Teaching Strategies: Critical Thinking Questions

TEACHING STRATEGIES: CRITICAL THINKING QUESTIONS Chapter 11 Cervical and Thoracic Spinal Conditions

1. A football player comes off the field shaking his left arm. Following the history and observation components of an assessment, a burner or injury to the brachial plexus. 1A. Assess sensory and motor function for this injury.

1B. Sensory and motor function are normal. Perform and explain the brachial plexus traction test.

1C. What factors will determine the athlete’s readiness for return to play?

2. An adolescent swimmer, who specializes in the butterfly stroke, complains of localized pain and tenderness in the midback region. The pain developed gradually and only hurts during execution of the stroke. 2A. Explain and demonstrate palpation and testing using the HOPS procedure.

2B. What condition(s) might be suspected for this athlete in the area of the thoracic spine? TEACHING STRATEGIES: CRITICAL THINKING QUESTIONS Chapter 11 Cervical and Thoracic Spine Conditions

1. A football player comes off the field shaking his left arm. Following the history and observation components of an assessment, a burner or injury to the brachial plexus. 1A. Assess sensory and motor function for this injury. Sensory and motor assessment should be performed bilaterally for nerve roots C5–T1. Motor assessment includes: shoulder abduction, elbow flexion and extension, thumb extension, and finger abduction and adduction.

1B. Sensory and motor function are normal. Perform and explain the brachial plexus traction test. The brachial plexus test is performed by passively flexing the athlete’s neck to one side while applying downward pressure on the opposite shoulder. Pain that increases or radiates into the arm (being depressed) indicates brachial plexus injury.

1C. What factors will determine the athlete’s readiness for return to play? Before the athlete can return to participation, full strength, range of motion, and restoration must be restored in the involved extremity.

2. An adolescent swimmer, who specializes in the butterfly stroke, complains of localized pain and tenderness in the midback region. The pain developed gradually and only hurts during execution of the stroke. 2A. Explain and demonstrate palpation and testing using the HOPS procedure. The following structures should be palpated:  thoracic spinous processes  intervertebral ligaments  intervertebral muscles  latissimus dorsi Functional testing should include AROM and RROM:  trunk flexion and extension  trunk lateral flexion  trunk rotation  shoulder flexion, extension, abduction, adduction, horizontal abduction, horizontal adduction, and rotation Testing should also include movements of the butterfly stroke.

2B. What condition(s) might be suspected for this athlete in the area of the thoracic spine? Given the athlete’s age and the activity, the individual may have Scheuermann’s disease.