Pathology, Psych & Tools

Question 1

what Kendall posture has the highest level of pain and where?

Answer 1

flat back posture shows the most pain in the lumbar spine

Question 2

scoliosis

Answer 2

• see a C-shaped or S-shaped curvature and rotation
• where the lateral flexion deviation is, the rotation will be towards the other side
• Cobb angle > 10°
• critical threshold: 30-50°

Question 3

ribs and vertebrae characteristics for scoliosis

Answer 3

• spinous process deviated to concave side - tells us about rotation (which will be opposite)
• on convex side, rib is pushed posteriorly
• on concave side, rib is pushed laterally and anteriorly

Question 4

test for scoliosis

Answer 4

Adam’s forward bend test

• subject stands in front of tester with back to them, bends forward to flex each segment of the spine
• will see offset (often in thoracic spine) from rotation where ribs are pushed back, etc

Question 5

categories of scoliosis

Answer 5

congenital
neuromuscular
idiopathic

Question 6

congenital scoliosis

Answer 6

a result of malformation of vertebrae

Question 7

neuromuscular scoliosis

Answer 7

spinal muscular insufficiency/atrophy

• can result from other disease conditions (cerebral palsy, spina bifida, muscular dystrophy) or spinal cord injury
• seen least frequently, usually born with it

Question 8

idiopathic scoliosis pathology

Answer 8

can be structural (fixed) or functional (flexible)

• the most common type of scoliosis, cause unknown
• structural = some bony adaptation that progressively makes it harder to correct (need surgery)
• functional = caused by muscular adaptations; if you lie a person on a table, their scoliosis will “disappear”
• condition could start flexible and become fixed

Question 9

development of structural scoliosis

Answer 9

can be from:
- failure of vertebral formation - vertebrae are incompletely developed - can have fused hemi-vertebra or just hemi-vertebra

or

• failure of vertebral segmentation - multiple sites of fusion where normally would be segmented - can have block vertebra, bars where TPs fused together

Question 10

idiopathic scoliosis populations
categories?
gender ratio?
genetic or sporadic?

Answer 10

- IJA categories:
I - infantile < age 4. a small portion
J - juvenile age 4-10
A - adolescent ages 11+. largest group
- gender ratio 2:1 females to males
- genetic connection (97% of people with scoliosis have a blood relative with some scoliotic curve)

Question 11

ankylosing spondylitis

Answer 11

• primary problem is a chronic inflammatory condition
• then it progresses and results in severe spinal flexion deformity
• begins at sacroiliac joint early-mid adulthood and we see progressive stiffening/fusion of the vertebrae going up the spine

Question 12

how does vertebral fusion look in ankylosing spondylitis

Answer 12

• starts with inflammation of joints
• result is bamboo spine: bodies of vertebrae begin fusing together starting on the anterior and posterior edges, closing in on the disc

Question 13

Scheuermann’s disease
who’s the affected population?
what happens to cause this?

Answer 13

• shows up in adolescents and progresses into adulthood
• usually affects those who are taller than average
• osteochondrosis from T7-T10: impairment of blood supply to this vertebral region, causes them to fail on the anterior side and bone collapses on the ant leading to flexion deformity

Question 14

Parkinson’s disease

what are the postural adaptations?

Answer 14

a neurological condition
3 common postural adaptations:
- camptocormia
- pisa syndrome
- antecollis

Question 15

camptocormia

Answer 15

an overall flexed posture approaching 45° that looks like the person is looking down

Question 16

pisa syndrome

Answer 16

a posture that looks like some lateral flexion/person is leaning

Question 17

antecollis

Answer 17

aka dropped neck

• chin drops to chest because of a hypertonic cervical flexor group (overactivation pulls chin to chest)
• ADLs greatly impaired by this - solution is to use botox to paralyze these muscles

Question 18

is kyphosis severity related to lung function?

Answer 18

FEV1 measured to asses lung function and kyphosis increase with age

• men don’t see much of an issue - their kyphoses don’t change as much as women’s with age
• women with larger kyphotic angles saw greater decline in lung function than women with more neutral posture (equivalent to smoking 15 cigarettes/day)

Question 19

self esteem and slumped vs upright posture

in healthy populations

Answer 19

• having upright posture helps maintain self esteem after a stress task
• slumped posture sees dramatic decrease in self esteem after stress task

Question 20

self esteem and slumped vs upright posture

in populations with mild/moderate depression

Answer 20

• those who had an upright posture had greater increase in positive affect, decreased fatigue after the test and used words that were less self-focused (self-focus often being a symptom of the disorder they have)

Question 21

how does personality relate to posture?

Answer 21

• most extroverts have a neutral posture

- most introverts have a swayback posture

Question 22

does bracing help with posture?

Answer 22

harness like braces around the shoulders, limit motion

• muscles aren’t developing to fix the problem but could keep condition from worsening
• not aesthetically pleasing

Question 23

does taping help with posture?

Answer 23

research shows no negatives, but no strong support in favour of it either

Question 24

wearable tech for posture?

Answer 24

ex. opterlife
computer chips you wear that beep when you’re out a particular posture
- expensive but more discrete