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Thoracic CS Flashcards

(19 cards)

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1
Q

Anterior Tender Points

  • Pain is ______ and ______
  • The patient may give a history of comfort in ______
  • The injury may have occurred with rapid ______ from a ______ position
  • May present with increased ______
  • Treated in ______​
  • If stretches are prescribed for several days later, generally use ______
A

Anterior Tender Points

  • Pain is diffuse and posterior
  • The patient may give a history of comfort in flexion
  • The injury may have occurred with rapid extension from a flexed position
  • May present with increased kyphosis
  • Treated in flexion
  • If stretches are prescribed for several days later, generally use extension
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2
Q

Posterior Tender Points

  • Pain is _____ and __________
  • The patient may give a history of comfort in __________
  • The injury may have occurred with the rapid __________ from a(n) __________ position
  • May present with __________ curve of thoracic spine
  • Treated in __________
  • If stretches are prescribed for several days later, generally use __________
A

Posterior Tender Points

  • Pain is specific and posterior
  • The patient may give a history of comfort in extension
  • The injury may have occurred with the rapid flexion from a(n) extended position
  • May present with decreased curve of thoracic spine
  • Treated in extension
  • If stretches are prescribed for several days later, generally use flexion
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3
Q

AT1 through AT7 L

  • Location
    • AT1
    • AT2
    • AT3
    • AT4
    • AT5
    • AT6
    • AT7
    • AT7 L
  • Tx Position
    • Support of PT’s neck?
    • Motion?
    • How do you increase the motion?
    • When can you use minor sidebending?
A

AT1 through AT7 L

  • Location
    • AT1
      • Midline at the suprasternal notch
    • AT2
      • Midline where the manubrium meets the sternum
    • AT3
      • On the sternum at the level of the costal cartilage related to the named vertebra
    • AT4
      • On the sternum at the level of the costal cartilage related to the named vertebra
    • AT5
      • About 2-3 cm above the xiphoid junction
    • AT6
      • At the xiphisternal junction
    • AT7
      • At the tip of the xiphoid
    • AT7 L
      • Just inferolateral of AT7 on either side
      • 2 Points
  • Tx Position
    • Support of PT’s neck?
      • Physician supports the patient’s head and neck with one arm and hand
    • Motion?
      • Flexion
    • How do you increase the motion?
      • Physician places a knee under the cervical and upper thorax spine if more flexion is neede
    • When can you use minor sidebending?
      • Minor sidebending toward may be needed for the lateral AT7 L
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4
Q

AT1 through AT7 L

  • Location
    • AT8
    • AT9
    • AT10
    • AT11
    • AT12
A

AT1 through AT7 L

  • Location
    • AT8
      • Halfway between AT7 and AT 9 approximately 4-5 cm inferior to the xiphoid process
    • AT9
      • Approximately 1-2 cm superolateral to the umbilicus
      • DO AFTER AT7 and BEFORE AT8
    • AT10
      • Approximately 1-2 cm inferolateral to the umbilicus
    • AT11
      • Approximately 4 cm inferolateral to the umbilicus
    • AT12
      • Superomedial (internal) surface of the iliac crest on the mid-axillary line
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5
Q

AT7 to AT9

  • Tx position
    • Sidebend where?
    • Rotate where?
    • Flex or Extend?
    • Leg on what side of PT?
    • How do you support the PT’s head/neck?
A

RoAT7 to AT9

  • Tx position
    • PT Supine
    • Being Patient
    • SB to tender point
      • Use physician leg on the opposite side of the tender point to increase SB
    • Flex to the tender point
      • Push your elevated femur against PTs upper thoracic spine while supporting PTs head/neck with your arm/hand
    • Rotate away from the tender point

(LU) F STRA

Leg Up

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6
Q

AT9 - AT12

  • Tx position
A

AT9 - AT12

  • Tx position
    • PT Supine
    • PT’s knees to 90º, hips to 135º
    • Flex to the level of TP
    • Rotation of knees to the side of TP
    • Pull feet toward the side of the TP
    • Can add a pillow to assist with flexion
    • F STRA
      • Rotation from the segment below TP being rotated toward TP
        • ​​This rotates the segment the opposite way
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7
Q

Posterior thoracic tender points (PT1-12) and Lateral posterior thoracic tender points (LPT1-12)

  • Where are the PT’s located?
    • In what order to you palpate them?
  • Where are the LPT’s located?
A

Posterior thoracic tender points (PT1-12) and Lateral posterior thoracic tender points (LPT1-12)

  • Where are the PT’s located? In what order to you palpate them?
    • On the lateral edges of the inferior aspect of each vertebra’s spinous process
    • Palpate from:
      • Lateral to medial
      • Inferior to superior
      • Posterior to anterior
      • At about a 45° degree angle toward the inferolateral aspects of the spinous processes
  • Where are the LPT’s located?
    • On the lateral aspects of the transverse processes

