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Patho 3 (Path 312) > Kyphoscoliosis (Mod 1) > Flashcards

Kyphoscoliosis (Mod 1) Flashcards

1
Q

Definition of Kyphoscoliosis

A

Combo of Scoliosis and Kyphosis

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2
Q

Scoliosis

A

S or C shaped curvature

  • Structural (actual deformity) v.s Nonstructural (postural deformity)
  • Severity of lung function varies
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3
Q

Define Kyphosis

A

Posterior curvature of the spine (hunchback)

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4
Q

What is the difference between Structural and nonstructural Scoliosis?

A
  • Structural = A congenital disorder
  • nonstructural scoliosis = postural and can be corrected…not an actual deformity
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5
Q

Etiology of Scoliosis

A
  1. Congenital
  2. Neuromuscular
  3. most commonly Idiopathic (infantile, juvenile, adolescent) Growth can progress/develop scoliosis as you get older
  4. Postural
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6
Q

Etiology of Kyphosis

A
  1. Degenerative diseases of the spine (arthritis)
  2. Fractures caused by oseteoporosis
  3. Slipping of vertebrae forward on another
  4. Other disorders (polio, spina, bifida)
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7
Q

Risk Factors for Kyphoscoliosis

A
  • Gender;females more likely than males
  • Genetics
  • Age; younger age = greater risk of progression; working with gravity it will progress
  • Angle of the Curve -> Greater initial curve = greater risk of progression
  • Location; Upper spine = greater risk of progression
  • Height; taller people= greater risk of progression
  • Spinal problems at birth
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8
Q

What are Anatomical alterations bc of Kyphoscoliosis?

A

Restrictive Lung Pathology Lungs are literally being squished

  • Alveolar Hypoventilation
  • Atelectasis
  • Weak cough leading to secretions
  • Spirometry- All volumes decreased, RV/TLC ration remains normal
  • ABG’s; Acute alveolar hyperventilation with hypoxemia or Chronic Ventilatory failure with hypoxemia
  • Mediastinal shift
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9
Q

Diagnosis of Kyphoscoliosis

A
  • Appearance and physical examination
  • Spinal x-ray which identifies by examining curve measurement; specifically identifies the Cobb Angle
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10
Q

How will Kyphosis physically appear and what problems can be expected ?

A

Uneven shoulder height, prominence of scapula, uneven waste height, elevated hips, balance problems, pain (in the knees)

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11
Q

Sections of the spine?

A
  1. C7
  2. L12
  3. T5
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12
Q

General Management and Treatment for Kyphoscoliosis?

A

Management depends on cause, degree, and location of the curve, and timing of growth

  • Observation (Cobb angle < 20), postural
  • Bracing (25-45 deg)
  • Surgery (Cobb angle >40-50 deg)
  • Objective is to prevent worsening of the curve during growth
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13
Q

What is the primary treatment for idiopathic scoliosis?

A

Bracing (soft or hard shell)

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14
Q

What does surgery for scoliosis involve?

A

Instrumentation and fusion

  • using the cortex duboisset technique
  • Harrington rod method was used before infusions
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15
Q

Respiratory care treatment for patients with kyphoscoliosis

A
  1. Oxygen Therapy- Home oxygen, HHHFO (acute)
  2. Airway Clearance-Physical therapy, MIE, Manually
    Assisted Cough, Bronchoscopy
  3. Lung Expansion- MLVRM, LVRM
  4. Pneumonia- increased risk with lower lung volumes
  5. Pain management
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16
Q

Associated issues with Infantile Scoliosis

A

Shows up in infancy

  • severe under 2 needing surgery and when they’re growing up rapidly, wee see curvatures really quickly
17
Q

Optimal period to target therapies for Scoliosis?

A

Juvenile growth period to prevent curve from getting worst.

  • Back braces would be the route since the patient is actively still growing
18
Q

Why is adolescent Scoliosis more difficult to manage than juvenille?

A

Stabilized and quit growing.

  • as you progress into adulthood some cases get worse as you age, most don’t bust sometimes it progresses
19
Q

Postural Scoliosis therapies?

A

Physio can either fix or improve it

20
Q

How severe is postural Scoliosis?

A

Never severe, its usually a mild curve that may not be noticed

21
Q

Why is height a risk factor for Scoliosis?

A

Growing longer = more opportunity for the spine to curve

22
Q

Is a upper spine or lower spine curve a higher risk for Scoliosis?

A

Upper spine/thoracic region = greater risk of progression

23
Q

Which gender is at higher risk of developing Scoliosis?

A

Females: but male cases usually present as more severe though.

24
Q

What organs would be affected by Scoliosis

A

The lungs and bowel could be squished by curves with Scoliosis.

  • the spine can rotate as well when you get the “chicken wing” on your shoulder
  • aka mediastinal shift on cxr
25
Q

How could Scoliosis cause atelectasis?

A

From physical force of the curve

  • A weak cough leads to secretion build up.
  • A buildup leads to pneumonia and plugging leading to atelectasis
26
Q

Why are RV and TLC with Scoliosis patients worse when tested with a spirometer?

A

RV and TLC are normal because the ratio is decreased uniformly

  • The volumes as a whole are diminished
27
Q

When should spirometry be tested for Scoliosis patients?

A

Done before the patient goes for stabilization operation once a a person get to spinal surgery their lung volumes will remain the same as before the surgery they don’t get better

  • Just preventing it from getting worst
28
Q

What is the Cobb angle?

A

A measurement used diagnose Scoliosis or Kyphoscoliosis

29
Q

When is surgery considered for Scoliosis?

A

If the Cobb angle >40-50 degrees

30
Q

When is bracing considered for Scoliosis?

A

If the Cobb angle is 25-45 degrees

31
Q

If the cobb angle is < 20 degrees, what steps should be taken?

A

Just watch and observe. it could be postural.

32
Q

Why is home O2 helpful for Scoliosis patients?

A

Home O2 because of chronic atelectasis and low lung volumes

  • usually associated with another disorder
33
Q

What risk is usually associated with lower lung volumes and Scoliosis?

A

Pneumonia

34
Q

What pathology is associated with Kyphosis

A

Polio

35
Q
A

Patho 3 (Path 312) (10 decks)

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