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To assess for possible [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome]].<br> ...ully turn her head away from the side being tested and extend the cervical spine.

...gia. Archives of physical medicine and rehabilitation. 1992 Aug 1;73(8):735-7. * The cervical spine is passively and maximally rotated away from the side being tested.

...Encyclopedia". Medical-dictionary.thefreedictionary.com. Retrieved 2012-08-24.</ref><br> ....; Copabianco, John D.; Cox, James J. (2009). OMT review. pp. 3–5. ISBN 978-0967009018.</ref><br>

...used to diagnose facet joint injury in the spine especially in the lumbar and cervical region.<br> ...y with the thumbs over the spinous or transverse processes of the thoracic spine on both sides. The clinician looks for pain or hypomobility /hypermobility

Test for presence of [[Thoracic Outlet Syndrome (TOS)|thoracic outlet syndrome]].<br> ...atment/head-neck-back/thoracic-outlet-syndrome-more-than-just-a-pain-in-the-neck</ref>

...orsi Muscle|latissimus dorsi]], [[Quadratus Lumborum|quadratus lumborum]], and [[trapezius]]. When testing the thoracic and lumbar spine strength a few differences are noted:

...nostic tool used in the identification of [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]]. It is also known as the “elevated arm stress tes Please refer to the [[Thoracic Outlet Syndrome (TOS)|Thoracic Outlet Syndrome (TOS)]] page.

...ichter]], [[User:Meghan Barclayas|Meghan Barclayas]] and [http://www.physio-pedia.com/User:Shannon_Petersen Shannon Petersen] part of the [[Des Moines U ...in may benefit from treatment directed at the cervical or thoracic spines, and/or wrist.

...l subjects.] Journal of Manual & Manipulative Therapy. 2019 Mar 15;27(2):92-8. ...segment. Which can be painful for patients with lower cervical spine pain and dysfunction.<ref name=":0" />

[[File:Piron-guillaume-y5hQCIn1c6o-unsplash.jpg|right|frameless]] Thoracic back pain is more likely to be caused by serious underlying pathology than

...to administer with excellent inter and intra-rater reliability, validity, and responsiveness. <br> Musculoskeletal conditions of the lumbar-pelvic region eg

...nvLOvDZxoN2q9qAMIR8_X0_wow Clinical Orthopaedic Rehabilitation: An Evidence-based Approach.] 3rd ed. Philadelphia: Elsevier Health Sciences, 2011</ref>< ...n DG, Wiesel SW, Boden SD. Low Back and Neck Pain: Comprehensive Diagnosis and Management. 3rd ed. Philadelphia: Elsevier Health Sciences, 2004.</ref>

[[File:Sam-burriss-zHSX9o2 B7Y-unsplash.jpg|right|frameless|600x600px]] ...ion: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review.] BMC Musculoskeletal disorders. 2009 Dec;10(1)

...ng process is relevant as there is evidence of correlations between injury and posture.<ref name=":1" /> Abnormal [[Posture|postures]] can influence muscl Studies of various sports find load accumulation and uneven muscle tone can cause postural faults. [[File:Cyclist Emilia Fahlin

...he Cervical Flexion-Rotation Test. J Manipulative Physiol Ther. 2008;31:293-300</ref> ...r, these tests involve a high degree of skill on the part of the examiner, and their reliability has been questioned.

'''Original Editor '''- [[User:Whitney Bass|Whitney Bass]] and [[User:Kim Bevillard|Kim Bevillard]] ...rs' Guide to the Musculoskeletal Examination: Fundamentals for the Evidence-Based Clinician. Buckner: Evidence in Motion; 2008.</ref><br>

...erior lumbar spine. It consists of 12 vertebrae that are distinct in shape and function from vertebrae found in other regions of the vertebral column. ...c vertebrae are medium sized and heart shaped. They are all weight-bearing and generally increase in size from superiorly to inferiorly with an increase i

...control study.] Brazilian journal of physical therapy. 2019 Jul 1;23(4):346-54. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630105/#bi * Stiff upper thoracic spine or rounded upper spine causing cervical spine to hyperextend to see ahead.

