Physical Therapy for Thoracic spine

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Physical Therapy for Thoracic spine
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?????????????????????

• ?????????????????????????????????????????????
  thoracic spine
• ??????????????????????????????????????????????????
  ????????
• ??????????????????????????????????????????????????
  ??????? thoracic spine ??????????????? ??????????

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Common Pathologies _at_ Thoracic Spine

• thoracic inlet syndrome
• Scheuermanns disease
• intervertebral joint lesion (joint dysfunction)

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Thoracic inlet
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Thoracic inlet
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Thoracic inlet syndrome

• ??????????? neurovascular structures ?????????
  thoracic inlet
• subclavian artery and vein ??? brachial plexus
• ?????????????? ??????????
• ??????????????? insidious

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Structures ????????

• presence of cervical rib
• subluxated first thoracic rib
• shortened anterior and middle scalene muscle
• anomalous fibromuscular bands

• malunion of a fractured clavicle
• Pancoasts tumor of the apex of the lung
• altered posture
• tight pectoralis minor muscle
• anomalous thoracic vertebral transverse process

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Contributing Factors

• trauma
• occupational stress
• obesity
• pendulous breasts

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PT Treatment

• control pain
• correct ??????
• correct contributing factors

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Scheuermanns disease

• osteochondrosis of the vertebral epiphyses
• anterior part of vertebra ??????
• Tx ?? kyphosis ??????????? ????????
• x-ray - vertebra ??????????????????? gt 3 ???
• 12-16 ?? ?????? ???????
• ?????????????????????????????? 20-22 ??
• ??????? compensation ??? excessive lumbar lordosis

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??????

• ?????????????
• aseptic necrosis of the vertebral bodies
• herniated nuclear materials within vertebral
  bodies
• anterior disc lesion which affects the end plate
  of the vertebra
• resultant of heavy workloads to the spine
• genetic

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PT Treatment

• Tx extension strengthening
• postural correction
• avoiding heavy lifting, slouch sitting, repeated
  bending twisting
• mobilisation, massage, brace, surgery

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IJL / Joint dysfunction

• ???????????????? facet / costovertebral /
  costotransverse joint movement
• ??????????????????????????????????
  ???????????????? rotation
• ????????????????????????????????????????????
• referred pain
• ????? nerve root sympathetic nervous system
  T4 syndrome

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Contributing Factors

• unaccustomed lifting
• stretching
• pushing
• exercise
• trauma
• posture ???????????? thoracic kyphosis

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PT Treatment

• mobilisation
• manipulation
• massage
• electrotherapy
• correct posture