Term
| why is differential dx of throacic pain difficult |
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Definition
compicated biomechanics and funciton of the region
proiximity to vital organs
many articulations |
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Term
| pain arising from inflammatino of the axial spine can mimic a variety of serious conditions including (7) |
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Definition
cardiac/pulomnary pathology
renal colic
fracture
tumor
visceral retroperitoneal abnormalities
abdominal aortic aneurysm |
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Term
| where does the T spine begin at clinically |
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Definition
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Term
| which thoracic vertebra are typically examined as part of the cervical exam |
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Definition
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Term
| if pain is referred proximal to the inferior angle where should the exam begin |
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Definition
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Term
| if pain is referred distal to the inferior angle of the scauplae where should the exam begin |
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Definition
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Term
| cervical apophyesal referal patterns: C2-C3 |
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Definition
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Term
| cervical apophyesal referal patterns: C3-C4 |
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Definition
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Term
| cervical apophyesal referal patterns: C4-C5 |
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Definition
| back of neck onto trap and supraspinatus area |
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Term
| cervical apophyesal referal patterns: C5-C6 |
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Definition
| supraspinatus area to just lateral of spine |
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Term
| cervical apophyesal referal patterns: C6-C7 |
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Definition
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Term
| sources of pain in the thoracic region (5) |
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Definition
thoracic facets/zygapophyseal jts
Ribs: costovertebral/transverse jts
Disc pathology
rib/vertebral body fx
nonmechancial |
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Term
| Thoracic Exam: Hx: Clinician must determine if the pain is provoked or alleivated with (4) |
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Definition
movement or posture
respiration
eating or drinking
exertion |
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Term
| Thoracic Exam: Hx: pain/relief with movement or posture is what kind of pain |
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Definition
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Term
| Thoracic Exam: Hx: pain/relief with respiration is pain d/t what |
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Definition
| rib dysfunction or pleuritic pain |
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Term
| Thoracic Exam: Hx: pain/relief with eating or drinking is pain d/t what |
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Definition
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Term
| Thoracic Exam: Hx: pain/relief with exertion is d/t what |
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Definition
| rib dysfunction or cardiac pain |
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Term
| Thoracic Exam: Systems Review: major confounder for thoracic pain |
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Definition
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Term
| Thoracic Exam: Systems Review: why can viscerogenic pain apepar as thoracic spine pain |
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Definition
| visceral and somatic afferent nerves transmit pain messages from a peripheral stimulus and converge on the same projectio neurons in teh dorsal horn |
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Term
| Differential dx of the thoracic region: (7) |
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Definition
heart disease (MI)
thrombosis of the lower aorta (dissecting aortic aneurysm)
osteoporosis (compression fx)
scheurmann's disease (anterior wedging of vertebrae, kyphotic deformity, adolescents 10%)
visceral disease
pleurisy
akylosing spondylitis |
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Term
| Visceral Disease and their Segmental Derivation: haert |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: lungs |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: esophagus |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: stomach and duodenum |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: liver and gall bladder |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: pancrease |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: small intestine |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: appendix and asecnding colon |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: epididymis |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: overy, testes |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: bladder, kidney, uterus |
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Definition
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Term
| Visceral Disease and their Segmental Derivation: colon, rectum, cervix, prostate, urethra |
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Definition
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Term
| Thoracic exam: in regards to the thoracic curve (3) |
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Definition
smoothness of the curve
degree of kyphosis
lateral curvature of the T spien |
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Term
| Thoracic exam: in regards to the chest wall |
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Definition
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Term
| Thoracic exam: TP and SP at same level |
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Definition
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Term
| Thoracic exam: TP 1/2 level above the SP |
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Definition
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Term
| Thoracic exam: tp above the SP |
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Definition
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Term
| when should the costals be examined |
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Definition
| after teh thoracic jts have been examined and treated, or the testing of which proved negative |
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Term
| neurological examination and the thoracic spine |
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Definition
difficult to do
dermatomal loss of 1 segment may not result in loss of sensation |
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Term
| Thoracic exam: where should sensation be tested |
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Definition
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Term
| Thoracic exam: sensation testing of T8 |
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Definition
| area just below the xyphoid process |
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Term
| Thoracic exam: sensation testing of T10 |
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Definition
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Term
| Thoracic exam: sensation testing of T12 |
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Definition
| lower abdominal region on level with the ASIS |
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Term
| joint dysfunction in teh thoraci cspine can be d/t what tissues |
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Definition
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Term
| joint dysfunction in the thoracic spine is d/t what |
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Definition
| reduction in mobility due to adpative shortening of spinal tissues |
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Term
| THoracic jt dysfunction: loss of motion most common in what motions |
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Definition
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Term
| if the rib is stuck down what type of restriction is it |
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Definition
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Term
| if the rib is stuck up what type of restriction is it |
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Definition
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Term
| zygapophyseal dysfunction has what pattern of limitaiton |
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Definition
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Term
| zygapophyseal dysfunction is ID'd how |
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Definition
| AROM, PROM, SSMT/PIVM, and PAIVM (Spring testing) |
