CHIR12006

Week 7 Study Guide Questions

Q1. Which is the most appropriate primary contact for a T3-T4 Prone Crossed
Bilateral Hypothenar/Transverse Push – Rotation?
Primary hand hypothenar contact over the superior transverse process (of T3) on the
opposite side to the rotation restriction.

Q2. Which is the most appropriate contact for a T7- 8 Opposite Side Thenar
Transverse Drop?
Standing on the opposite to the contact, the practitioner’s primary contact is thenar over
the transverse process. If it were an extension restriction, the contact would be over the
inferior vertebra and if it were a flexion restriction, this would be over the superior vertebra.

Q3. Which is the correct LOD for T4- T5 Opposite-Side Thenar-Transverse

Drop?
The line of drive for this would be primarily A-P and I-S.

Q4. Which is the correct LOD for Prone Bilateral Hypothenar/Transverse Push
(Carver Bridge)?
Primarily P-A and I-S depending on the level of the adjustment – as this would change
moving down the thoracic spine.

Q5. Which is the most appropriate method of management in scoliosis cases

with curves less than 10 degrees?
In cases were the spine’s scoliosis is les than 10 degrees, the most appropriate measures
would be to observe the area and note any changes. If it were a young child presenting with
this, as they grow, this could fix itself however if it were a grown adult presenting with the
condition, treatment would be necessary.

Q6. Which is the most appropriate method of management in scoliosis cases

with lumbar curves between 30-40 degrees?
In this case, the most appropriate measures would be to provide conservative management
as well as a surgical referral to a specialist. This would also depend on the age of the patient.

Q7. Which is the most appropriate method of management in scoliosis cases

with thoracic curves greater than 50 degrees?
In this case, the chance of surgical intervention is quite high.

Q8. What is considered the average number of degrees for the thoracic spine
to form a kyphotic curve?
Depending on age and gender the normal range of kyphotic curve is as follows:
Age Male Female
2-9 21 24
10-19 28 26
20-29 26 27
30-39 29 28
40-49 30 33
50-59 33 41
60-69 35 45

Q9. Explain the significance of the disc height to body ratio of 1:5 in the
thoracic spine.
The disc height in the thoracic spine is the shallowest out of the whole spinal column – a 1:5
ratio. Due to this, there is significantly lower flexibility. In addition to this, the nucleus is
located more centrally within the thoracic disc than any other spinal area.

Q10. What is the significant structural characteristic of the thoracolumbar

spine?
The most important structural characteristics of the thoracolumbar spine are:
- T11 contains costal facets however none on the transverse process for rib tubercle
articulation, beginning to structurally take on lumbar characteristics.
- T12 also has complete articulation surfaces for the 12th rib however resembles a
lumbar vertebra.
- In addition to T12, the articular surfaces are convex and directed in the sagittal line,
like in the lumbar spine.

Q11. Name all of the structures of the thoracic spine in the diagram below
1. Spinous Process
2. Transverse process
3. Superior articular process
4. Foramen of the vertebra
5. Vertebral body
6. Pedicle
7. Lamina
8. Superior vertebral arch
Q12. Complete the table below Global ROM of thoracic spine

Flexion 25-45 degrees

Extension 25-45 degrees
Lateral Flexion 20- 40 degrees
Rotation 30-45 degrees

Q13. The presence of idiopathic structural scoliosis is suggested by what

findings in the thoracic spine?
Scoliosis is a lateral curvature of the spine with the following characteristics upon
assessment:
- Shoulder or scapular asymmetry
- Asymmetry of paraspinal muscles or the rib cage when the patient bends forward
- Inability to see waist symmetry when the patient is sitting
- Increased kyphosis or lordosis
- Curves of the spine unable to straighten when trunk is flexed

How is it assessed by clinicians in a clinical setting?

Idiopathic scoliosis is the most common scoliosis which is generally caused by a genetic
variation. Idiopathic scoliosis is subdivided according to age at which the disease is
diagnosed: adolescent (≥10 years), juvenile (3 to 10 years), and infantile (0 to 3 years).

Q14. Label the radiograph below.

a. Sternoclavicular joint
b. Spinous process of T3
c. Vertebral body of T7
d. Pedicle of T9
e. Transverse process of T10
f. Intervertebral disc
g. Clavicle
h. Left 6th rib
i. Inferior articular process
j. Heart
k. T10 costotransverse joint
l. L1 vertebral body
https://www.pinterest.com.au/pin/51228514483701077/?lp=true

Q15. Label the radiograph below.

A. Right Pedicle
B. Left Superior articular facet
C. Left costovertebral joint
D. Spinous process
E. Inferior vertebral endplate

https://www.pinterest.com.au/pin/51228514483701077/?lp=true
Q16. Using (Cobb Lippman’s method) what is the Cobb’s Angle in the image
below.

http://rebeccamcmillandesign.com/