Kyphoscoliosis Flashcards
Define scoliosis
A lateral curvature of the spine in a C or S shape with associated rotation of the spinal column
What are the three etiologies for scoliosis?
Congenital
Neuromuscular
Idiopathic
Describe congenital scoliosis
Problem in the the formation of the spine or with fusing of the ribs during fetal development produces scoliosis
If you are looking at someone, what are postural presentations that suggest they have scoliosis?
Uneven shoulder height
Prominent shoulder blades
Uneven waist height
Elevated hips
One sided lean
Describe neuromuscular scoliosis
When a neuromuscular condition creates muscle weakness, poor muscle control, or paralysis, scoliosis can develop
What are examples of conditions that can cause neuromuscular scoliosis?
Cerebral palsy
Muscular dystrophy
Spina bifida
Poliomyelitis
What age range accounts for most cases of idiopathic scoliosis?
Adolescent
> 10 years old
What are the risk factors that impact the development of scoliosis
Gender ( girls more than boys)
Age (younger onset = greater curve progression)
Angle of curve ( greater curvature, the greater the chance it will get worse)
Location ( more prominent in middle or lower spine)
Height (taller people have an increased chance of curve progression)
Spinal problems at birth
What is the threshold for diagnosing scoliosis?
Scoliosis can be defined as a curve of greater than 10 degrees that appears when a patient bends from an upright position toward the ground
What can cause non-structural scoliosis?
Poor posture
Leg length disparity
Pain
Describe non-structural scoliosis
curve that develops side to side as a C or S shaped curve
Results from a cause other than the spine itself
Describe structural scoliosis
A curve associated with vertebral rotation involving the twisting of the spine that appears in three dimensions
What is the cobb angle?
The degree of lateral curvature that is calculated from a radiograph
What cobb angle is associated with poor outcomes?
Greater than 50 degrees
What cobb angle is associated with compromised pulmonary function?
Greater than 70 degrees
What can a cobb angle of greater than 70 degrees cause?
Shortness of breath
Compromised cough
Impaired airway clearance
What is the definition of kyphosis?
Excessive forward curvature of the thoracic spine
What is different about the epidemiology of kyphosis vs scoliosis?
Scoliosis is not associated with aging
Kyphosis is more prevalent in older people than younger people
Describe the etiology of kyphosis
Degenerative diseases of the spine such as arthritis or disc degeneration
Fractures cause by osteoporosis
Slipping of one vertebra forward on another
What is spondylolisthesis?
The slipping of one vertebra forward on another
What disorders are associated with kyphosis?
Endocrine diseases
Connective tissue disorders
Infections = tuberculosis
Muscular dystrophy
Neurofibromatosis
What pathological impacts does kyphoscoliosis have on a patient?
Lung restriction and compression resulting from thoracic deformity
Mucus accumulation throughout the tracheobronchial tree
Atelectasis
What might you find in a physical exam of a patient with kyphoscoliosis?
Increased HR, RR, BP
Cyanosis
Digital clubbing
Peripheral edema and venous distention
Cough and sputum production
What is kyphoscoliosis?
Combines elements of scoliosis and kyphosis
C or S shaped lateral curves of scoliosis with the forward curvature of kyphosis
What might you find when performing a chest assessment on a patient with kyphoscoliosis?
Obvious thoracic deformity
Tracheal shift
Increased tactile and vocal fremitus
Cyanosis
What kind of heart failure might you see in a patient with kyphoscoliosis?
Right heart failure
Increase PVR due to chest wall deformity
How would the blood gas of a patient with severe kyphoscoliosis present?
Partial or fully compensated respiratory acidosis
Uncompensated respiratory acidosis
What would the chest xray of a patient with kyphoscoliosis look like?
Thoracic deformity
Mediastinal shift
Increased lung opacity
Atelectasis
Enlarged heart
What are the main treatment options for kyphoscoliosis?
Braces
Surgery
When is surgery generally performed on patients with kyphoscoliosis?
Usually recommended for curvatures of the spine greater than 40-50 degrees
Performed to correct unacceptable deformity and prevent further curvature
What should RTs know about surgery on patients with kyphoscoliosis?
That in most case it does not improve ventilatory function
What is the most wild performed surgery for scoliosis?
Spinal fusion
What is the responsibility of the RT in caring for patients with scoliosis/kyphosis/kyphoscoliosis?
Oxygen therapy
Bronchopulmonary hygiene
Lung expansion therapy