...th a thin outer layer of compact bone. Similar to the first rib, the 11th and 12th ribs are considered atypical ribs due to their anatomical features< * Wide and short, consisting of a single articular facet for the costovertebral joint.

...a supine position (lying on your back) keeping your upper extremity fixed and rotating your lower extremity. It is a twisting motion of your lower trunk ...arms in the opposite direction.<ref>[http://morphopedics.wikidot.com/lumbar-rotation#:~:text=Lumbar%20rotation%20can%20be%20preformed,of%20your%20lower%

[[File:Osteoarthritic Spine (48605563867).png|right|frameless|alt=|476x476px]] ...and intervertebral disc degeneration: Quite different, quite similar.] JOR spine. 2018 Dec;1(4):e1033.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PM

...nent of the nervous system that is being tested and are divided into upper and lower limb tests. ...he ULTT's are equivalent to the straight leg raise designed for the lumbar spine.

...[https://members.physio-pedia.com/course_tutor/tanya-bell-jenje/ Tanya Bell-Jenje]<br> == Subjective Assessment ==

...refore be used in conjunction with a full subjective history and objective examination for comparable signs. ...one or more methods that reduce their symptoms and/or increasing movement and function<ref name=":0">Eleanor Richardson & Jeremy Lewis. The Shoulder Symp

...153016392695/Effect-of-standing-postural-deviations-on-trunk-and-hip-muscle-activity.pdf?origin=publication_detail (last accessed 10.12.2019)</ref> ...structural misalignments of body posture in the sagittal plane]. Scoliosis and spinal disorders. 2018 Dec 1;13(1):6. Available from: https://www.ncbi.nlm.

...tion, as is the case with other syndromes such as chronic fatigue syndrome and irritable bowel syndrome. It is widely considered a better practice to use ...t with various neck, arm and shoulder movements such as shoulder elevation and cervical side flexion.

...n of a classification approach to physical therapy. Journal of Orthopaedic and Sports Physical Therapy 2007; 37 (6), 290–302.</ref>. ...the alignment of the lumbar spine have been noted in subjects with flexion-related lumbar pain<ref name=":1" />.

[[File:WhatsApp Image 2020-04-10 at 3.26.18 PM.jpg|thumb|256x256px|external and internal intercostal muscles]] ...in their function<ref>https://www.kenhub.com/en/library/anatomy/intercostal-muscles</ref>.

[[File:Sam-burriss-zHSX9o2 B7Y-unsplash.jpg|right|frameless]] ...ted to the particular orientation, structure, and function of the thoracic spine in the vertebral column.

...Cervicothoracic Manipulation: A Single-Arm Trial. Phys Ther.2010; 90(1): 26-42.</ref><br> #'''Pain-free shoulder flexion &lt; 120˚'''

...yday decision making.It consist of a combination of medical signs,symptoms and other clinical findings in predicting the probability of specific disease o ...range of motion less than 60 degrees''', '''positive distraction test''', and '''positive Spurling's test A'''.&nbsp;{{#ev:youtube|Ov40c0GV_I8}}

<div class="noeditbox"> This article is currently under review and may not be up to date. Please come back soon to see the finished work!!</d This guide gives a general overview of the anatomy of the thoracic spine. It also includes some facts regarding pathophysiology in this region.

...]. Journal of Back and Musculoskeletal Rehabilitation. 2019 Jan 1;32(1):179-89. ...individuals with a flexed head and neck posture, particularly the elderly and those who have [[Parkinson's - Clinical Presentation|Parkinson's Disease]

...''Original Editor '''- [https://members.physio-pedia.com/course_tutor/petra-zikmann/ Petra Zikmann] '''Top Contributors''' - {{Special:Contributors/{{FU ...and treatment of back and pelvic disorders. AAEP Focus Meeting - Lameness and Imaging. 2007.</ref>

