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Disease 3 > Kyphoscoliosis > Flashcards

Kyphoscoliosis Flashcards

1
Q

Define scoliosis

A

A lateral curvature of the spine in a C or S shape with associated rotation of the spinal column

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2
Q

What are the three etiologies for scoliosis?

A

Congenital
Neuromuscular
Idiopathic

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3
Q

Describe congenital scoliosis

A

Problem in the the formation of the spine or with fusing of the ribs during fetal development produces scoliosis

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3
Q

If you are looking at someone, what are postural presentations that suggest they have scoliosis?

A

Uneven shoulder height
Prominent shoulder blades
Uneven waist height
Elevated hips
One sided lean

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3
Q

Describe neuromuscular scoliosis

A

When a neuromuscular condition creates muscle weakness, poor muscle control, or paralysis, scoliosis can develop

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4
Q

What are examples of conditions that can cause neuromuscular scoliosis?

A

Cerebral palsy
Muscular dystrophy
Spina bifida
Poliomyelitis

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5
Q

What age range accounts for most cases of idiopathic scoliosis?

A

Adolescent
> 10 years old

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6
Q

What are the risk factors that impact the development of scoliosis

A

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

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7
Q

What is the threshold for diagnosing scoliosis?

A

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

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8
Q

What can cause non-structural scoliosis?

A

Poor posture
Leg length disparity
Pain

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8
Q

Describe non-structural scoliosis

A

curve that develops side to side as a C or S shaped curve
Results from a cause other than the spine itself

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9
Q

Describe structural scoliosis

A

A curve associated with vertebral rotation involving the twisting of the spine that appears in three dimensions

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10
Q

What is the cobb angle?

A

The degree of lateral curvature that is calculated from a radiograph

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10
Q

What cobb angle is associated with poor outcomes?

A

Greater than 50 degrees

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11
Q

What cobb angle is associated with compromised pulmonary function?

A

Greater than 70 degrees

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11
Q

What can a cobb angle of greater than 70 degrees cause?

A

Shortness of breath
Compromised cough
Impaired airway clearance

12
Q

What is the definition of kyphosis?

A

Excessive forward curvature of the thoracic spine

13
Q

What is different about the epidemiology of kyphosis vs scoliosis?

A

Scoliosis is not associated with aging
Kyphosis is more prevalent in older people than younger people

14
Q

Describe the etiology of kyphosis

A

Degenerative diseases of the spine such as arthritis or disc degeneration
Fractures cause by osteoporosis
Slipping of one vertebra forward on another

15
Q

What is spondylolisthesis?

A

The slipping of one vertebra forward on another

16
Q

What disorders are associated with kyphosis?

A

Endocrine diseases
Connective tissue disorders
Infections = tuberculosis
Muscular dystrophy
Neurofibromatosis

17
Q

What pathological impacts does kyphoscoliosis have on a patient?

A

Lung restriction and compression resulting from thoracic deformity
Mucus accumulation throughout the tracheobronchial tree
Atelectasis

17
Q

What might you find in a physical exam of a patient with kyphoscoliosis?

A

Increased HR, RR, BP
Cyanosis
Digital clubbing
Peripheral edema and venous distention
Cough and sputum production

18
Q

What is kyphoscoliosis?

A

Combines elements of scoliosis and kyphosis
C or S shaped lateral curves of scoliosis with the forward curvature of kyphosis

19
Q

What might you find when performing a chest assessment on a patient with kyphoscoliosis?

A

Obvious thoracic deformity
Tracheal shift
Increased tactile and vocal fremitus
Cyanosis

20
Q

What kind of heart failure might you see in a patient with kyphoscoliosis?

A

Right heart failure
Increase PVR due to chest wall deformity

20
Q

How would the blood gas of a patient with severe kyphoscoliosis present?

A

Partial or fully compensated respiratory acidosis
Uncompensated respiratory acidosis

21
Q

What would the chest xray of a patient with kyphoscoliosis look like?

A

Thoracic deformity
Mediastinal shift
Increased lung opacity
Atelectasis
Enlarged heart

22
Q

What are the main treatment options for kyphoscoliosis?

A

Braces
Surgery

22
Q

When is surgery generally performed on patients with kyphoscoliosis?

A

Usually recommended for curvatures of the spine greater than 40-50 degrees
Performed to correct unacceptable deformity and prevent further curvature

23
Q

What should RTs know about surgery on patients with kyphoscoliosis?

A

That in most case it does not improve ventilatory function

24
Q

What is the most wild performed surgery for scoliosis?

A

Spinal fusion

25
Q

What is the responsibility of the RT in caring for patients with scoliosis/kyphosis/kyphoscoliosis?

A

Oxygen therapy
Bronchopulmonary hygiene
Lung expansion therapy

Disease 3 (9 decks)

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