Exam 4 Opp Thoracic Dysfunction

Front 1

Anatomic Landmarks

Name the spinal level:

... – Sternal notch
... – Spine of the Scapula
T4 – ... is the T4 dermatome
... – sternal angle attaches to the 2nd rib
... – inferior angle of the scapula
T10 – ... is the T10 dermatome

Back 1

T2
T3
Nipple
T4
T7
umbilicus

Front 2

Thoracic motion:

Motions include rotation, sidebending, flexion and extension

THE MAIN MOTION OF THE THORAX IS ... (down to about T10)

Upper and middle thoracic = Rotation> flexion/extension> sidebending

Lower thoracic (T11, 12)= flexion/extension> sidebending> rotation

Back 2

ROTATION

Front 3

Rotation:

greatest motion of the thoracic spine

the orientation of the thoracic articular facets allows them to glide relative to each other with an axis of rotation near the ... of the vertebral body.

motion is limited by multiple ... tensions

Back 3

center
ligamentous

Front 4

what are the 4 muscles that make up the superficial layer of the back?

Are large muscle groups responsible for somatic dysfunction usually?

Back 4

trapezius
latissimus dorsi
rhomboid minor
rhomboid major

no

Front 5

Deep layer:

1. Semispinalis thoracis
2. Multifidus
3. Rotatores thoracis
-longus
-brevis
4. Levatores costarum
-brevis
-longus

Which 2 of these are more responsible for single segment (small muscle) lesions (type 2 lesions)?

Back 5

Multifidus
rotatores thoracis

Front 6

Rule of 3:

The spinous processes of T1,2,3 project directly posteriorly so that the tip of each spinous process is in the ... as the transverse process of the associated vertebrae.

Back 6

same plane

Front 7

Rule of 3's:

The spinous processes of T 4,5,6 project slightly inferiorly, so that the tip of each spinous process is about ... the transverse process of its associated vertebrae and the one below.

Back 7

½ way between

Front 8

rule of 3's:

The spinous processes of T7,8,9 project more inferiorly so that the top of each spinous process is in the same plane as the transverse of the ...

Back 8

vertebrae below

Front 9

Rule of 3's:

T10 follows rules as T7-9 (describe)

T11 follows rules as T4-6 (describe)

T12 follows rules of T1-3 (describe)

Back 9

-at level of TP of vertebrae below
-1/2 way between TP of vertebrae below and its own
-at level of its own TP

Front 10

what is this?

A decrease in the threshold for excitation of neurons innervating the region of dysfunction.

Back 10

facilitation

Front 11

facilitation:

This ... threshold of neurons is facilitation (more on edge, less able to deal with stress from environment

Facilitation may lead to dysfunction in regions innervated (persistent low grade stimulation) by the same pool of neurons.

Segments become or stay facilitated from:
1) higher brain centers - ...
2) viscera by sym/parasymp visceral ...
3) somatic afferents muscle spindles, golgi tendon, nociceptors

Back 11

lowered
emotions
afferents

Front 12

what is this?

a somatic dysfunction which produces a stimulus that may generate a visceral (organ) dysfunction elsewhere

ex. the squirts

Back 12

somato-visceral reflex

Front 13

what is this?

a dysfunction of the visceral system which produces a stimulus that may generate a secondary somatic dysfunction elsewhere

ex. appendicitis --> psoas spasm

Back 13

viscero-somatic reflex

Front 14

what is this?

a dysfunction of the visceral system which produces a stimulus that may generate a secondary visceral dysfunction elsewhere

Back 14

viscero-visceral reflex

Front 15

what is this?

a somatic dysfunction which produces a stimulus that may generate a secondary somatic dysfunction elsewhere

Back 15

somato-somato reflex