...raadpleegd op 24/11/2012, http://www.coreconcepts.com.sg/mcr/cobb-angle-and-scoliosis/ 3</ref>&nbsp; [[Image:Scoliosis cobb.gif|right]] ...f name="p2">James, J. (1976) Scoliosis, Churchill Livingstone, London, pg 7-11 1A</ref>&nbsp;

...ussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]] [[File:SPINE ANATOMY.jpg|thumb]]

...[https://members.physio-pedia.com/course_tutor/tanya-bell-jenje/ Tanya Bell-Jenje]<br> [[Category:Thoracic Spine]]

...based on the course by [https://members.physio-pedia.com/course_tutor/nick-rainey/ Nick Rainey] ..., G. (2020, December). Non-radicular low back pain: Assessment and evidence-based treatment. ''Australian Journal of General Practice''. Royal Australia

...r:Krista Dayton|Krista Dayton]] as part of the [[Temple University Evidence-Based Practice Project|Temple University EBP Project]] Pain and symptoms localized in or around elbow. May present with neurological sympto

...ort], Journal of Bodywork and Movement Therapies, Volume 20, Issue 4, P:722-727,</ref> ...Some Basic Science Aspects], Physiotherapy, 1997, Volume 83, Issue 4, P:186-189,</ref>&nbsp;

...ed Anatomy of the Lumbar Spine">Ombregt, L. Applied Anatomy of the Lumbar Spine. Chapter 31 In: A System of Orthopaedic Medicine. Elsevier, 2013.</ref> ...ts of the posterior elements that help guide the movement of the vertebrae and protect the spinal cord.

'''Edited April 2022''' - by [[User:Adrianna Simmons|Adrianna Simmons]] and [[User:Jeannine Escobar|Jeannine Escobar]] as part of the [[Arkansas Colleg ...he ULTT's are equivalent to the straight leg raise designed for the lumbar spine.

...ts of 11 physical examinations items that are associated with the scapular and humeral kinetic chain. == Scapula Spine Distance: SSD ==

...isten Templin|Kristen Templin]] as part of the [[Temple University Evidence-Based Practice Project|Temple University EBP Project]] [[File:Thoracic grade 2 T6 PA mobilisations.png|right|frameless]]

...|dermatome]]” is a combination of two Greek words; “derma” meaning “skin”, and “tome”, meaning “cutting” or “thin segment”. Dermatomes are are ...7, C8, and T1 Nerve Roots, whereas the ulnar nerve is derived from C7, C8, and T1.

...ical Center. http://www.umm.edu/programs/spine/health/guides/cervical-spine-anatomy. Accessed 21 april 2017.</ref><ref name="Gray">Gray H. Gray's Anatom ...re classic vertebrae, having a body, pedicles, laminae, spinous processes, and facet joints.

...uxation, spinal cord injury without radiological abnormality, and multiple thoracic compression fracture<ref name=":0">Basu S (2012) Spinal injuries in childre ...y. A Review By Organ System. Phy. Med. and Rehab Clinics, 2015; 26(1); 109-132.

...llow us to create individual, patient-centred goals and ultimately a tailor-made treatment plan based on the client's needs. ...AP Notes|SOAP]] format as a guide. Below we have a systematic flow for the assessment of the neurological patient.

...]] based on the course by [https://members.physio-pedia.com/instructor/nick-rainey// Nick Rainey]<br> '''Top Contributors''' - {{Special:Contributors/{{ ...it is beneficial to develop standard practice protocols. Following evidence-based protocols means that you reduce the chance of a poor outcome. You shou

...natomical region of the neck with or without radiation to the head, trunk, and upper limbs". ...t of patients with neck pain: a review of definitions, selection criteria, and measurement tools; Journal of Chiropractic Medicine Jun 2010; 9(2): 49–59

...-type headache, cluster headache and other trigeminal autonomic cephalgias and what are categorized as other primary headaches. ...ther primary headaches are clinically heterogeneous. According to the (ICHD-III) the pathogenesis of other primary headaches is still poorly understood.

