Exam Two - PPT2 Flashcards
Lumbar Gravity Line is creates by locating the center of _____ and dropping a line.
L3 body
If the Lumbar Gravitational Line passes 1 cm in front of the tip of the sacrum to 1 cm posterior to tip of the sacrum, it is __________
Normal
If the Lumbar Gravitational Line falls forward of the sacrum, there is ________ _______ _________
Anterior weight bearing (discs)
If the Lumbar Gravitational Line falls behind, the lumbar spine has _________ __________ ___________.
Posterior weight bearing (Facets)
Predental space should be up to _______ in adults
3mm
Predental Space should be up to _______ in children
5mm
Increased distance of Predental Space may indicate…
Fracture of odontoid to transverse ligament injury
Atlas Dens Interval (ADI)
AKA
Predental Space
Cervical Gravitational Line is created by locating the center of the tip of the __________ __________, then dropping it.
Odontoid Process
Cervical Gravitational Line is normal if the line goes through ___________
Any part of the body of C-7 vertebra
Risser Sign AKA
Iliac Epiphysis Sign
Apophysis Sign
Risser Sign checks for what?
Bone maturity (maturation)
Crest of Ilium begins maturing at the age of ______
About 16
Crest of the ilium maturation is complete in _____ years
Average 2 years
7months - 3.5 years
The whiter the part on the on the X-ray, the thicker or denser the structure is refered to as __________
Radiopague
The darker the part on the object, the less dense it is and is known as ___________
Radiolucent
The 5 densities seen on X-rays
1) ______ -blackish
2) ______-Dark gray
3) _____ light gray
4) _____Whitish
5) _____ bright white
1) Air
2) fat
3) water
4) bone
5) metal
The long upright pyramid is AKA _________, which extends from the tip of the odontoid process of C-2 to the inferior aspect of the vertebral body of L-5
1st general pyramid
The short inverted pyramid AKA _____ extends from the base of the sacrum to the tip of the coccyx
2nd general pyramid
Inside the first general pyramid there are ______ smaller pyramids
Three
What are the three smaller pyramids that are inside the first general pyramid?
Upright pyramid- at tip of odontoid process to the bottom of T-1
Inverted pyramid- bottom of T-1 to the bottom of L-5
Upright pyramid- bottom of T-5 to the bottom of L-5
Together there are _____ total pyramids. _____ General and the ______ smaller ones
5; 2; 3
A _____ is a normal anterior to posterior bending of the spinal column
Curve
The foot may ______ or ______. This will affect the knees, hips and spine
Pronate (turn out) or Supinate (turn in)
What are the two types of curves in the spine?
Anterior and posterior curves
_______ curve that apexes or has the convexity toward the anterior (concavity toward the back)
Anterior curve
________ curve that apexes or has the convexity toward the posterior (concavity faces front)
Posterior curve
Anterior curves are AKA _________ curves
Posterior curves are AKA _________ curves
Lordotic curves (cervical and lumbar) Kyphotic curves (Thoracic, sacral, coccyx)
At birth, the body has _____ curve
1 posterior C-shaped primary curve
How do the secondary curves develop in the child?
Secondary curves develop as the child begins to move its body against gravity
When does the cervical curve (first secondary curve) begin to develop?
3-4 days
When is the child able to hold its head upright because the cervical curve is basically developed?
3-4 months
What are the two sagittal plane curves?
Primary curves
Secondary curves
At birth, 1 C-shaped primary posterior curve is present from the _____ to the ______
Head to the coccyx
What what age doe the lumbar curve begin and when is it fully formed?
Begins at 6-9 months
Formed by 10-18 months
The first lordotic/ secondary curve is the cervical curve that extends from ______ to ________
Tip of the odontoid process of C-2 to the base of T-2
What is the normal disc space on an x-ray at the disc space?
35-45 degrees
If the curve is less than 35 degrees in the =cervical spine, it is called
Hypolordotic
If the cervical curve is more than45 degrees then it is considered
Hyperlordotic
The second secondary curve is the ______ curve and that does it extend from?
Lumbar curve
It extends from the base of T-12 to the base of the last lumbar
What is the normal curve considered to be when measures from top of L-1 tot he top of the sacrum?
50 and 60 degrees
When unable to see S-1 use L-1 to L-5. What is the degrees for a normal lumbar curve when measuring from L-1 to L-5
35-45 degrees
Between the ages of _____ and ______ the lumbar vertebrae grow 2 times faster than the rest of the spine
2 and 16
The thoracic curve is a ______ curve and part of the original ______ curve
Kyphotic; primary
What is the length of the thoracic curve?
