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scoliosis Flashcards

1
Q

QL Origin insertion action and nerve

A

O-illiolumbar ligament and posterior illiac crest

I-12th rib (inferior border) and TVP L1-4

Action= lateral flexion bilateral extension and stabilizes 12th rib during insipration/depresses it upon forced expiration elevates coxal bone

Nerve Lumbar plexus L1-L4

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2
Q

Lattisumus Dorsi Origin insertion nerve action

Referral:
pain will be felt in the anterior part of the shoulder and the lower back.

A

O-SPT7-S5 via thoracolumbar fascia
posterior illiac crest; ribs 10-12 and inferior scapular border

I-floor of the bicipital groove of the humerus

Nerve is thoracodorsal nerve C(6)-8

Action:Adducts, extends and medially rotates the humerus

ASSISTS FORCED INSPIRATION

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3
Q

intercostals Origin; insertion nerves and action

A

External O-rib above (inf border)
I-rib below (sup border)
N-intercostal nerves (t1-12)
A-Elevates rib during INSPIRATION
Internal O-rib below (sup border)
I-Rib above (inf border)
N-intercostal nerves(T1-12)
A-decreases thoracic cavity volume during FORCED EXPIRATION (draws adjacent ribs together)

Innermost O/I= adjacent ribs in lateral curve of rib cage
***assists in both external and internal intercostals MORE forced expiration (internal)

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4
Q

What special test do you perform for scoliosis

A

Hemipelvis

Functional/structural test

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5
Q

What’s rom for thoracic spine

A

Flex 20-45
Ext25-45
Lat flex 20-40
Rotation 35-50

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6
Q

Rom of lumbar spine

A

Flex 40-60
Ext 20-40
Lat flex 15-20
Rotation 3-18

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7
Q

Thoracic spine review

What organs are located in the right upper quadrant?

A 
Liver 
Gallbladder
Duodenum 
Pancreas
Right kidney
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8
Q

What organs are located in the left upper quadrant

A 
Kidney left 
Spleen
Stomach
Pancreas
Splenic flexure
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9
Q

Right lower quadrant holds what organs

A

Cecum
Appendix
Right ovary and tube

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10
Q

Left lower quadrant holds the

A

Left ovary and tube

Sigmoid colon

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11
Q

Functional scoliosis may be due to

A

Poor posture or postural changes NOT positional

Are able to be corrected

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12
Q

Scoliosis curves are named for the side that the _____ occurs on.

A

Convexity

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13
Q

The _____ is the distance on the spine that the curve occurs

A

Span

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14
Q

The apex is the vertebrae that is _________.

A

Farthest away form midline

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15
Q

What is the major curve in a S scoliosis

A

The curve that is the largest with the greatest angulation

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16
Q

The minor curve in an S scoliosis is also referred to as the

A

Compensatory curve

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17
Q

What is the transitional vertebra in terms of scoliosis

A

The one that marks the end of one curve and beginning of the next

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18
Q

List the degrees in terms of severity
Mild
Moderate
Severe

A

0-20 degrees
20-50
Greater than 50

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19
Q

What refelex is likely responsible for secondary curves

A

Righting reflex

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20
Q

The fact that the entire body head to toe can be involved in a scoliosis is a example of what principal?

A

Wolffs principal
Over time bones remodel themselves along the line of force being applied to them ( applied also to connective tissues, muscles and viscera)

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21
Q

Causes of scoliosis

A 
Idiopathic 
Iatrogenic
Congenital
Functional 
Neuromuscular
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22
Q

Idiopathic scoliosis explain the differences in who is more apt to get it and when

A

Infantile idiopathic more common in boys (up to 3yrs old)
Juvenile scoliosis occurs equally boys to girls 4-9
Adolescent more common girls age 10-16

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23
Q

Which muscles may cause idiopathic scoliosis when spindle cells have abnormal response

A

Paraspinals

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24
Q

The _____ in the inner ear if asymmetrical May influence spinal posture

A

Labyrinth

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25
Q

Fun fact:
Study found increase in labyrinth sensitivity on convex side and right eye dominance may be associated with left sided curves

A

;) the more you know

26
Q

List some things you should check for in a functional scoliosis

A

Unilateral pes planus
Short tibia,/small Hemipelvis (places sacrum on oblique angle in standing )

Fractured tibia and femur (can cause pelvis to be oblique and spine must compensate)

Short humerus (must lean to affected side) 
Torsion of the occiput on sphenoid (cranial sacral!!!!)

