Dr. Ebraheim’s educational animated video describes neurological examination of the thoracic spinal nerve roots.
Logical examination of the spinal cord and nerve roots the thoracic spine neurological evaluation of individual nerve roots 12 vertebrae in the thoracic region the spinal canal in the thoracic region is relatively small the spinal cord could be easily injured in this area pain in the thoracic region can occur due to thoracic discarnation or different types of etiology
Such as cardiovascular retroperitoneal new plastic or thoracic spine conditions the point of consideration is the thoracic disc herniation in general herniated thoracic discs can be found in about 40% of asymptomatic people it usually who cares during the fifth decade of life it appeared more in the lower thoracic region with 75% of all classic discarnation or
Care between t8 and t12 and the most common level involved is t 11 t12 what are the findings in thoracic disc herniation the patient can get radiculopathy due to irritation of the thoracic nerve roots and compression of the spinal cord can easily occur due to small thrusted spinal canal and division can get myelopathy so you may find radiculopathy and you may
Find myelopathy or both exile back pain or chest pain is a common finding the axial pain usually involves the mid to lower thoracic region the radicular pain usually starts in the back and reds and clearly like a band to the interior chest wall the pain runs along to the course of the intercostal nerve and goes and tilly towards the ribs myelopathy can occur
The patient can have gait disturbance leg weakness bladder and bowel dysfunction good examination you may find upper motor neuron findings such as clonise hyperreflexia and positive babinski sign and the patient may have white based gate during emulation the patient will have normal reflexes in the upper extremities and the hyperreflexia in the lower extremities
If you find the hyperreflexia of the opera’ extremities then the patient has cervical spinal cord compression discrimination between t11 and t12 may affect the conus medullaris and this lesion may affect the blood of function the diagnosis of thoracic discrimination is usually difficult the diagnosis is usually confirmed by an mri the mris may have a high false
Positive rate so understudied asymptomatic individuals about 70% of these asymptomatic individuals have thoracic disc abnormalities and about 35% have disk herniation and about 30% of these patients have spinal cord compression despite these findings these people were asymptomatic and not complaining the treatment non-operative treatment is used in the majority of
Cases and it includes non destroy del anti-inflammatory medications and physiotherapy the majority of patients will improve with non-operative treatment surgery is indicated when the pain is severe are not responding to long periods of conservative treatment or when you have drastic disc herniation with malaba thei due to compression of the thoracic spinal cord
There is a debate between dissimilar nand discs removal combined with fusion posterior laminectomy and disc excision at the highest rate of neurological deficit slicing discs and nation are usually managed safely by an entire approach or posterolateral approach that will include costo transfers ectomy the entire approach is used for central disc herniation and
Because intercostal neuralgia the lateral or cos two transverse ectomy is used for lateral discrimination so let’s take disk herniation at different levels in the thoracic spine t1 and t2 disclination it will affect t1 nerve root and the sensation this is the area of sensation that is supplied by t1 nerve root it around the medial side of the elbow the mortar the
Interosseous muscles causing abduction and abduction of the fingers you can see the area of sensation of t2 nerve root as illustrated in this diagram t3 in the third intercostal space the nibble is t4 the xiphoid process is t7 damn belicus is t10 the groin is t12 all these are great landmarks in evaluating the sensory changes of the thoracic nerve roots and it
May help you in defining the level of injury of the patient thank you very much i hope that was helpful you
Transcribed from video
Neurological Evaluation Of The Thoracic Nerves – Everything You Need To Know – Dr. Nabil Ebraheim By nabil ebraheim
