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Orthopedics > Scoliosis > Flashcards

Scoliosis Flashcards

1
Q

Primary: located on the Thoracic & Sacral area aka____

A

KYPHOSIS

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2
Q

Secondary: located on the cervical & Lumbar area aka___

A

LORDOSIS

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3
Q

defined as a lateral curvature in the spine. It usually involves thoracic and lumbar regions.

A

Scoliosis

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4
Q

Scoliosis is the lateral curvature of the spine greater than or equal to ______, of unknown etiology

A

10° Cobb with rotation

Cobbs - coronal plane
rotation- transverse plane

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5
Q

What can be the result of Three-dimensional torsional deformity of spine and trunk

A

+Lateral curvature in the frontal plane
○ Axial rotation in the horizontal plane
○ Disturbance of the sagittal plane normal curvatures, kyphosis and lordosis, usually, but not always, reducing them in direction of a flat back

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6
Q

presenting from birth through age 21

0-2

A

Infantile scoliosis

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7
Q

presenting from age 3 through age 9+11

3-9

A

Juvenile scoliosis

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8
Q

presenting from age 10 through age 17+11

10-17

A

Adolescent scoliosis

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9
Q

presenting from age 18 & beyond

18+

A

Adult scoliosis

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10
Q

absence of idiopathic curvature associated with degenerative changes and collapse of sagittal and coronal balance;

A

de novo Scoliosis

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11
Q

more debilitating d/t bone development will also cause progression of abn curvature of spine)

A

de novo Scoliosis

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12
Q

most common form of scoliosis!

A

Adolescent idiopathic scoliosis (AIS)

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13
Q

spine deformity that is present before 10 years of age

A

Early Onset Scoliosis (EOS)

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14
Q

Cobb deg: up to 20

A

low

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15
Q

Cobb deg: Moderate

A

21-35

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16
Q

Cobb deg: 36-40

A

moderate to severe

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17
Q

Cobb deg: severe

A

41-50

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18
Q

Cobb deg: 51-55

A

severe to very severe

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19
Q

postural or functional scoliosis since there is no bony deformity!

A

Nonstructural

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20
Q

Not progressive and reversible type of scoliosis

A

Nonstructural

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21
Q

type of scoliosis which is Easily correctable once the cause is determined (treatment and rehab procedures can be done)

A

Nonstructural

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22
Q

type of scoliosis which is caused by muscle guarding or spasm from a painful stimuli in the back or neck, and habitual or asymmetrical postures, hysteria, nerve root irritation, inflammation, or compensation caused by leg length discrepancy or contracture (in the lumbar spine)

A

Nonstructural

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23
Q

type of scoliosis which shows segmental limitation, and side bending is usually symmetrical

A

Nonstructural

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24
Q

type of scoliosis which disappears on forward flexion

A

Nonstructural

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25
Q

type of scoliosis which usually found in the cervical, lumbar, or thoracolumbar area ○ can be changed with forward or side bending and with positional changes, such as lying supine, realignment of the pelvis by correction of a leg-length discrepancy, or with muscle contractions

A

Nonstructural

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26
Q

type of scoliosis which

A

Structural

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27
Q

type of scoliosis which

A

Structural

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28
Q

type of scoliosis which

A

Structural

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29
Q

type of scoliosis which

A

Structural

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30
Q

type of scoliosis which primarily involves bony deformity

A

Structural

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31
Q

type of scoliosis which often progressive and irreversible

A

Structural

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32
Q

type of scoliosis which is Genetic, idiopathic or congenital

A

Structural

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33
Q

type of scoliosis which is Structural change in bone & normal flexibility of spine is lost

A

Structural

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34
Q

type of scoliosis which is Rotation of the vertebral bodies is toward the convexity of the curve

A

Structural

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35
Q

type of scoliosis which caused by neuromuscular diseases or disorders (e.g., cerebral palsy, spinal cord injury, progressive neurological or muscular diseases), osteopathic disorders (e.g., hemivertebra, osteomalacia, rickets, fracture), and idiopathic disorders

A

Structural

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36
Q

type of scoliosis which is patient lacks normal flexibility, and side bending becomes asymmetrical

A

Structural

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37
Q

type of scoliosis which is curve does not disappear on forward flexion and a posterior rib hump is detected

A

Structural

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38
Q

type of scoliosis which is most commonly seen in the thoracic or thoracolumbar spine = ribs rotate with the vertebrae, so there is prominence of the ribs posteriorly on the side of the spinal convexity and prominence anteriorly on the side of the concavity.