How the clients stands/sits (all weight to one side?)

27
Q

Tps in what muscle may cause appearance of short leg?

A

Quadratus lumborum

28
Q

Unilateral _____ shortening and ITB contracture can produce ____ pelvic tilt while unilaterally shortened _____ and ____ muscles lead to thoracic curving and lateral pelvic tilt

A

Tensor fascia lata
Lateral
Abdominal obliques
Latissumus dorsi

29
Q

List several neuromuscular causes of scoliosis

A

Cerebral palsy
Freidreichs ataxia
Muscular dystrophy
Spinal cord lesions

30
Q

Paralysis following polio can result in _____ scoliosis

A

Long C curve

On side of impairment

31
Q

List some congenital causes that contribute to scoliosis

A
  • Hemivertebrae( incomplete formation of 1/2 vertebra)
  • Vertebral wedging ( slows growth and occurs on concave side)

-Vertebral bridging ( failure of segmentation bony
bars occur btwn vertebra

-malformed or absent ribs

32
Q

Scoliosis is often associated with what two major spine deformities

A

Hyper lordosis

Hyper kyphosis

33
Q

Vertebral bodies rotate toward the _____, tvps are ____ on convex side causing ________.

Ribs are flattened and more closer together on the ______ side and tvps are ______.

A

Convexity ; posterior ; rib humping

Concave; anterior

34
Q

From an anterior view ribs appear more prominent on the _____ side and muscles appear bulkier on what side?

A

Concave

Convex

35
Q

What muscles are shorter on the concave side

A

Multifidus
Erector spinae
Intercostals

36
Q

Which muscles acting unilaterally will increase the severity of the curve

A 
Abdominals
Iliopsoas 
Lats 
Intercostals 
Erector spinae
37
Q

The shoulder on the convex side will be _____ due to actions of ______ and _____.

A

Elevated
Upper trapezius
Levant or scapulae

38
Q

What muscles and in what sequence together will maintain a pelvic obliquity

A

One side :
Tight quadratus lumborum
Iliopsoas
Adductors

Other side:
Tight tfl and gluten medius

39
Q

Origin and insertion gluten medius

A

Originates : between ant and posterior gluteal lines and gluteal aponeurosis

Inserts: post lat surface greater trochanter

Superior gluteal nerve

Abduction primary assist medial rotation

40
Q

Multifidus Origin/ insertion

A

Sacrum mammillary process L5-T12
Tvps all t spine
Articular processes of all c spine

Inserts on SPs L5-C2 (2-4 vertebrae above origin

Extension lateral flexion
CONTRALATERAL ROTATION

41
Q

Levator scapulae origin insertion

A

Posterior tubercles C1-C4

Vertebra, border of scapula superior to spine

Dorsal scap nerve C5
Cervical nerve C3/4

Elevates and rotates scapula inferiorly (glenoid fossa)
Extension and lateral flexion if scapula fixed

42
Q

Internal obliques origin insertion

A

Origin:
Thoracolumbar fascia
Anterior 2/3 illiac crest
Lateral 2/3 inguinal ligament (external obliques)

Insertion:
Ribs 10-12
(Abdominal aponeurosis ) to Linea alba xiphoid process pubic symphysis

Flexion
Ipsilateral flex and rotation *****

Supports compresses abd viscera and assist forced expiration micturition parturition defecation Vomitting

43
Q

External oblique origin insertion

A

Ribs 5-12

Abdominal aponeurosis to xiphoid process
Linea alba pubic crest, tubercle

Anterior 1/2 illiac crest

CONTRALATERAL rotation **
Lateral flexion
Flexion
Supports compresses viscera and assists expiration (forced) micturition parturition defecation Vomitting

44
Q

Illiopsoas origin insertion

A

Vertebral bodies discs and tvps T12 to L4

Lesser trochanter of femur

Lumbar plexus L1-4

Primary flexion of hip
If legs fixed flexes trunk

45
Q

TFL origin insertion nerve

A

Anterior illiac crest (ASIS)