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Term
| zygapophyseal dysfunction intervention |
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Definition
posture correction
mobilization
manipulation
specific exercise direction to reduce restriction |
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Term
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Definition
| hypomobility at T3-T4, T4-T5, T5-T6 |
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Term
| pain associated with T4 syndrome |
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Definition
vague arm pain not following a dermatomal pattern, hand is always involved
diffuse posterior head and neck pain |
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Term
| T4 syndrome has tendernesss and stiffness where |
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Definition
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Term
| intervention for a pt with T4 syndrome |
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Definition
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Term
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Definition
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Term
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Definition
| stretching, lifting, pushing of trauma |
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Term
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Definition
thrust and non thrust manipulation
neuromboilizaiton (slump stretching) |
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Term
| costabertebral/constotransverse disorders: MOI (4) |
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Definition
trauma
unguarded motions into rotation or reaching backwards
sneezing or coughing |
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Term
| costabertebral/constotransverse disorders: restrictions in motion |
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Definition
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Term
| costabertebral/constotransverse disorders: may cause pain referral to what regions |
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Definition
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Term
| costabertebral/constotransverse disorders: pain is provked how |
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Definition
| pressure on the pathological rib/PAIVM or spring testing |
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Term
| costabertebral/constotransverse disorders: need to rule what out prior to tx |
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Definition
|
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Term
| costabertebral/constotransverse disorders: segments that are most commonly affected |
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Definition
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Term
| costabertebral/constotransverse disorders: pain is worse with what position |
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Definition
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Term
| costabertebral/constotransverse disorders: pain may be d/t what (2) |
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Definition
|
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Term
| costabertebral/constotransverse disorders: results in local pain where |
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Definition
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Term
| costabertebral/constotransverse disorders: may refer pain from where to where |
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Definition
| midlien to lateral chest wall |
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Term
| costabertebral/constotransverse disorders: dx is confirmed how |
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Definition
| movement of the rib at the costovertebral jt and spring testing |
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Term
| costabertebral/constotransverse disorders: tx with what |
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Definition
mob/manip
ROM ex
deep breathing
posture correction |
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Term
| thoracic disc pathology: if nerve signs are present what should be done |
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Definition
| refer out immediately to r/o tumor |
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Term
| thoracic disc pathology: if there are nerve signs that are not tumor related how will they appear |
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Definition
| only at the corresponding level of injury d/t the nerve root being horizontal |
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Term
| thoracic disc pathology: what type of protrusion |
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Definition
| central dis protrusion and may result in cord compression |
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Term
| thoracic disc pathology: where is disc pathology most common |
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Definition
|
|
Term
| thoracic disc pathology: pain referral |
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Definition
variable
can be proximal to the C spine and distal to the lumbar region |
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Term
| MDT THoracic Derangement: 1 |
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Definition
| central or symmetrical pain, rapdily reversible |
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Term
| MDT THoracic Derangement: 2 |
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Definition
| acute kyphosis, rare, usually the result of trauma or serious disease |
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Term
| MDT THoracic Derangement: 3 |
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Definition
| unilateral or asymmetrical pain across the thoracic region with or without radiation to the chest wall, rapidly reversible |
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Term
| MDT THoracic Derangement: if sagital plane exercises have no effect, what motion and to which side |
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Definition
| rotation to the side of pain |
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Term
| mgmt of thoracic discogenic patholgoy: why is stabilization not always possible |
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Definition
| ribs make the T spine pretty stable |
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Term
| mgmt of thoracic discogenic patholgoy: most common direciton specific ex |
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Definition
| extension and rotation to painful side |
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Term
| cause of 25-35% of all spinal frctures |
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Definition
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|
Term
| most common type of fracture d/t osteoporosis |
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Definition
| anterior wedge between the 9th and 11th |
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Term
| prophylatic tx of osteoporosis by McKenzie |
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Definition
| prone extension with pillows underneath abdomen and the hands clasped behind teh back for 15-20 reps atarting at age 50 |
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Term
| disease seen in 10% of males and females equally and typically seen in pubescent athletes |
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Definition
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Term
| involves a defect in the ring apophysis of the vertebral body and anterior wedging of the affected segment |
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Definition
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Term
| clinical presentation of scheurmann's disease |
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Definition
| increased kyphosis and pain with extension and rotation |
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Term
| mgmt of scheurmann's disease (5) |
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Definition
posture ed
exercise (rotaiton and extension)
stretching of tight mm
strengthening of weakened structures
bracing |
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Term
| Thoracic outlet syndrome involves what nerve root levels |
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Definition
|
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Term
| Thoracic outlet syndrome is what type of syndrome |
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Definition
| neurovascualr compression syndrome |
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Term
| Thoracic outlet syndrome 3 other structures that may be compromised |
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Definition
brachial plexus
subclavian aa
sublcavian vv |
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Term
| Thoracic outlet syndrome: brachial plexus, subclavian aa, subclavian vv may be compromised at what 4 structures |
|
Definition
ant/mid scalenes
over 1st rib/accessory rib
between clavicle and 1st rib
under pec minor at coracoid |
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