Image: PT4 tenderpoints in purple and LPT4 tenderpoints in blue

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8
Q

THORACIC RULE OF 3’S

  • Location of the SPs of T1 to T3
  • Location of the SPs of T4 to T6
  • Location of the SPs of T7 to T9
  • T10 is like
  • T11 is like
  • T12 is like
A

THORACIC RULE OF 3’S

  • Location of the SPs of T1 to T3
    • The tip of the spinous processes are in the same plane as the transverse processes of the associated vertebra
  • Location of the SPs of T4 to T6
    • The tip of the spinous processes are about half way between the transverse processes of its associated vertebra and the one immediately inferior
  • Location of the SPs of T7 to T9
    • The tip of the spinous processes are one level below the transverse processes of the corresponding vertebra
  • T10 is like
    • T7 to T9
  • T11 is like
    • T4 to T6
  • T12 is like
    • T1 to T3
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9
Q

ALL POSTERIOR THORACIC (PT and LPT)

  • PT Position
  • General Motion
  • The physician on what side of table?
    • Head of Table
    • Same Side of Tender Point
    • Opposite Side of Tender Point
A

ALL POSTERIOR THORACIC (PT and LPT)

  • PT Position
    • Prone
  • General Motion
    • Extension
  • The physician on what side of table?
    • Head of Table
      • PT 1 through 6
      • LPT 1 through 7
        • L is upside down 7
        • LPT 4 through 6 can also be opposite side of TP
    • Same Side of Tender Point
      • PT 7 through 12
    • Opposite Side of Tender Point
      • LPT 4 through 12
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10
Q

What is always the PT tender point treatment position?

A

E SARA

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11
Q

PT1 – PT3

  • PT arm placement?
  • Physician hand placement?
  • Support of patients head/neck?
A

PT1 – PT3

  • PT arm placement?
    • Arms hanging over the sides of the table
  • Physician hand placement?
    • Physician cups the point of the patient’s chin with a hand, with the palm on the side that will support the patient’s cheek and jaw
  • Support of patients head/neck?
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12
Q

PT4 – PT6

  • PT arm placement?
  • Physician hand placement?
  • Support of patients head/neck?
A

PT4 – PT6

  • PT arm placement?
    • Arms extended forward and parallel to the head
  • Physician hand placement?
    • Gently lift the chin slightly to bring the head, neck and upper thoracic spine into extension
  • Support of patients head/neck?
    • Physician man use a knee or thigh to help support the patient’s head and neck or their supporting hand
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13
Q

PT7 – PT9

  • PT arm placement?
  • PT head placement?
  • Physician hand placement?
A

PT7 – PT9

  • PT arm placement?
    • Swimmer motion to induce sidebending AWAY from TP
    • Extended arm should go back to neutral before starting Tx
  • PT head placement?
    • Rotate head AWAY from TP before Tx
  • Physician hand placement?
    • Pull up on the opposite shoulder to create extension and rotation away
    • Sidebend and rotate the patient’s body to the level of the tenderpoin
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14
Q

PT10 – PT12

  • PT arm placement?
  • PT head placement?
  • Physician hand placement?
A

PT10 – PT12

  • PT arm placement?
    • Swimmer motion to induce sidebending AWAY from TP
    • Extended arm should go back to neutral before starting Tx
  • PT head placement?
    • Rotate head AWAY from TP before Tx
  • Physician hand placement?
    • Physician grasps the contralateral ASIS and pulls the pelvis posteriorly
      • This will cause extension and rotation away from the tender point
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15
Q

What is the general treatment position for all LPT tender points?

A

E SART

(LEEEEEEE)E SART

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16
Q

LPT 1 - 7

  • PT arm placement?
  • PT head placement?
  • Physician hand placement?
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A

LPT 1 - 7

  • PT arm placement?
    • Swimmer motion to induce sidebending AWAY from TP
    • Extended arm should go back to neutral before starting Tx
  • PT head placement?
    • Rotate head TOWARDS the TP before Tx
  • Physician hand placement?
    • Physician lifts the patient’s head, places a thigh under the ipsilateral shoulder and anterior chest or extends the head of the table to induce extension
17
Q

LPT 4-9

  • PT arm placement?
  • PT head placement?
  • Physician hand placement?
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A

LPT 4-9

  • PT arm placement?
    • Swimmer motion to induce sidebending AWAY from TP
    • Extended arm should go back to neutral before starting Tx
  • PT head placement?
    • Rotate head TOWARDS the TP before Tx
  • Physician hand placement?
    • Physician lifts the patient’s shoulder on the side of the tender point inducing rotation towards and extension
18
Q
Study These Flashcards
A

LPT 10-12

  • PT arm placement?
    • Swimmer motion to induce sidebending AWAY from TP
    • Extended arm should go back to neutral before starting Tx
  • PT head placement?
    • Rotate head TOWARDS the TP before Tx
  • Physician hand placement?
    • Pull posteriorly on the ipsilateral ASIS to induce extension and rotation toward the tender point
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