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47 Cards in this Set
- Front
- Back
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Scoliosis
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An abnormal lateral curvature of the spine in the coronal plane. Scoliosis (rotoscoliosis) is an abnormal sidebending accompanied by rotation.
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Type I mechanics:
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Describes multiple vertebral units. Sidebending to one side will be accompanied by rotation to the opposite side.
NSxRy |
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A scoliotic curve is always named for the direction of the _____.
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CONVEXITY
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Double Major Scoliosis
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Most common type. An apex in both thoracic & lumbar spine.
“S”-shaped curve |
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Single Scoliosis
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An apex in the thoracic OR lumbar spine
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Junctional Scoliosis
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Uncommon. An apex at either the cervicothoracic (C7-T1) or thoracolumbar (T12 -L1) junction.
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What type of scoliosis is this?
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double major
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What type of scoliosis is this?
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right thoracic
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What type of scoliosis is this?
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left lumbar
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What type of scoliosis is this?
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right thoracolumbar
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Idiopathic scoliosis
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70-90% of scoliotic curves are in this category. Adolescent idiopathic scoliosis (10-18 years old) is the most common. Diagnosis of exclusion. Unknown cause
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1 in every ___ children develop scoliosis by the age of 10-15 years.1 in every ___ children present with clinical symptoms related to their curvatures.
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20, 200
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Are boys or girls more likely to have scoliotic symptoms progress and produce symptoms?
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girls, 3-5 times more likely
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Acquired scoliosis
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-Response to inflammation or irradiation
-Osteomalacia -Sciatic irritability -Psoas syndrome -Healed leg fracture -Hip or knee prosthesis |
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Which curves have higher risk for progression, thoracic or lumbar?
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thoracic
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_____ sign (ossification of iliac crest on x-ray) determines bone maturity.
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Risser
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Functional Scoliosis
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Flexible, and potentially reversible. Reducible with sidebending to the opposite side. May progress into a structural scoliosis.
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Structural Scoliosis
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Relatively fixed and inflexible.
Non-reducible with sidebending to the opposite side or lift therapy. |
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_____ syndrome is the most common cause of Type I group curve mechanics.
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Short Leg Syndrome
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In a static postural exam, levelness should be observed for: (6 items)
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1. Popliteal creases
2. Greater trochanters 3. Iliac crests 4. Scapular inferior angles 5. Acromion processes 6. Mastoid processes |
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Adam's Test
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"hump" becomes apparent w/ forward flexion; vertebral rotation carries ribs w/ rotation.
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What type of scoliosis does this patient have?
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right scoliosis
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Which side is the convexity on?
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right side convexity; scoliosis named for CONVEXITY!
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To which side is the patient sidebent and rotated?
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sidebent Left, rotated Right
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Adam's Test: If Pt has a rib hump present w/ flexion, direct the Pt to...
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bend to the side of fullness while flexed.
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Adam's Test: If Pt has a rib hump present w/ flexion that diminishes or disappears w/ Pt sidebent toward convexity, it is a _____ scoliosis.
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functional; structural scoliotic curves do not reduce with with sidebending towards convexity.
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When are X-rays appropriate in scoliosis screening?
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-Static postural exam abnormality
-Adams test confirms structural scoliosis -OMT not entirely successful -Congenital abnormality suspected -Monitor progress of postural treatment regimen |
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Which side is closest to film, anterior or posterior?
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posterior; Erect AP postural radiograph
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Cobb Angle
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Erect AP postural radiograph used to measure severity:
-Line across top of superior vertebra -Line across bottom of inferior vertebra -Perpendicular lines off both lines -Angle of intersection is the Cobb angle |
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Mild Scoliosis
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5-15 ̊
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Moderate Scoliosis
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20-45 ̊
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Severe Scoliosis
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>50 ̊
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Impaired Respiratory Function
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>50 ̊
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Impaired Cardiovascular Function
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>75 ̊
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Lumbosacral Angle (LSA) / Ferguson's Angle
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Angle between line from sacral base to line parallel to the ground
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A lumbosacral angle >40 degrees may result in:
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-Increased lumbar lordosis and extension (sway back)
-Shearing forces on intervertebral discs |
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A lumbosacral angle <30 degrees may result in:
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-Decreased lumbar lordosis (flat back)
-Compressive forces on articular facets |
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When is MRI indicated?
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If you suspect an underlying neurological disorder (ie: focal neurological deficit on clinical neurological exam) as the etiology of the scoliosis, MRI imaging of the brain is indicated.
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Arnold-Chiari Malformation
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brain stem settling into the neck and its associated syrinx (spinal fluid cyst)
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Schroth exercise:
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-Physiotherapeutic rehabilitation popular in Europe
-Also focuses on rotational breathing exercises and integration of exercise in daily life |
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Schroth breathing pattern:
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What is the initial and increase heel lift protocols for a Flexible Pt?
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intial: 1/8" lift; increase every 2 weeks NO MORE than 1/16"
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What is the initial and increase heel lift protocols for a Fragile Pt? (aged, arthritis, osteoporosis, acute pain)
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initial: 1/16" lift; increase every 2 weeks NO MORE than 1/16"
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What is the initial and increase heel lift protocols for an Injured Pt? (Where leg length was suddenly shortened)
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initial: Full amount; no increase protocol indicated
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Thicker heel lifts may need to be applied to the _____ of the shoe in some cases.
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outside
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Moderate-Severe scoliosis Tx:
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-Moderate: same as Mild plus consider bracing
-Severe: same as Moderate plus consider surgery if visceral compromise or rapidly progressive curve despite conservative management |
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Harrington Rod
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utilizes Axial loading; accompanied by bone grafts
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