Observations & signes cliniques thoraciques supérieurs


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Le rachis thoracique supérieur est à la confluence des souffrances cervicales, cervico-brachiales et scapulaires. Il est le passage obligé et préalable des traitements destinés aux membres supérieurs et aux cous sensibles. 

Cliniquement, il peut être considéré comme la poursuite thoracique du rachis cervical inférieur jusqu’en T4 : lorsqu’on demande à un sujet vu de dos de poser une oreille sur l’épaule homolatérale ou de tourner la tête à droite ou à gauche, la courbe dessinée par la ligne de ses épineuses ne s’arrête pas en C7 et doit être harmonieuse jusqu’en T4. 

Ainsi, les concepts cliniques de gains de mobilité allant vers la convergence ou la divergence articulaires sont similaires à ceux développés dans la région cervicale inférieure : 

  • La somme des convergences réalisant une extension et une convergence articulaire droite se fait en extension / inclinaison latérale droite / rotation droite, 
  • La somme des divergences réalisant une flexion et la divergence articulaire droite se fait en flexion / inclinaison latérale gauche / rotation gauche.

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