A

Structural

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39
Q

type of scoliosis which is 75% to 85% of all cases of structural scoliosis

A

Idiopathic scoliosis

40
Q

type of scoliosis which vertebral bodies rotate into the convexity of the curve with the spinous processes going toward the concavity of the curve

A

Idiopathic scoliosis

41
Q

type of scoliosis which disc spaces are narrowed on the concave side and widened on the convex side

A

Idiopathic scoliosis

42
Q

pattern of scoliosis which deviation is in the right

A

DEXTRO scoliosis

43
Q

pattern of scoliosis which deviation is in the left

A

LEVO scoliosis

44
Q

MC scoliotic curve:

A

DEXTROTHORACIC Scoliosis (85-90% of AIS)

45
Q

result of double major curve type of scoliosis

A

C-curve or S-curve:

46
Q

largest abnormal curves in the spine and the first to development; readily observable

A

Major or primary curves

47
Q

considered to develop after major curve or compensation for major curve to maintain balance

A

Minor or secondary curves

48
Q

fixed rotational prominence on the convex side, which is best seen on forward flexion from the skyline view

A

Razorback Deformity

49
Q

Thoracic scoliosis results in a very poor cosmetic appearance or greater visual defect

A

Razorback Deformity

50
Q

Deformation of the ribs along with the spine

A

Razorback Deformity

51
Q

Vary from a mild rib hump to a severe rotation of the vertebrae

A

Razorback Deformity

52
Q

Based on the extent of development of secondary sexual characteristics that Determines the progression of the scoliosis

A

Tanner Staging

53
Q

Tanner stages Stage 1:

A

prepubertal

54
Q

Tanner stages Stage 2:

A

enlargement

55
Q

Tanner stages Stage 3:

A

further enlargement

56
Q

Tanner stages Stage 5:

A

Mature stage

57
Q

Critical Threshold in cobbs angle

A

30° to 50° Cobb’s angle

58
Q

what happens in critical threshold

A

Higher risk of health problems in adult life

Worst case scenario: compression and malposition of the organs within the rib cage = difficulty in breathing esp pag mas malaki yung Cobb’s angle since may compression of structures thus leading to dec rib expansion pag humihinga!

59
Q

Bone growth in the period of skeletal immaturity is retarded by mechanical compression on the growth plate and accelerated by growth plate tension.

A

Hueter Volkmann’s Law

60
Q

Postural Ax for scoliosis

A

Plumb line test

61
Q

what is Plumb line test

A

confirmatory test and para malaman yung severity (yung thread ididikit mo sa spine and since straight yung thread you will look for asymmetries of the spine);

62
Q

findings in plumb line test

A

Asymmetric shoulder level.

Rib hump/bump in structural scoliosis

Protrusion of hip on one side

Pelvic obliquity

Inc lumbar lordosis

Uneven waist crease.

63
Q

What is the normal pelvic angle:

A

30°.

64
Q

Radiographic eval: measures degree of angulation

A

Cobb’s Angle

65
Q

Radiographic eval: measures degree of rotation

A

Nash-Moe Grading

66
Q

Radiographic eval: skeletal maturity

A

Risser Staging

67
Q

Radiographic eval: a triad classification system that consists of curve type, lumbar spine modifier and sagittal thoracic modifier (orthopedic surgeons need to know this)

A

Lenke Classification

68
Q

What is the skin for scoliosis assessment?