It extends between T2 and T12 vertebral segments and apexes at the disc space between T 6 and T7 motor unit
The normal kyphotic curve is between _____ and ____ degrees with an average of _______
20 and 40; 30
What should you see when looking form behind the patient or from the side?
Concavity, convexity, concavity, convexity
What are curvatures?
Adaptive bendings of the spine
Curvatures involve how many segments?
3 or more segments
What are the curvatures?
Kyphosis, lordosis and scoliosis
What is a kyphosis (hunchback)?
An exaggerated thoracic curvature
What is a lordosis (swayback)?
An exaggerated lumbar curvature
Define kyphosis
Abnormally increased convexity in the curvature of the thoracic spine as viewed from the side
What is anklyosing spondylitis?
Progressive spinal flexion deformities (may progress to a chin-on chin deformity
Lateral curvature of the spine of greater than 10 degrees is known as _______
Scoliosis
What is idiopathic scoliosis?
A lateral deviation and rotation of the spine without an identifiable cause
what does scoliosis mean?
Curvature
What type of X-ray can identify if the patient has scoliosis?
A-P X ray
Scoliosis is named for the direction that the curvature _________
Convexes (apexes)
If the scoliosis convexes to the left then is is referred to ________
If the scoliosis convexes to the right then it is referred to as _______
Levoscoliosis
Dextroscoliosis
What is rotatory scoliosis?
Most scoliosis curvature have an element of rotation in them known as rotatory scoliosis
When naming scoliosis what are the steps?
1) name the area that the scoliosis is located in (cervical, thoracic, lumbar, etc)
2) name the side of the curvature (dextro or Levi)
3) add rotatory if there is some rotation
The medial profession begins to call a lateral curvature scoliosis at _______ degrees
10
The curvature usually begins in the ________ then proceeds _____ the spine at various stages
Lower back; up
What are the 3 major classifications of scoliosis?
Structural
Nonstructural
Transient structural
What is the most common form of scoliosis and affects 70% of all patients who have scoliosis?
Idiopathic scoliosis
What does idiopathic mean?
Unknown cause
Non structural scoliosis is called ___________ scoliosis
Physiological scoliosis (functional)
Structural scoliosis is called _________ scoliosis
Pathological
How can you tell the difference bwteeen physiological scoliosis and pathological scoliosis
Adams sign
Most idiopathic scoliosis were due to decrease in what?
Foundation support (subluxation)
What are the two ways X rays for scoliosis are measured by?
COBBs angle or Riser-Ferguson measurement
Explain the Cobb method of angle measurement
1) identify the upper and lower end vertebrae
2) draw lines extending along the vertebral borders
3) Measure Cobb Angle directly or geometrically
When do the epiphyseal plates fuse?
Between ages 16-20
In scoliosis, the muscle contracture is on the side of the ________ and the weak muscles are on the side of the ________ resembling a bow
Concavity
Convexity
What are the 3 types of idiopathic scoliosis?
Infantile, juvenile, and adolescent
In idiopathic scoliosis:
-infantile begins ________
Juvenile begins _______
Adolescent begins ______
Before age 3
Begins between ages of 3 and 10
Begins after the age of 10 to maturity
With _____ curves there are more frequent CNS problems
Left
** LEFT IS NOT RIGHT
______ to _____ year olds grow the fastest and scoliosis gets worse
12-16
Are males or females more likely to have scoliosis?
Female
Do thinner or overweight people have more scoliosis?
Thinner
What a re the 3 body types?
Ectomorph: Tall. Thin (flower growth)
Endomorph: larger, thicker
Mesomorph: athletic build
A ______ brace used for non operative lumbar scoliosis management
Boston brace
What is the boston brace primarily used for?
Lower thoracic, thoracolumabr and lumbar curves
______ brace used for non operative treatment of thoracic and lumbar scoliosis
Lyon
What is the brace that is most commonly used for treatment of kyphotic conditions?
Milwaukee brace
What is the primary goal of the Milwaukee brace?
To stop progression of scoliosis
What is bone age?
Bone age = physiological age = age of maturity of the body
What is te chronological age in scoliosis?
14-15
How does one measure anterior or posterior slippage?
Georges line
The Risser sign looks are the crest of the ilium to obeserve bone maturity. What are the 5 grades of the Risser sign?
Grade 1: put to 25% complete Grade2: 26-50% complete Grade 3- 51% to 75% Grade 4- 76 to 100% Grade 5- where fusion is completed and total cessation of growth
The prudential space should be no more than ____ mm in adults and _____ mm in children
3mm in adults and 5 mm in children
