S3_L2: Spinal & Pediatric Orthoses Flashcards
Where is location of the superior border of sacroiliac corset?
At the anterior and posterior sides of the iliac crest
Where is location of the inferior border of sacroiliac corset?
At the pubic symphysis and gluteal bulge
Where is location of the anterior superior border of the lumbosacral corset?
At the xiphoid process
Where is location of the posterior superior border of the lumbosacral corset?
At the inferior angle of the scapulae
Where is location of the anterior superior border of the thoracolumbar corset?
At the xiphoid process
Where is location of the posterior superior border of the thoracolumbar corset?
At the level of the scapular spines
(Midscapula)
Where is location of the pelvic band of rigid spinal orthoses?
At the level of greater trochanters, above the inferior edge of the sacrum below
the PSIS
Where is location of the superior border of the thoracic band of rigid spinal orthoses?
At the level of T9-T10 or below the inferior angle of the scapula
TRUE OR FALSE: The spinal orthosis is donned while the pt is in supine
True
What is the thoracolumbosacral orthosis for scoliosis with a double curve or S curve?
Boston orthosis
What does CASH stand for?
Cruciform Anterior
Spinal Hyperextension
It is a TLSO given to pts with severe osteoporosis or kyphosis
Jewett Brace / Anterior Hyperextension / Thoracolumbosacral Orthosis Flexion Control
What rigid spinal orthosis component restricts lateral movements and spans from the edges of the thoracic and pelvic bands?
Lateral uprights
What rigid spinal orthosis component is obliquely placed on the thoracic and pelvic bands and serves to restrict rotational movements?
Oblique Lateral Uprights
The interscapular band crosses what landmark?
the distal 3rd of the scapula
What is the flexible spinal orthosis that provides sensory feedback
for proper posture and supports the trunk through increasing
intra-abdominal pressure?
Lumbar binder
Determine whether a flexible or rigid orthosis is described
- Made of cloth or bendable materials
- Restricts trunk motion
- Elevates intraabdominal pressure
- For sensory feedback, does not restrict movement entirely
- May modify spinal alignment
A. Flexible spinal orthosis
B. Rigid spinal orthosis
C. Both
- A
- B
- C
- A
- B
TRUE OR FALSE: Biofeedback can provide postural correction
True
TRUE OR FALSE: Bracing increases the intraabdominal
pressure for pneumatic support.
True
TRUE OR FALSE: Flexible spinal orthoses help strengthen the abdominal muscles that could help the patient’s
case through proper stabilization of
spine. In this way, it provides spinal stability.
True
Determine whether a sacroiliac belt or corset is described.
- Can be used for posttraumatic stabilization of pelvic joints
- At the level of the sacrum only between iliac crest and trochanters
- Its primary function is to approximate the pubis symphysis & SI joint
- Can be used for post-partum
- Can be used during the latter part of pregnancy
- Can be used for posttraumatic sacroiliac separations
A. Sacroiliac belt
B. Sacroiliac corset
C. Both
- B
- A
- B
- C
- A
- A
The lumbar binder is wrapped around the lumbar region and held in place by what type of closure?
Velcro closure
It is the most common flexible orthosis for pts with LBP
Lumbosacral corset
TRUE OR FALSE: The lumbosacral corset may limit flexion, extension, lateral flexion but not rotation
True
Strings at the side of a corset acts as a pillar which restrict what movements?
Lateral movements
A rigid structure located posteriorly would restrict (1)__, while if located anteriorly, it would restrict (2)___.
- extension
- flexion
TRUE OR FALSE: The thoracolumbar corset provides trunk stabilization and may limit flexion, extension, lateral flexion, and rotation.
True
Straps that wind around the shoulder and axillary area provides support on the thoracic spine and limits what movement?
Rotational movements
The cowhorns curve around the (1)__, end just below the clavicle and (2)__ to the deltopectoral groove
- pectoralis major
- lateral
Cowhorn is also known as
Anterior Extensions of Thoracic Band with Subclavicular Pads
Where is location of the superior border of the lumbosacral posterior uprights?
Inferior angle
Where is location of the superior border of the thoracolumbosacral posterior uprights?
Scapular spine
Where is location of the inferior border of the lumbosacral and thoracolumbosacral posterior uprights?
Inferior edge of pelvic band
TRUE OR FALSE: Posterior uprights should be placed along the paraspinal muscles, avoiding the bony prominences.
True
What rigid spinal orthosis component holds the posterior uprights together to maintain alignment and limit friction during scapular motions?
Interscapular band
It is also the attachment of the axillary straps
The boston orthosis is used for mid-thoracic or lower
scoliosis curves of what degree?
Less than or equal to 40º
TRUE OR FALSE: Boston orthosis is commonly prescribed for pts with scoliosis. It can also be used to treat spondylolisthesis and conditions of
severe trunk weakness (i.e. muscular dystrophy).
True
The boston orthosis is for pts with scoliosis at the level (1)__ or higher, while the wilmington orthosis is for severe scoliosis at the level of (2)__.
- T6
- T10-T12
TRUE OR FALSE: The Wilmington orthosis has posterior uprights, straps, and pads. It is a cervicothoracolumbosacral orthosis.
True
TRUE OR FALSE: In scoliosis orthoses, the pads and straps are used to apply pressure to areas
of convexity of spinal curves.
True
Additional: The pad is placed on the apex of the curve for a lateral push
The Milwaukee orthosis is used for __ curves and scoliotic curves of ≤ 40º.
Kyphotic
Lumbosacral Orthoses
- Flexion-extension control
- Flexion-extension-lateral flexion control
- Extension-lateral flexion control
- Has an abdominal support which is smaller with
minimal straps
A. Chairback orthosis
B. Knight Orthosis
C. William’s Orthosis
- A
- B
- C
- C
Thoracolumbosacral orthosis
- Flexion-extension control
- Flexion-extension-lateral flexion control
- Flexion-lateral flexion-rotation control
- All motions are greatly limited except for extension & lateral flexion in the thoracic area
- Commonly seen in elderly women in the clinics
A. Taylor
B. Knight-Taylor
C. Cowhorn
- A
- B
- C
- C
- B
Determine whether the soft or rigid collar is described
- Greatly limit flex
- Slightly limits flex
- Does not decrease the
loading on the axial spine - Slightly limits Ext, lat flex, rot
- Does not limit Ext, lat flex, rot
A. Soft collar
B. Rigid collar
C. Both
- B
- A
- C
- B
- A
Thoracolumbosacral orthosis
- For severe
destabilization of the spine (e.g. fx, MVA) - Recommended for those with more stable spine through MD referral
- Maximum
immobilization and stabilization of TLS spine - Flexion control
- May cause discomfort as it pushes sternum
backwards to inc pressure on thoracic spine
A. Jewett / Anterior Hyperextension
B. Cash
C. Plastic Body Jacket
- C
- B
- C
- A
- A
Cervical Thoracic Orthosis: Custom Orthosis
- The primary method for conservative fracture stabilization
- Given for acute injuries and adjunct to internal fixation for cervical fx & dislocations
- Has holes that extend to the back of the head and straps that extends to the level of the chest
- It is the most restricted custom molded orthosis
- Has a forehead band and is given to pts with high cervical cord injuries
- Restricts flex, ext, lat flex, rot
A. Custom Molded-Halo Orthosis
B. Custom Molded-Minerva Orthosis
C. Custom Molded-Cuirass Orthosis
D. All of the above
- A
- A
- C
- A
- B
- D
Cervical orthoses
- May or may not have chin component
- Flexion-extension control
- Degree of limitation of flexion depends on components used
- Restricts motion of mandible and occiput
- Used for soft-tissue injury such as neck sprainor arthritic changes
A. Basic Collar
B. Philadelphia Collar
- B
- A
- B
- B
- A
Cervical orthoses
- Used primarily for eating
- Flexion-Extension-Lateral flexion-Rotation control
- Has no anterior uprights
- Has a mandibular support
- Flexion & extension is greatly limited as compared with lat rotation.
A. Sternal Occipital Mandibular Immobilizer
B. FER Control - Variation
C. Post Appliance / Four Poster
- B
- C
- B
- A
- C
Cervical Orthosis
- Has posterior uprights
- It has lateral uprights that hold the occipital piece
- Without mandibular support to allow for functional movement of the jaw
A. Sternal Occipital Mandibular Immobilizer
B. FER Control - Variation
C. Post Appliance / Four Poster
- C
- A
- B
TRUE OR FALSE: The longer the upright, the more it will decrease the axial load as it tends to lift the entire head.
True
TRUE OR FALSE: If the sole goal is abdominal compression, a corset will suffice.
True
Source: O’Sullivan 7th ed p.1303
TRUE OR FALSE: Motion limitation in rigid orthoses is accomplished by a series of three-point pressure systems, in which force in
one direction is bracketed by two counteracting forces in the opposite direction.
True
Source: O’Sullivan 7th ed p.1303
TRUE OR FALSE: Lumbosacral orthoses limit trunk motion, which may alleviate low back pain
True
Source: O’Sullivan 7th ed p.1304
TRUE OR FALSE: Lumbosacral orthoses do not
appear to cause muscle weakness.
True
Source: O’Sullivan 7th ed p.1304
TRUE OR FALSE: The principal effect of orthoses may be that these act as proprioceptive reminders to the wearer to limit motion.
True
Source: O’Sullivan 7th ed p.1304
TRUE OR FALSE: The Philadelphia collar has mandibular and occipital extensions and
a rigid anterior strut.
True
Source: O’Sullivan 7th ed p.1304
TRUE OR FALSE: A post orthosis is used for moderate control of the cervical spine
True
Source: O’Sullivan 7th ed p.1304
TRUE OR FALSE: Most scoliosis orthoses are intended to be worn for 18-23 hours per day for several years until the patient reaches skeletal maturity
True
Source: O’Sullivan 7th ed p.1305
TRUE OR FALSE: The openings of the scoliosis orthoses are over the concavities of the curves, while interior pads apply the corrective forces
True
Source: O’Sullivan 7th ed p.1306
TRUE OR FALSE: Scoliosis brace effectiveness depends on skeletal immaturity, trunk flexibility, curve less than 35°, snug contact of
the orthosis with the torso and compliance with the wearing protocol
True
Source: O’Sullivan 7th ed p.1306
Determine which pediatric orthosis is being described
- Indicated for children with myelodysplasia
- Standing and walking are permitted on this orthosis
- It positions the individual in standing with a desk for those who have difficulty standing up
A. Standing frame
B. Swivel walker
C. Parapodium
- C
- B
- A
Determine which pediatric orthosis is being described
- The child is permitted to swing the leg backward and forward
- It can be considered as a combination of a standing frame and swivel walker
- It can be used for both children and adults.
- Allows knee flexion, thereby permitting the individual to sit
A. Standing frame
B. Swivel walker
C. Parapodium
- B
- C
- A
- C