A

+presence of café-au-lait spots
(neurofibromatosis);
+faun’s beard (spinal
dysraphism)

69
Q

To detect structural or functional scoliosis

A

ADAM’S FORWARD BENDING TEST

70
Q

● Ask the patient to bend forward and reach
for the toes and look for asymmetry!
● Ask the patient to flex forward at the hips
with the fingertips of both hands together
so that the arms drop vertically. The feet
should be together, and both knees should
be straight. Any alteration from this posture
will cause the spine to rotate, giving a false
view.

A

ADAM’S FORWARD BENDING TEST

71
Q

Upon forward bending if rib hump in adams forward bending test

A

○ (+) = STRUCTURAL

○ (-) = FUNCTIONAL

72
Q

What to note for adams forward bending test

A

○ asymmetry of the rib cage
○ asymmetry in the spinal
musculature
○ Presence of pathological kyphosis
○ Whether lumbar spine straightens or flexes as it normally should
○ Whether there is any restriction to forward bending, such as spondylolisthesis or tight hamstrings

73
Q

Test that is usually done c radiographic findings

A

LATERAL BENDING TEST

74
Q

The result of LATERAL BENDING TEST when it Does not disappear on lateral bending

A

structural scoliosis

75
Q

The result of LATERAL BENDING TEST when Cobb’s of 25° or more on ipsilateral side-bending
radiographic views

A

STRUCTURAL Scoliosis

76
Q

Objective measure of spinal curve & rotation

A

SCOLIOMETER

77
Q

degree of scoliosis where the risk of progression in
adulthood increases, as well as the risk of health
problems and reduction of quality of life.”

A

Over 30°

78
Q

degree of scoliosis where , there is a consensus that it is almost certain that scoliosis is going to progress in adulthood and cause health problems and reduction of quality of life.

A

Over 50°

79
Q

increase in the
magnitude of the deformity by more than 5° at
consecutive follow-up appointments of between 4 &
6 months.

A

Curve progression

80
Q

tx based on cobb angle and deg of progression: Observation = <20

A

Observation

81
Q

tx based on cobb angle and deg of progression: Observation = 20-40

A

Bracing

82
Q

tx based on cobb angle and deg of progression: Observation = >40

A

Surgery

83
Q

tx based on cobb angle and deg of progression: Observation = 40-50 deg

A

pain + DJD

84
Q

tx based on cobb angle and deg of progression: Observation = >60 deg

A

cardiopulmonary changes and life expectancy

85
Q

wearing a brace mainly in bed (8-12hr/day)

A

Nighttime Rigid Bracing

86
Q

wearing a rigid brace mainly

outside school and in bed (12–20 h per day)

A

Part Time Rigid Bracing

87
Q

wearing a rigid brace
all the time (at school, at home, in bed,
etc.)

A

Full Time Rigid Bracing

88
Q

Indication for bracing

A

cobb angle = at least 25
degrees & skeletal immaturity

cobb angle = less than 25
degrees but rapidly progressed

89
Q

Surgery indication

A

curves exceeding 45 or 50 deg

90
Q

Brace for Above t6

A

milwaukee

91
Q

Brace for Below t6

A

miami

92
Q

Brace for Below t8

A

boston, wilmington,

yamamoto

93
Q

TECHNIQUES TO INCREASE LATERAL
FLEXIBILITY OF THE SPINE: lie prone, stabilize
pelvis, reach toward knee with arm on concave
side and contralateral arm reach forward;
parang pinapaflex mo lang si pt

A

For thoracic curves

94
Q

stabilize the thoracic
curve by holding on to the edge of the table for
mobilization to be on lumbar spine, examiner
craddles legs and lateral bend away from
concavity

A

TECHNIQUES TO INCREASE LATERAL

FLEXIBILITY OF THE SPINE: For lumbar curves

95
Q

heel sitting with
abdomen resting on ant thighs, flex both ue
forward, then have pt lateral bend away from
concave side, hold for 30 secs, 5 reps

A

TECHNIQUES TO INCREASE LATERAL

FLEXIBILITY OF THE SPINE: For thoracic scoliosis

Orthopedics (5 decks)

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