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Prosthetics and Orthotics (Spring 2017) > Orthotic Considerations for the Spine > Flashcards

Orthotic Considerations for the Spine Flashcards

1
Q

what does SIO stand for, and what does it encompass

A

Sacroiliac Orthosis - encompass the sacral and iliac regions of the lower spine and pelvis

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2
Q

what does LSO stand for, and what does it encompass

A

Lumbosacral Orthosis - encompass the lumbar and sacral regions of the lower spine

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3
Q

what does TLSO stand for, and what does it encompass

A

Thoracolumbosacral Orthosis - encompass the cervical, thoracic, lumbar, and sacral regions of the spine

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4
Q

what does CO stand for, and what does it encompass

A

Cervical Orthosis - encompass the cervical spine

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5
Q

what does CTO stand for, and what does it encompass

A

Cervicothoracic Orthosis - encompass the cervical and thoracic region

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6
Q

what does HCTO stand for, and what does it encompass

A

Head-Cervical-Thoracic Orthosis - encompass the head, cervical, and thoracic region

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7
Q

Custom or Stock:

Ordered according to measurements taken of patient and is presized (S, M, L, XL)

A

stock

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8
Q

Custom or Stock:

This mechanism is likely to increase probability of appropriate fit and function

A

Custom

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9
Q

Custom or Stock:

Patient is casted or measured followed by orthotic fabrication to meet the exact dimensions of the cast

A

Custom

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10
Q

Custom or Stock:

More difficult to obtain proper fit due to body morphology and size of anatomic landmarks

A

Stock

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11
Q

what are the three major functions of spinal orthoses

A
  1. Immobilize gross spinal motions (limit the trunk in all degrees of freedom)
  2. Immobilize individual motion segments (reduce range of motion of an intervertebral segment)
  3. Apply external forces to correct deformity or prevent progression of a deformity
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12
Q

Thee indications for spinal orthoses

A
  1. Immobilize gross spinal motions (limit the trunk in all degrees of freedom)
  2. Immobilize individual motion segments (reduce range of motion of an intervertebral segement)
  3. Apply external forces to correct deformity or prevent progression of a deformity
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13
Q

Three indications for spinal orthoses in the category of:

Immobilize gross spinal motions (limit the trunk in all degrees of freedom)

A
  1. muscle strain, ligament sprain
  2. whiplash soft tissue injury
  3. NM based trunk weakness
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14
Q

Two indications for spinal orthoses in the category of:

Immobilize individual motion segments (reduce range of motion of an intervertebral segment)

A
  1. Spondyloslisthesis

2. s/p Spinal fusion

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15
Q

Two indications for spinal orthoses in the category of:

Apply external forces to correct deformity or prevent progression of a deformity

A
  1. Idiopathic scoliosis

2. Scheuermann’s Disease

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16
Q

for patients with spondyloslisthesis, what is the orthosis trying to do

A

keep them out of extension and bring them into flexion

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17
Q

Similar to the principles applied to other body regions, motion in spinal orthoses is controlled utilizing either __ or ___.

A

using 3 point or 4 point pressure systems

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18
Q

in general, where does the primary force originate when trying to correct a scoliosis

A

at the convex side projecting into concavity

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19
Q

spinal curves are named according to the…

A

convexity

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20
Q

3 point system controlling R lower thoracic curve (general)

A

Primary: Originating at the convexity on the R side, projecting medially

Secondary: above and below the convexity on the concave side (at the trimlines)

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21
Q

is the control of rotation at the spine and control of rotation at the hip the same?

A

no, it is significantly different

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22
Q

why is controlling rotation in the spine and at the hp significantly different

A

osteokinematics

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23
Q

rotation in the spine will be controlled through…

A

a four point pressure system

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24
Q

why is a four point pressure system necessary to control rotation in the spine

A

it is necessary to manage the counter-rotation present between upper and lower trunk utilized in a variery of functional activities

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25
Q

controlling R rotation, what is the general 4 point system

A

Trunk:

  1. Posterior Right
  2. Anterior Left

Pelvis:

  1. Anterior Right
  2. Posterior Left
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26
Q

Indications for Cervical Orthoses (COs)

A

soft tissue injuries primarily due to trauma in which c-spine stability is not affected

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27
Q

what is the most mobile segment of the spine due to design

A

the cervical spine (7 vertebrae and surrounding soft tissue)

