chest deformities

What are the chest deformities

§ PIGEON CHEST (PECTUS CARINATUM):

§ FUNNEL CHEST (PECTUS EXCAVATUM):

§ BARREL CHEST:

What chest deformity is this

sternum projects forward and downward; increase A-P dimension

§ PIGEON CHEST (PECTUS CARINATUM):

What chest deformity is this

due to overgrowth of ribs, pushing sternum posteriorly; o A-P dimension of chest is decreased; heart may be displaced; causes depression of sternum on inspiration

§ FUNNEL CHEST (PECTUS EXCAVATUM):

What chest deformity is this

sternum projects forward and upward; A-P diameter increased; seen in pxs with emphysema

§ BARREL CHEST:

This is a primary cause of rib pain:

Ø Common form of inflammation of the costal cartilages in the costochondral or costosternal joint

Ø (-) chest swelling

Ø S/Sx: tenderness and sharp, aching chest pain aggravated by physical activity (e.g. deep breathing, coughing, sneezing)

COSTOCHONDRITIS

This is a primary cause of rib pain

Ø Less common form of painful inflammation within the costochondral joint

Ø (+) chest swelling (nodule) in the costochondral jt area

Ø S/Sx: chest pain and tenderness

TIETZE SYNDROME

WHAT CONDITION IS THIS

● “STRUMPELL-MARIEARTHRITIS/DISEASE”

● Belongs to a group of diseases called SERONEGATIVE SPONDLYOARTHROPATHIES

● Chronic inflammatory disorder of the axial skeleton affecting the SI joint and the spine

● Usually begins in the SI joint (sacrolitis) and lumbar spine then extends proximally along the vertebral column

● HALLMARK:BILATERALSACROILITIS

ANKYLOSINGSPONDYLITIS

What is the hallmark of ankylosing spondylitis

bilateral sacroilitis

What is this

Ossification of anterior spinal ligament and ankylosis of the apophyseal joint leading to complete fusion

BAMBOO SPINE:

What is this

Squaring of lumbar vertebrae’s anterior concavity Insidious onset of back pain and tenderness in SI joint persistent symptomsfor at least 3 months

○ SYNDESMOPHYTE FORMATION:

WHAT CONDITION IS THIS

It refers to the pain felt in the low back area; most common cause of sick leaves; work related musculoskeletal disorder

Low Back Pain

Classifications of Low Back Pain?

Viscerogenic

Vasculogenic

Psychogenic

Neurogenic

Spondylogenic

Mechanical (Postural) LBP

CLASSIFICATION OF LBP:

LBP due to disease of internal organs (kidneys, pancreas, or pelvic viscera)

1. Viscerogenic –

CLASSIFICATION OF LBP

due to obstruction of blood vessels

2. Vasculogenic –

CLASSIFICATION OF LBP

seen in hysterical patients (anxiety disorders) sxs created by the subconscious mind

3. Psychogenic –

CLASSIFICATION OF LBP

due to nerve root compression

4. Neurogenic –

CLASSIFICATION OF LBP

due to bony lesions

5. Spondylogenic –

CLASSIFICATION OF LBP

due to faulty posture; relieved by rest

6. Mechanical (Postural) LBP –

A type of mechanical (postural) LBP

pain is experienced at the lumbar area only

Ø Centralization –

A type of mechanical (postural) LBP

pain radiates down to the LE

Ø Peripheralization –

WHAT CONDITION IS THIS

Ø Aka slipped disc (x)

Ø DEFINITION: condition that affects IV discs of the vertebral spine

Ø MOI: heavy bending, twisting, or heavy lifting

Ø Snapping sensation in low back after lifting heavy weight object (30-45 yrs old more susceptible)

Ø Neurologic sxs due to nerve root compression – most common sequelae

Ø May also cause myelopathy and cauda equina syndrome (w/c may lead to bowel and bladder dysfunction as well as subtle anesthesia)

Ø S/SXS:

o Leg pain > back pain

o RADIATING pain (low back region) à SI region à below knee)

o Sharp shooting pain

o Dec lumbar lordosis

o Lateral shifting of the spine: if herniation is lateral to the nerve root, pt bend away; if herniation is medial to nerve root, bend towards that side

Disc Herniation

LEVEL OF DISC HERNIATION

• Most common:

between L5-S1 levels & L4-L5 levels

LEVEL OF DISC HERNIATION

• 2nd most common:

between L3-L4 & L2-L3

LEVEL OF DISC HERNIATION

• Most common direction of herniation:

posterolateral

Hallmark of Disc herniation

: straining (Valsalva), sneezing, or coughing

TYPE OF DISC PROTRUSION

disc bulges posteriorly without rupture of the annulus fibrosus (AF)

Ø DISC PROTRUSION:

TYPE OF DISC PROTRUSION

nucleus pulposus herniates through an incomplete defect in the AF

Ø DISC PROLAPSE:

TYPE OF DISC PROTRUSION

nucleus pulposus herniates past through a complete defect in the AF

Ø DISC EXTRUSION:

TYPE OF DISC PROTRUSION

nucleus pulposus herniates outside through the completely ruptured AF; (+) discal fragment

Ø DISC SEQUESTRATION: