1. Injuries and Evaluation Techniques for Thoracic Region

2. Pathology of Thoracic Region History and Palpation provide most information –Few pathologies have visible signs and symptoms –Thoracic vertebrae fractures are rare but can happen Err on the side of safety – refer to Physician

3. Thoracic Injuries Rib Contusions/Fractures –Lateral portions of 5 th -9 th ribs are most commonly fractured –MOI: Acute traumatic blow –Anterior/Posterior blow vs. Lateral blow Repetitive stresses/Muscle contractions –S/S: Point tenderness – maybe crepitus Breathing painful – holds chest in splinted position –Tests: Rib compression tests –Tx: All evaluated by physician Ice, pain meds, ace wrap or rib belt –Importance of protective equipment

4. Thoracic Injuries Sternum Fracture –Possible but rare. Referral to physician. Flail Chest –Four or more ribs fractured in two or more places Pain with breathing – portion doesn’t expand with inhalation. Exhalation makes the chest segment protrude

5. Thoracic Injuries Costochondral Injury –Potential separation/subluxation MOI: trauma or hyperflexion or hyperabduction of shoulder –Pain is anterior –“snap” or “pop” often heard –Breathing, coughing, sneezing, and movement = pain Costovertebral Injury –Potential separation/subluxation MOI: trauma or hyperflexion of trunk or neck motion –Pain is posterior –Breathing, coughing, sneezing, and movement = pain TX: –Ice to relax spasm –Manual therapy to reposition –Ace wrap to splint/REST

6. Solar Plexus Injury Blow to celiac (solar) plexus – “Got wind knocked out” –Trauma to the celiac plexus (solar plexus) a complex network of nerves located in the abdomen can cause the diaphragm to spasm –Produces transient paralysis “can’t breath” –Treatment: Short inspirations and long expirations –“Breath out hard”