...] based on the course by [https://members.physio-pedia.com/course_tutor/ian-horsley/ Ian Horsley]<br>'''Top Contributors''' - {{Special:Contributors/{{F ...the differential diagnosis. An accurate diagnosis will enable us to manage and treat our patients more effectively.

...and can be described as an exaggerated anterior curvature of the thoracic spine that is associated with aging<ref name="Jang et al." /> ...racic spine is normal and present due to the shape of the vertebral bodies and intervertebral discs,

...rdination]] and [[balance]].A common problem for surfers is Surfer's neck (and [[Surfer's Back]]) ...ilitation program incorporating stretches, strengthening and co-ordination and postural training.

...ome testing is an essential part of [[Neurological Assessment|neurological examination]] when suspecting [[radiculopathy]]. Myotomes are much more complex to test ...ome|center|900x900px|Differentiation of somites into dermatome, sclerotome and myotome|thumb]]

...based on the course by [https://members.physio-pedia.com/course_tutor/shala-cunningham/ Shala Cunningham ]<br> ...s). It also introduces the Proposed Classification System for the Cervical Spine.

...NA®. 2019 Nov 3;1(1).</ref>{{#ev:youtube|WiRm0Fj8esw}}<ref>Drs. Viral Jain and James McCarthy. Neuromuscular scoliosis. Available from:https://www.youtube ...sis. Orthopaedics & Traumatology: Surgery & Research. 2013 Feb 1;99(1):S124-39.[https://www.sciencedirect.com/science/article/pii/S1877056812002745]</re

...Med. 2020 Sep 11:pnaa282.</ref> although CGH can also refer to the orbital and frontal regions.<ref>Kaplan A. Introduction to Cervicogenic Headache Course ...capula and Cervicogenic Headaches|upper trapezius]] and [https://www.physio-pedia.com/Anterior_Neck_and_Cervicogenic_Headaches sternocleidomastoid].

...fractures: an anatomical approach. Eur J Orthop Surg Traumatol 2008;18:189-195 [Level2]</ref> ...iorly from the body. The odontoid process lies anterior to the spinal cord and is used as the pivot for the rotation of the head. The C1 vertebra, carryin

...reased flexion of the hips, and a compensatory hyperlordosis in the lumbar spine. ...s maximus, gluteus medius and gluteus minimus. These muscles are inhibited and substituted by activation of the superficial muscles.

...spect of the popliteal fossa, it branches medially to the [[Tibial Nerve]] and laterally to the [[Common Peroneal Nerve]]. It is a mixed nerve.<ref>Giuff ...d from the ventral rami of the fourth lumbar to third sacral spinal nerves and is a continuation of the upper part of the [[Sacral Plexus|sacral plexus.]]

...ow joint. Physiotherapists have a functional knowledge of the complicated 3-joint elbow complex as well as its associated anatomy. They can apply this k ...ividualised to the specific problems and contributing factors found in the assessment.

...e disease in back pain? Physiotherapy Practice and Research. 2017;38(2): 73-77.</ref> ...ll.<ref name=":0" /><blockquote>"Our job as health professionals is to try and identify [serious pathologies] early." -- Laura Finucane</blockquote>

...'''- [[User:Kim Jackson|Kim Jackson]] as part of the [http://members.physio-pedia.com Physiopedia Plus] neck pain course. ...ank.org/country/trinidad-and-tobago?view=chart</nowiki>.</ref> limitations and difficulties of treating neck pain in the Caribbean.

...The most common swimming injury regions are the shoulder, neck, lower back and knee. ...ntion strategies in competitive swimmers]. Sports health. 2012 May;4(3):246-51. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435931/ (l

...s injuries of the clavicle and its articulation. JBJS. 1967 Jun 1;49(4):774-84.</ref> ...es between the manubrium and the disc and the second lies between the disc and the clavicle.

...based on the course by [https://members.physio-pedia.com/course_tutor/donna-fisher/ Donna Fisher]<br>'''Top Contributors''' - {{Special:Contributors/{{F ...ghtweight foams and thermoplastics are used, which facilitates new designs and more comfort for the user.

...ritis: Diagnosis and Treatment; ''Am Fam Physician.'' 2009 Sep 15;80(6):617-620</ref> * It is a clinical diagnosis and does not require specific diagnostic testing in the absence of concomitant

...class="editorbox"> '''Original Editor '''- [[User:Cindy John-Chu|Cindy John-Chu]] <br> ...sense on the same side from damage to the dorsal column and a loss of pain and temperature sensation (hemianaesthesia) contralateral to the lesion owing t

...e Case Reports of Dysfunction and Manual Therapy Guidelines for Assessment and Treatment of These Structures. Topics in Compan An Med; 29, 1: 1–5. </re ...annesburg, 2015 </ref> Together with the thoracic cage, the costovertebral and costotransverse joints provide stability.<ref name=":1" />

...es of low back pain]] have been ruled out, individuals are said to have non-specific (or simple or mechanical) back pain. ...he source of low back pain.] European Spine Journal. 2007 Oct 1;16(10):1539-50.</ref>

...itor '''-Lieveld Jean Yves,&nbsp;Mostafa Mataichi,&nbsp;Ismael El Habouchi and David Herteleer ...nes Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Associ

...[PTCU Excellence and Innovation Unit Project]]. This space was created by and for the students at Cairo University. Please do not edit unless you are inv ...ecific and radiological predictive factors for curve progression. European Spine Journal. 2021 Mar 26;30(7):1813–22.</ref>

...lininger|Chris Slininger]] as part of the [[Texas State University Evidence-based Practice Project]] ...ribes compression of the neurovascular structures as they exit through the thoracic outlet (cervicothoracobrachial region).

...slaghs|Fien Selderslaghs]], [[User:Mirabella Smolders|Mirabella Smolders]] and [[User:Wout Theys|Wout Theys]] [[File:Bianca-jordan-IPjWtxPJUQc-unsplash.jpg|right|frameless]]

...eferral pattern to the head, so it too should be considered when assessing and treating CGH.<ref name=":1">Kaplan A. Superior Scapula - Cervigenic Headach ...valuation and treatment strategies. Curr Pain Headache Rep. 2001; 5(4): 361-8.</ref>

...P, Goldsmith CH. Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol 1990;17:1022–4 Although various iterations exist, the most commonly used is the 11-item NPRS.<ref>Williamson A. Pain: a review of three commonly used pain rati

...Courtney Smith|Courtney Smith]] as part of the [[Temple University Evidence-Based Practice Project|Temple University EBP Project]] ...ent<ref name=":0" />. To do this there are three essential elements of the examination:

...ne the extent and nature of the relationship between thoracic manipulation and shoulder pain. ...Scale|visual analog pain scale]]), patient rating of overall improvement, and Quick [[DASH Outcome Measure|DASH]] measurement.

...it can also occur in the [[Thoracic Anatomy|thoracic]] and [[Lumbar|lumbar spine]].<ref name=":0">Seidenwurm, D. J., & Expert Panel on Neurologic Imaging. ( ...odegenerative Disease|neurodegenerative]], neoplastic vascular, idiopathic and nutritional disorders that result in myelopathy. These causes are much less

.../books/NBK499966/ (last accessed 20.4.2020)</ref> Image R severe case - pre-operative image of a 22 year old male with Scheuermann's Disease ...[https://search.proquest.com/openview/ff361ff1a9fb8c730bcf25b99dc8ffec/1?pq-origsite=gscholar&cbl=40235 Current concepts in Scheuermann's kyphosis]. Ort

...of Physical Therapy Musculoskeletal 1 Project]]. This space was created by and for the students at Arkansas Colleges of Health Education School in the Uni [[File:Indian-yogi-yogi-madhav-P SxnJhID1s-unsplash (1).jpg|right|frameless]]

==Shoulder Examination== ...an help guide decisions about the need for special tests or investigations and ongoing management.