Iliotibial band

Superior gluteal nerve L4-S1

46
Q

Upper traps origin

A

Superior nuchal line medial 1/3
EOP
Ligamentum nuchae up to c7 then SPs c7 to t12

Inserts on spine of scapula acromion process lateral 1/3 clavicle

Accessory nerve (cnXI) 
Cervical nerve c3/4
47
Q

What is the action of upper traps

A

Elevate and rotate scapula superiorly
Extend head and neck
Rotate head and neck contralateral
Laterally flex to same side

48
Q

Latissumus dorsi origin and insertion and

A

SPs t7 to s5
Via thoracolumbar fascia
Posterior illiac crest and inferior angle of scapula

Floor of bicipital groove of humerus

Extends adducts and medically rotates humerus
Assist forces INSPIRATION

49
Q

What muscles do we test often in scoliosis and what is often found

A

Abdominals weak

Any muscles in concave side (tight so usually weak) glute med test on high side

50
Q

List 5 CIs to treating scoliosis

A

Jt mobs to fused or vertebra immobilized by rods

Rib springing or jt play to hypermobile jts or ribs or history of subluxation

Randomly treating fascia

Heat over metal rods

Longitudinal or stretching work to muscles of convex side

51
Q

What secondary conditions may develop in scoliosis

A

Intercostal neuralgia
Thoracic outlet syndrome

May be result of pes planus

52
Q

When recording a scoliosis the therapist lists what 5 important things

A 
Span if curve
Apex if curve(s) 
Transitional vertebra
Functional or structural 
S or C curve
53
Q

Person with leg length discrepancy will weigh bear on the ____ leg while they will ___ the hip and knee of the _____ leg or position it to the _____ or side.

A

Short
Longer
Front

54
Q

If client has both knees fully extended and locked the pelvis is now _______ and _____ on the shorter leg side

It is said a client weight bears more on the ____ side than the _____.

A

Laterally tilted
Lower

Convex
Concave

55
Q

With pelvic torsion:
___________ raises the innominate bones and sacrum on the same side while ________ lowers it on the same side

With leg length differences people often ______ on the long leg side and _____ on the short to even them out

A

Anterior rotation
Posterior rotation

Posteriorly rotate
Anteriorly rotate

56
Q

Left thoracic pattern and cafe au lait spots or faux beard is most common with _______ scoliosis

A

Non idiopathic

57
Q

What is the most common pattern for idiopathic scoliosis

Where is the apex

A

Right thoracic curve t5-t11 and a compensatory lumbar curve from t12 to l4

Apex t8

58
Q

Scoliosis resulting from neurological conditions generally appear as

What will you see

A

Lumbar or thoracolumbar curve extending to the pelvis

Pelvic obliquity
Prominent hip and adduction of femur

59
Q

Lateral view of C curve scoliosis you will see an increased _____ on the short leg side; Anteriorly the _____ is lower on the short limb side ribs on the ____ side will be prominent and if a small hemipevis is involved face bones on the ___ side may be found

A

Anterior tilt (5 to 10 degree women 0-5 degree men is normal)

ASIS
Concave
Same

60
Q

In a right thoracic left lumbar S curve scoliosis fill in the blank :

May be a ____ compensatory cervical curve

_____ AC joint is higher
____ scapula higher and possibly winged
___rib humping is present
Asymmetrical skin folds with more on the ____ side
Illiac crests higher on the ____
Lateral pelvic tilt PSISs are _____ on the ____ side while in a torsion they will be ____ on the ________side.
Unilateral pes planus on the ____ is possible

A 
Left 
Right
Right
Right
Concave 
Right
Lower
Dropped 
Higher
Anteriorly rotated shorter side 
Left or concave
61
Q

From a superior view describe what you’d see in a unilateral torsion and what you’d see in a opposing torsion

A

Unilateral AC and ASIS anterior on one side

Opposing AC on one side and ASIS on other are anterior

62
Q

Homecare for scoliosis

A

Heel sitting exercises :
Sits with knees bent heels under glutes bends forward abdomen rests on ant thighs and arms stretched above head
Laterally walks hands to side of Convexity when fill stretch reached inhales and exhales and goes deeper into Convexity repeated several times

Strengthening for weak convex muscles:
Lie on concave side lift shoulder off ground hold 5-10 seconds and release repeat several times upper arm slides down lateral thigh

Ctp (10 decks)

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