Podcast
Questions and Answers
Visceral pain in the thoracic spine is often related to connections with which structure?
Visceral pain in the thoracic spine is often related to connections with which structure?
- Sympathetic chain ganglion (correct)
- Cerebrospinal fluid
- Parasympathetic nervous system
- Dorsal root ganglion
Pain originating from the epigastric area and radiating to the middle thoracic spine may indicate which pathology?
Pain originating from the epigastric area and radiating to the middle thoracic spine may indicate which pathology?
- Peptic ulcer (correct)
- Cholecystitis
- Cardiac ischemia
- Renal colic
Which symptom is commonly associated with cholecystitis?
Which symptom is commonly associated with cholecystitis?
- Bilateral leg pain
- Left lower quadrant pain
- Diffuse headaches
- Right upper quadrant and scapular pain (correct)
Which condition is characterized by pain that presents 1-2 hours after a fatty meal?
Which condition is characterized by pain that presents 1-2 hours after a fatty meal?
Which of the following is a sign of a dissecting thoracic aneurysm?
Which of the following is a sign of a dissecting thoracic aneurysm?
What is a common symptom of renal colic?
What is a common symptom of renal colic?
What is the significance of 'limited chest expansion' in the context of inflammatory disorders affecting the thoracic spine?
What is the significance of 'limited chest expansion' in the context of inflammatory disorders affecting the thoracic spine?
What symptom is associated with neoplastic conditions affecting the thoracic spine?
What symptom is associated with neoplastic conditions affecting the thoracic spine?
What is a common symptom of the inflammatory disorder ankylosing spondylitis?
What is a common symptom of the inflammatory disorder ankylosing spondylitis?
Which of the following is a potential sign of an inflammatory or systemic disease affecting the thoracic spine?
Which of the following is a potential sign of an inflammatory or systemic disease affecting the thoracic spine?
Compression and/or irritation of structures going down the arm is characteristic of which condition?
Compression and/or irritation of structures going down the arm is characteristic of which condition?
Paresthesia in the hand is a sign of what condition?
Paresthesia in the hand is a sign of what condition?
What vascular symptom is associated with arterial thoracic outlet syndrome?
What vascular symptom is associated with arterial thoracic outlet syndrome?
Upper extremity edema, cyanosis, and paresthesia are signs of what condition?
Upper extremity edema, cyanosis, and paresthesia are signs of what condition?
What is the purpose of bracing in scoliosis treatment?
What is the purpose of bracing in scoliosis treatment?
What is a common symptom of a rib sprain/strain?
What is a common symptom of a rib sprain/strain?
What action may be limited due to a rib sprain/strain?
What action may be limited due to a rib sprain/strain?
Anterior chest pain, tenderness to palpation of the costochondral joints, and pain with deep breaths are signs of what condition?
Anterior chest pain, tenderness to palpation of the costochondral joints, and pain with deep breaths are signs of what condition?
In cases of costochondritis, it is MOST important to rule out what other possible causes of pain?
In cases of costochondritis, it is MOST important to rule out what other possible causes of pain?
What is a typical characteristic symptom of myofascial pain?
What is a typical characteristic symptom of myofascial pain?
What can aggravate myofascial pain?
What can aggravate myofascial pain?
In postmenopausal women, compression fractures are often linked to which factor?
In postmenopausal women, compression fractures are often linked to which factor?
An extreme kyphotic curve, also known as ______ is a sign of compression fracture.
An extreme kyphotic curve, also known as ______ is a sign of compression fracture.
Severe, localized pain represents what condition?
Severe, localized pain represents what condition?
What is the cause of Scheuermann's disease?
What is the cause of Scheuermann's disease?
Which age group is most commonly affected by Scheuermann's disease?
Which age group is most commonly affected by Scheuermann's disease?
Which curve angle is associated with bracing for Scheuermann's Disease?
Which curve angle is associated with bracing for Scheuermann's Disease?
Which of the following is a symptom of a rib sprain/strain?