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28
Q

three types of COs

A
  1. flexible
  2. semi-rigid
  3. rigid
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29
Q

does the soft foam collar control motion? why or why not

A

no - no bars and no bands

30
Q

purpose of the soft foam collar

A

reminds the patient to limit motion of the neck

31
Q

does the soft foam collar provide stability

A

very little control of the cervical spine

32
Q

what type of general CO is a Philadelphia Collar

A

semi-rigid

33
Q

describe the outside of Philadelphia collar’s appearance

A

outer plastic/semi-rigid frame

34
Q

describe the inside of Philadelphia collar’s appearance

A

inner soft pad or closed cell foam shell

35
Q

why is the Philadelphia collar considered semirigid

A

rigid bars, no bands

36
Q

CTOs are considered ______ COs

A

rigid

37
Q

why is there increased control in CTOs

A

increased control due to materials and increased stability from the orthotic because the design extends down to the thoracic spine

38
Q

indications of CTOs

A
  • ligamentous injuries of cervical spine
  • stable cervical spine fractures
  • s/p cervical spine fusion/stabilization
39
Q

in the two post design for rigid cervical orthoses, where do the anterior and posterior sections attach

A

anterior: mandibular portion
posterior: occipital portion

40
Q

what is a key feature of the two post design in rigid cervical orthoses

A

shoulder straps

41
Q

what does SOMI stand for relative to CTOs

A

Sterno-Occiplital-Mandibular Immobilizer

42
Q

what type of post design in CTO

A

three point design

43
Q

what type of patients use CTOs

A

patients with poor head control

44
Q

what type of orthosis is a Halo Orthosis

A

CTO

45
Q

indications for Halo Orthosis:

A

injury to C-Spine resulting in instability (fractures)

46
Q

Halo Orthoses are an alternative to…

A

traction

47
Q

how long are Halo Orthoses used for

A

immobilization for 6-12 weeks until fracture is healed/stable

48
Q

what special consideration for care must be taken into consideration for halo orthoses

A

clean the pin sites where the halo goes into the skull

49
Q

Three indications for Thoracic, Lumbar, and Sacral Orthoses

A
  1. increase intra-abdominal pressure
  2. intervertebral stabilization/support (segmental immobilization)
  3. global limitation of motion
50
Q

a corset is a _______ orthosis

A

semi-rigid

51
Q

what is a corset typically made of

A

canvas or dacron material, reinforced with vertical “stays”

52
Q

on the corset, vertical “stays” are similar to

A

bars

53
Q

what can the stays of a corset be made of

A

plastic or metal (with varying degrees of stability)

54
Q

what parts of the spine can corset encompass

A
  • sacral
  • lumbosacral
  • thoracolumbar sacral
55
Q

a rigid spinal orthosis will have both ____ and ____ present

A

bars and bands

56
Q

what must a rigid spinal orthosis be composed of

A

solid material such as metal or rigid plastic

57
Q

what is the cause of an idiopathic scoliosis

A

no known cause

58
Q

three types of scoliosis

A
  1. idiopathic
  2. neuropathic
  3. myopathic
59
Q

to find the degree of present scoliosis, what method is commonly used

A

the Cobb method

60
Q

describe the initial setup of using the Cobb method

A

choose the most tilted vertebrae above and below the apex of the curve

61
Q

after the most tilted vertebrae has been found, then what (Cobb angle)

A

the angle between intersecting lines drawn perpendicular to the top of the top vertebrae and the bottom of the bottom vertebrae is the Cobb angle

62
Q

what Cobb angle indicates surgery

A

greater than 40 degrees

63
Q

are three point pressure systems utilized to control motion in the spine

A

yes

64
Q

what is one of the earliest and most effective designs for idiopathic scoliosis

A

Milwaukee Orthosis

65
Q

three indications for Milwaukee Orthosis

A
  1. scoliosis curves between 25-40 degrees
  2. children who are not yet skeletally mature
  3. apex of curve is at T8 or above
66
Q

what design also adresses the problem of scoliosis, but is more appropriate for curves with an apex below T8

A

Boston TLSO

67
Q

the Boston TLSO is higher on the same/opposite side of the convexity

A

higher on the opposite side of convexity

68
Q

what does the Charleston Orthosis do

A

provides overcorrection of the curve in the opposite direction

69
Q

what does the Charleston Orthosis attempt to control/correct

A

a scoliotic curve

70
Q

what shaped curve is the Charleson Orthosis most appropriate to correct

A

C shaped

71
Q

the Charleston Orthosis is known as…

A

An Overcorrection Orthosis

Prosthetics and Orthotics (Spring 2017) (14 decks)

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