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OMM II > Scoliosis > Flashcards

Scoliosis Flashcards

1
Q

What is the test that evaluates for scoliosis? What is assessed with this?

A
  • Adam’s forward bend test

- Assess rib prominence for rotation–will be opposite the side of the scoliosis

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2
Q

True or false: scoliosis usually has no symptoms

A

True

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3
Q

What are the s/sx of scoliosis when they occur?

A

Back pain
Rib pain
Breathing problems

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4
Q

What are the landmarks that should be palpated when evaluating scoliosis? (4)

A
  • Iliac Crests
  • ASIS
  • PSIS
  • Shoulders
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5
Q

What is the Cobb angle?

A

Angle between perpendicular lines drawn on the endplates (superior and inferior-most vertebrae) of the end vertebra

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6
Q

What degree of Cobb angle indicates scoliosis? Under this value dx = ?

A

10 degrees or more

Under = spinal asymmetry

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7
Q

What is the inter and intra observer reliability with Cobb angles?

A

5-7 degrees

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8
Q

How do we describe (“name”) scoliosis?

A

Defined by the convexity

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9
Q

The location of scoliosis is defined by the vertebra that is (most/least) deviated, and called the apical vertebra

A

Most

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10
Q

Levoscoliosis has a SD of what?

A

(Type I)

Sidebent right, rotated left

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11
Q

What is the difference between structural and functional scoliosis?

A

Structural = fixed, that will not correct with OMT

Functional = partially or completely treated with OMT

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12
Q

True or false: an uncorrected functional curve may progress into a functional curve

A

True

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13
Q

What are the four majors types of scoliosis? Which is the most common?

A
  • Idiopathic
  • Congenital
  • Neuromuscular
  • Acquired
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14
Q

What causes congenital scoliosis?

A

Malformation of the vertebrae

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15
Q

What causes neuromuscular scoliosis?

A

Muscle weakness or spasticity (e.g. cerebral palsy, myelomeningocele, muscular dystrophy)

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16
Q

What causes acquired scoliosis?

A

Tumor

Infx

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17
Q

What is the most common cause of scoliosis?

A

Idiopathic

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18
Q

When does congenital scoliosis begin?

A

During the first 6 weeks in uterine life

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19
Q

True or false: congenital scoliosis is thought to be genetic

A

False— caused by environmental factors

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20
Q

What are the 3 subcategories of idiopathic scoliosis? What defines each of these?

A
  • Infantile- (0-3 yrs)
  • Juvenile *(4-9 yrs)
  • Adolescent (more than 10 yo)
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21
Q

What percent of AIS require treatment?

A

3-9%

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22
Q

What is the F:M ratio of AIS?

A

10:1

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23
Q

Which is the more common type of AIS: right thoracic or left thoracic convexity?

A

Right

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24
Q

What is a double major AIS?

A

Thoracic and lumbar bent if different directions

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25
Q

Name the type of scoliosis: caused by muscular weakness

A

Neuromuscular

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26
Q

Name the type of scoliosis: most often progressive

A

Congenital

27
Q

Name the type of scoliosis: Tumor or infx are examples of causes

A

Acquired

28
Q

Name the type of scoliosis: 80% of all cases of scoliosis

A

idiopathic

29
Q

Are you more likely to progress with scoliosis if you have it when you’re younger or older?

A

Young

30
Q

True or false: the larger the curve, the more likely to progress

A

True

31
Q

True or false: double curves are less likely to progress

A

False

32
Q

True or false: all else equal, males are more likely to progress

A

False–females

33
Q

Curves measuring less than what degree at the end of growth, typically do not progress?

A

30 degree

34
Q

Curves measuring more than what degree at the end of growth typically progress?

A

40 degrees

35
Q

What are the two major outcomes of AIS?

A
  • Stabilization

- Progression

36
Q

What are the mobility morbidities with scoliosis?

A
  • balance difficulties

- Increased risk for falls, and asymmetric lower joints

37
Q

True or false: there is a strong correlation between the emotional problems and the degree of curvature of the scoliosis

A

False

38
Q

Does scoliosis increase the risk of LBP with preg?

A

No

39
Q

Does being pregnant increase the risk of progression of scoliosis?

A

No

40
Q

Is there an increased risk for C-section for pregnant women with scoliosis?

A

No

41
Q

What is the relative mortality of pts with scoliosis relative to the general population

A

Same

42
Q

At what degree of scoliosis do breathing problems begin?

A

more than 70 degrees

43
Q

What is the window of opportunity for surgical stabilization of scoliosis?

A

Progression of scoliosis may impair breathing so much that surgery is contraindicated, or will have increased mortality post surgery (Pneumonia etc)

44
Q

Curves over what degrees decreases VC?

A

70

45
Q

Curves over what degrees causes DOE?

A

90-100

46
Q

Curves over what degrees causes alveolar hyperventilation, CO2 retention, pHTN, and right sided heart failure?

A

More than 100

47
Q

When is bracing indicated for scoliosis?

A
  • If still growing

- If scoliosis gets worse in 6 months or less

48
Q

When is watchful waiting appropriate for scoliosis?

A

Still growing, but not severe enough for treatment

49
Q

What defines mild, moderate, and severe scoliosis, in terms of cobb angles?

A 
Mild = [10-20) degrees
Mod = [20-45]
Severe = more than 50
50
Q

True or false: OMT is intended to completely straighten scoliosis

A

False

51
Q

At what level (mild, mod, severe) should bracing be considered? Surgery?

A

Bracing = mod

Surgery =severe

52
Q

When is scoliosis concerning?

A

Progression of the curvature during periods of rapid growth

Respiratory/cardio compromise

53
Q

Cobb angles between what degrees in 12-14 years indicates surgery? What about in any age?

A

20-30 degrees

More than 30 degrees in any age

54
Q

Progression of the Cobb angle of more than how many degrees indicates surgical referral?

A

More than 5 degrees

55
Q

When is ortho referral for scoliosis not indicated?

A
  • Incidental finding

- Cobb angle less than 10

56
Q

What is the role of exercise in the treatment of scoliosis?

A

Will not stem progression, but may help prevent degenerative changes, and reduce pain

57
Q

What is the role of OMT in scoliosis?

A

Decrease pain, increase ROM and function

58
Q

True or false: OMT can stem the progression of scoliosis

A

False– only treats the symptoms

59
Q

What are the three major causes of functional scoliotic curves?

A
  • Postural imbalance
  • Focal muscle contraction
  • Type II dysfunction
60
Q

What are the three major steps in treating scoliosis with OMT?

A
  • Treat the curve
  • Treat transitional areas
  • Treat spinal hypo-mobility
61
Q

What should follow OMT treatments?

A

PT

62
Q

What are the 3 M’s with bracing?

A

Braces are more effective if scoliosis is:

  • Moderate
  • spine is Mobile
  • Spine not Matured
63
Q

What are the four main focuses of treatment of scoliosis with OMT?

A
  • pain
  • respiratory dysfunction
  • Balance/proprioception
  • psych issues
64
Q

Which way does the spine rotate toward with scoliosis?

A

Opposite (just like a type I)

OMM II (43 decks)

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