Which of the following is a symptom of a rib sprain/strain?
Which of the following is a neurological symptom of neurogenic thoracic outlet syndrome?
Which of the following is a neurological symptom of neurogenic thoracic outlet syndrome?
What can be a cause of myofascial pain?
What can be a cause of myofascial pain?
Flashcards
Dissecting thoracic aneurysm signs
Dissecting thoracic aneurysm signs
Sudden, severe, unrelenting chest pain possibly radiating to the upper back.
Cholecystitis signs
Cholecystitis signs
Right upper quadrant and scapular pain, possible fever, nausea, and vomiting, which presents 1-2 hours post fatty meal.
Renal Infection/Kidney Stones signs
Renal Infection/Kidney Stones signs
Renal colic/flank pain, fever, nausea, and vomiting. Increased risk with ongoing UTI.
Neoplastic condition signs
Neoplastic condition signs
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Ankylosing Spondylitis signs
Ankylosing Spondylitis signs
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Neurogenic TOS signs
Neurogenic TOS signs
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Arterial TOS signs
Arterial TOS signs
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Venous TOS signs
Venous TOS signs
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Rib Sprain/Strain signs
Rib Sprain/Strain signs
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Costochondritis signs
Costochondritis signs
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Myofascial Strain/Pain signs
Myofascial Strain/Pain signs
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Compression Fracture Signs
Compression Fracture Signs
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Study Notes
- T-spine is a common area for referral from viscera
Visceral Pathology
- Cardiac Ischemia signs & symptoms: Angina and Nausea
- Dissecting thoracic aneurysm: Sudden, severe, unrelenting chest pain that can radiate to the upper back
- Unrelieved with laying down
- Peptic Ulcer: Boring (drilling) pain from epigastric area to middle thoracic spine
- Triggered or relieved with meals
- Perforated ulcer can refer pain to the shoulder with irritation of the diaphragm
- Cholecystitis: Right upper quadrant and scapular pain
- Fever, nausea, and vomiting
- Pain presents 1-2 hours after a fatty meal
- Renal Infection and Kidney Stones: Renal colic/flank pain
- Fever, nausea and vomiting
- Increased risk for kidney infection with ongoing UTI
- Neoplastic Conditions: Constant pain, no relief with bed rest
- Night pain
- Ankylosing Spondylitis: Limited chest expansion, less 2.5 cm
- Morning pain and stiffness
- Inflammatory or Systemic Disease: Temperature > 100°
- Blood Pressure >160/95mmHg
- Resting Pulse > 100 bpm
- Resting Respiration > 25 bpm
- Fatigue
- Osteomyelitis, diskitis, epidural infection, pericarditis
Thoracic Outlet Syndrome
- Neurogenic TOS: Paresthesia, pain, hand and UE weakness
- May have "hard" neuro signs
- May lack neuro signs and have intermittent symptoms
- Arterial TOS: Paresthesia, upper extremity ischemia, claudication, decreased pulse
- Venous TOS: Upper extremity edema, cyanosis, paresthesia
Rib Sprain/Strain
- Pain in the thoracic region
- Can radiate laterally and anteriorly
- Achy or sharp pain
- Difficulty taking deep breath
- Painful coughing/sneezing
- Limited rotation and/or lateral flexion
Costochondritis
- Anterior chest pain
- Pain with trunk movements, deep breaths, coughing
- Tender to palpation of the costochondral joints
- Must rule out more serious causes of pain, can mimic various conditions, generally presents with abnormal vital signs
Myofascial Strain/Pain
- Tender to palpation
- Generalized ache, burning, sharp, tight symptoms
- Aggravated by movement/use
Compression Fracture
- "Dowager Hump" - Extreme kyphotic curve
- Severe, localized pain
- Occasionally no pain
- Pain in the area overlying affected segment
Scheuermann’s Disease
- Rigid hyper-kyphosis most often seen in adolescents
- Can be non-painful
- Might predispose to myofascial pain, but evidence uncertain
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