures would be LEAST appropriate for assessing functional limitations specifically related to thoracic spine pain?
If a patient reports that their thoracic pain is aggravated by deep breathing, which structure is MOST likely involved?
If a patient reports that their thoracic pain is aggravated by deep breathing, which structure is MOST likely involved?
A patient has difficulty with thoracic rotation to the right. Which joint accessory motion mobilization technique would be MOST appropriate to initially address this limitation?
A patient has difficulty with thoracic rotation to the right. Which joint accessory motion mobilization technique would be MOST appropriate to initially address this limitation?
When assessing thoracic lateral flexion ROM, it's important to differentiate the movement from:
When assessing thoracic lateral flexion ROM, it's important to differentiate the movement from:
In the context of thoracic spine examination, 'MOI' in 'History - MOI, timeframe, etc.' refers to:
In the context of thoracic spine examination, 'MOI' in 'History - MOI, timeframe, etc.' refers to:
Which muscle is LEAST likely to be considered part of the posterior musculature of the thoracic spine for palpation and strength testing?
Which muscle is LEAST likely to be considered part of the posterior musculature of the thoracic spine for palpation and strength testing?
If decreased accessory motion is found at the costotransverse joint of the 5th rib, which mobilization technique would be MOST specific to address this?
If decreased accessory motion is found at the costotransverse joint of the 5th rib, which mobilization technique would be MOST specific to address this?
The primary goal of 'locking out the lumbar spine' during thoracic ROM assessment is to enhance the reliability and validity of assessing:
The primary goal of 'locking out the lumbar spine' during thoracic ROM assessment is to enhance the reliability and validity of assessing:
When performing a Central PA mobilization, using a 'peace sign' hand position is an alternative to the hypothenar eminence grip. The 'peace sign' hand position involves:
When performing a Central PA mobilization, using a 'peace sign' hand position is an alternative to the hypothenar eminence grip. The 'peace sign' hand position involves:
For effective First Rib Inferior Glide mobilization, it is crucial to ensure that the elbow of the mobilizing arm is:
For effective First Rib Inferior Glide mobilization, it is crucial to ensure that the elbow of the mobilizing arm is:
Which of the following is the MOST important reason to reassess outcome measures after interventions for thoracic spine pain?
Which of the following is the MOST important reason to reassess outcome measures after interventions for thoracic spine pain?
Flashcards
Thoracic Spine Mobility Techniques
Thoracic Spine Mobility Techniques
To understand and demonstrate techniques for assessing thoracic spine mobility.
Thoracic Muscle Strength Assessment
Thoracic Muscle Strength Assessment
To understand and demonstrate techniques for assessing strength of thoracic musculature.
Thoracic Joint Accessory Motion
Thoracic Joint Accessory Motion
To understand and demonstrate techniques for assessing thoracic spine joint accessory motion.
Pain Location Documentation
Pain Location Documentation
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Initial Hypothesis (Pain)
Initial Hypothesis (Pain)
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What Makes Pain Worse?
What Makes Pain Worse?
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What Makes Pain Better?
What Makes Pain Better?
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History (MOI, Timeframe)
History (MOI, Timeframe)
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Patient Specific Functional Scale (PSFS)
Patient Specific Functional Scale (PSFS)
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Numeric Pain Rating Scale (NPRS)
Numeric Pain Rating Scale (NPRS)
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Oswestry Disability Index (ODI)
Oswestry Disability Index (ODI)
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ROM Active with Overpressure
ROM Active with Overpressure
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Palpation
Palpation
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Strength Testing
Strength Testing
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Joint Accessory Movement Assessment
Joint Accessory Movement Assessment
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ROM Patient Seated
ROM Patient Seated
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Spine of Scapula
Spine of Scapula
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Inferior Angle
Inferior Angle
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Last Rib
Last Rib
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Posterior Musculature
Posterior Musculature
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Rib Angle
Rib Angle
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Pectoralis Major
Pectoralis Major
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Pectoralis Minor
Pectoralis Minor
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Sternoclavicular Joint
Sternoclavicular Joint
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Sternocostal Joints
Sternocostal Joints
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Thoracic Paraspinals - Extensors
Thoracic Paraspinals - Extensors
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Middle Trap
Middle Trap
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Lower Trap
Lower Trap
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Rhomboids
Rhomboids
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Central PA
Central PA
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Unilateral PA
Unilateral PA
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First Rib Inferior Glide
First Rib Inferior Glide
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Study Notes
- Examination of the Thoracic Spine
Objectives
- Learners should understand and demonstrate methods for evaluating the thoracic spine's range of motion.
- Learners should understand and demonstrate methods for evaluating the strength of the thoracic musculature.
- Learners should understand and demonstrate methods for evaluating thoracic spine joint accessory motion.
Subjective Examination
- Includes gathering details about the pain location using a body chart and forming an initial hypothesis.
- Requires exploring factors that worsen or alleviate the pain and the amount of activity needed to trigger or ease the symptoms.
- Involves taking a history that covers the mechanism of injury (MOI) and the timeframe of the issue.
Outcome Measures
- Patient Specific Functional Score (PSFS).
- Numeric Pain Rating Scale (NPRS).
- Oswestry Disability Index (ODI).
- Neck Disability Index (NDI) is covered in the Cervical section.
- Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is covered in UE course.
Physical Examination Overview
- Includes assessment of Range of Motion (ROM).
- Includes spinal palpation.
- Includes strength testing.
- Includes joint accessory movement assessment.
Range of Motion (ROM)
- Patient should be seated with the lumbar spine locked out.
- Assess flexion, extension, rotation, and lateral flexion.
- Apply overpressure if movements aren't full or don't provoke symptoms.
Posterior Palpation
- Includes palpation of the spinous processes.
- Spine of the scapula corresponds to T3/T4.
- The inferior angle corresponds to T7.
- The last rib corresponds to T12.
- Palpate the rib angle and posterior musculature, including the middle and lower trapezius, rhomboids, and latissimus dorsi.
- Palpate the 1st rib.
Anterior/Lateral Palpation
- Includes palpation of:
- Rib angles.
- Sternum: specifically the sternoclavicular and sternocostal joints.
- Pectoralis major.
- Pectoralis minor.
Strength Testing
- Includes testing of the Thoracic Paraspinals (Extensors), Middle Trap, Lower Trap, and Rhomboids.
Central PA Joint Accessory Motion
- The patient is in prone position, with the therapist standing on one side.
- Apply pressure using hypothenar eminence.
- Use a "dummy" hand on the spinous process, applying force with the opposite hand directly anteriorly, similar to lumbar CPA.
- Use a "Peace Sign."
- Place "dummy" fingers on either side of the spinous process and apply force with the opposite hand directly anterior.
Unilateral PA Joint Accessory Motion
- Patient is prone, with the therapist standing on one side.
- Apply pressure using a "Dummy" thumb.
- Thumb should be placed on the chosen side at the desired level, applying force with either the opposite heel of the hand or opposite thumb directly anterior.
- Apply pressure using the hypothenar eminence.
- Similiar to a CPA but off to one side, and it's not as specific.
First Rib Inferior Glide Joint Accessory Motion
- The patient is seated, and the therapist stands behind.
- Support the opposite side of the head.
- Apply force through the lateral MCP toward the opposite hip.
- Align the elbow with the direction of force.
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