...lishing. Available from:https://www.health.harvard.edu/pain/7-faces-of-neck-pain [accessed 4/3/2023]</ref> ...ce workers: a 1-year longitudinal study.] Eur Spine J. 2009 Oct;18(10):1532-40.</ref>

...The carotid arteries are the primary vessels supplying blood to the brain and face. ...EM, Waheed A. [https://www.ncbi.nlm.nih.gov/books/NBK545238/ Anatomy, Head and Neck, Carotid Arteries]. InStatPearls [Internet] 2019 Jul 22. StatPearls Pu

...er:Madison Sanders|Madison Sanders]], [[User:Shelby Morgan|Shelby Morgan]] and [[user:Keri Henderson|Keri Henderson]] as part of the [[Arkansas Colleges o ...ain]] is typically not reproducible with isometric movements. The clicking and popping, as well as pain usually decreases when crossing the arm across the

...mes Study<ref>Ware J. SF-36 Health Survey Update. Spine. 2000. 25; 24: 3130-3139.<section> ...(SF-36). I. Conceptual Framework and Item Selection. Medical Care, 30, 473-483. </ref>:

...[https://members.physio-pedia.com/course_tutor/tanya-bell-jenje/ Tanya Bell-Jenje]<br> ...ll of these conditions must be considered when assessing patients who have thoracic pain.

...of Physical Therapy Musculoskeletal 1 Project]]. This space was created by and for the students at Arkansas Colleges of Health Education School in the Uni ...The Ober’s test must not be confounded with [[Noble's test|Noble’s test]] and the [[Renne test|Renne test]], two other tests that are commonly used to de

...ert Bardinas|Robert Bardinas]]; as part of the [[Temple University Evidence-Based Practice Project]] ...the [[elbow]] and the [[Wrist and Hand|wrist]]<ref>Jan Michael C. Lleva, Ke-Vin Chang.Ulnar Neuropathy. Available from: [https://www.ncbi.nlm.nih.gov/bo

...LLIF and ALIF, ''3''(1), 2–18. <nowiki>https://doi.org/10.3978/j.issn.2414-469X.2015.10.05</nowiki></ref>. ...l graft) within the intervertebral space after discectomy<ref name=":1" /> and successful union of two or more [[Lumbar Vertebrae|vertebra]]<ref name=":0"

[[File:Scoliosis-01.jpg|thumb|scoliosis clinical presentation|alt=scoliosis clinical presenta Scoliosis is an abnormal lateral curvature of the spine. It is most often diagnosed in childhood or early adolescence.

...elissa Osti|Melissa Osti]] as part of the [[Texas State University Evidence-based Practice Project]] [[File:T9-T10 change fracture from MVA.png|thumb|348x348px|T9-T10 chance fracture from MVA]]

.../1868602 Failed back surgery syndrome. Pain medicine]. 2011 Apr 1;12(4):577-606.</ref> ...yndrome]. Journal of clinical pharmacy and therapeutics. 2011 Aug;36(4):525-8.</ref>.

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished w ...97-306.</ref> Dysfunction in one can lead to a dysfunction in the other (co-dependency).

...based on the course by [https://members.physio-pedia.com/course_tutor/sasha-chelin/ Sasha Chelin] ...ing: functional assessment, ROM, palpation, special tests and neurological examination.

[[File:3d-medical-image-with-female-holding-neck-pain.jpg|right|frameless]] ...also be defined based on its duration (acute, subacute, [https://www.physio-pedia.com/Chronic_Neck_Pain chronic]) or reason for onset.

...''glenohumeral rhythm''') is the kinematic interaction between the scapula and the humerus, first published by Codman in the 1930s. <ref name="p4">Codman [[File:Scapulohumeral rhythm-1-.png|thumb|274x274px|

...refore, important to consider the role of the anterior neck when assessing and treating patients with CGH. ...n on the role of the upper cervical spine, please click [https://www.physio-pedia.com/The_Upper_Cervical_Spine_and_Cervicogenic_Headaches here].

...and rehabilitation. The syndrome encompasses various anatomical structures and can present with diverse clinical manifestations. ...scalene, costoclavicular, and subcoracoid spaces. Anatomical abnormalities and acquired conditions contribute to the compression of these structures, lead