Phys Med #3 Flashcards
Define Postural Dysfunction/syndrome
a condition that is usually due to poor posture, where normal spine curvature can become excessive and thus increase gravitational stress and cause undue wear and tear on joints. This causes pain in the lumbar and cervical regions.
ddx of postural dysfuntion/sydrome
- headache (cluster, migraine, tension)
- spinal deformaties (structural)
- neoplastic, traumatic
- osteochondrodystrophies (a disease of bone and cartilage)
what are the types of postural dysfunction?
lordosis (increased/absent)
kyphosis (increased/absent)
what are the 2 main types of excessive lordosis?
pathological lordosis and sway back
what is the pelvic angle of the pathological lordosis?
increased pelvic angle to 40 degrees (normal is 30)
what is tight and weak for pathological lordosis?
tight hip flexors and weak abdominal muscles
explain sway back?
pelvic in neutral or posterior tilt and increase in kyphosis at lumothoracic junction
- pelvic shifts anteriorly
what are the types of excessive/decreased kyphosis?
- Sheuermann’s disease
- humpback (Gibbus deformity)
- flat back
- Dowager’s hump
- Congential kyphosis
what is flat back?
pathological reduction in the normal kyphosis
what is sheuermann’s disease?
- usually occurs in adolescence
- vertebrae are wedge shape instead of cylindrical causing kyphosis
- usually between T10-L2
- inflammation of the bone and cartilage occurs around the ring epiphysis of the vertebral body
what is humpback?
usually a sharp angulation of the spine at a single vertebral level
what is dowager’s hump?
- often in older patients
- caused by osteoporosis
- thoracic vertebral bodies degenerate and wedge anteriorly
what is congenital kyphosis?
- curvature present at birth
vertebral bodes are triangular and often fuse anteriorly
what are the special tests for postural dysfunction/syndrome?
no special tests, simple observation/history of posture
what is rib subluxation/slipping rib syndrome?
when abnormal movement of a rib, usually a false rib, occurs due to an unstable cartilaginous attachment. This can cause impingement of an intercostal nerve
rib subluxation/slipping rib syndrome can also be known as:
- clicking rib
- displaced rib
- painful rib syndrome
what is scoliosis?
a lateral curvature of the spine within the vertebral column
- described according to the side of the CONVEXITY
how is scoliosis labelled as?
labelled as C-curves (1 curve) or S-curve (2 curves)
for scoliosis, primary curvature is…
where the vertebrae become misaligned
for scoliosis, secondary curvature is…
where above and below the curve tries to compensate to maintain normal head and pelvis position
what is structural curves?
fixed due to bony changes resulting in asymmetric side bending
what is functional curves
not fixed and mainly due to posture/muscle imbalances resulting in symmetric side bending
can be corrected with voluntary effort
what is a special test for scoliosis?
adam’s sign (test)
explain adam’s sign
when bending makes curve more obvious = structural
when bending makes curve go away = functional
list out the different degrees of Cobb Angle
- <25 degrees, observe only
- > 25 defrees, bracing (many types) also controversial
- > 45 degrees, surgical correction (rods or spinal fusion)
what is thoracic outlet syndrome?
a collection of syndromes that cause compression of the neurovascular bundle
- brachial plexus
- C8 and T1 nerve roots
- subclavian artery
where can the brachial plexus and its accompanying artery be compressed at for thoracic outlet syndrome?
between the anterior and middle scalenes
between the coracoid process and pec minor
between the clavicle and the first rib
what are the vascular symptoms of thoracic outlet syndrome?
- swelling and puffiness in the arm/hand
- bluish discolouration of the hand
- feeling of heaviness in the arm/hand
- pulsating lump over the clavicle
- deep, boring toothache-like pain in the neck and shoulder region, that increases at night
- superficial vein distention in the hand
what are the neurological symptoms of thoracic outlet syndrome?
- paresthesia along the inside forearm and palm
- muscle weakness and atrophy of gripping muscles and small muscles of the hand
- difficulty with fine motor tasks of the hand
- cramps of the muscles of the inner forearm
- pain in the arm and hand
- tingling and numbness in the neck, shoulder region, arm, and hand
what is compression fracture?
a fracture or break in bone that is due to compressive forces
what are the causes of compression fracture?
- osteoporosis
- compression type injury
- tumours
what is vertebral subluxation?
the alteration of the normal dynamic, anatomic, or physiologic relationships of contiguous (touching) articular structures. A motion segment in which alignment, movement integrity, or physiologic function is altered, although the contact between the joint surfaces remains intact