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PCM II > Scoliosis > Flashcards

Scoliosis Flashcards

1
Q

What is the normal curvature C and L spines?

A

Lordosis

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2
Q

What is the normal curvature of T spine?

A

Khyphosis

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3
Q

What is Scoliosis?

A

Abnormal curve, primarily in coronal plane

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4
Q

Scoliosis is named for the side of _.

A

convexity

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5
Q

What are some classification of scoliosis?

A
  • Idiopathic
  • congenital
  • acquired
  • neuromuscular (ms imbal and lack of trunk control)
  • syndromic
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6
Q

In what gender is infantile idopathic scoliosis more common?

A

Male

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7
Q

In infantile idiopathic scoliosis, what is the common scoliosis (left or right) and what region of spine

A

Convex to L and curve usually thoracolumbar

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8
Q

85% of infantile scoliosis clases resolve spontaneously, but if curve gets greater than what degree should you refer to ortho?

A

35

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9
Q

This type of idiopahtic scoliosis, most progress steadily and occasionally quiescent then become progressive and needs to be referred to ortho if Cobb angle reaches greater than 20 degrees.

A

Juvenile idiopathic scoliosis

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10
Q

what is the most common idiopathic scoliosis?

A

Adolescent idopathic scoliosis (80-85% of cases)

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11
Q

In dolescent idophatic scoliosis, incidence is amost equal betwen male and female, but progression to injury is more common in which gender/

A

female. (F 8.1: M 1.0)

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12
Q

What is the prevalence of curve type in adolescent idopathic scoiosis?

A

Most common - double major: right thoracic and left lumbar

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13
Q

What are some causes of congenital scoliosis?

A

Failure of formation (wedge vertabrae, hemivertbarae)

Failure of segmentation (unilateral unsegmentaed bar, bilateral (blck vertbrae)

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14
Q

With congenital scoliosis, what other anomalies are likely to seen?

A

Urinary tract
Cardiac
spinal dysraphism

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15
Q

What is the progression rate of congenital scoliosis?

A

50% progesses and will need surgery. 25% will not progress and another 25% will progess slightly but will not need surgery

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16
Q

Why is surgery a concern in congenital scoliosis?

A
  • Problem will not go away
  • bracing not effective (cannot correct a structural deformity)
  • Surgery can alter vertical growht
17
Q

What are some neuromuscular causes of scoliosis?

A

Cerebral palsy
Polio
Duchenne’s muscular dystrophy

18
Q

What are some syndromic causes of scoliosis?

A
  • Marfan’s
  • Ehler Danlos
  • Neurofibromatosis
19
Q

when screening, what are some things you you can check for scoliosis?

A

-level of hips
-arm length
-bulge on back
-lean to side
-prominence of scapula (superior and inferior borders)
-shoulder height difference
-crease at waist
-iliac crests
leg length

20
Q

What is Adam’s forward bend test

A

Indicates rotational component.

Asymmetry is noted on the side of the convexity

21
Q

beyond what degree does Cobb consider scoliosis?

A

10 degree

22
Q

How do you measure cobb’s angle?

A

Most cephalad vertebra whose superior surface angles INTO the curve
Most caudal vertebra whose inferior surface angles INTO the curve. Draw right angles to both these lines. Where they cross is Cobbs angle.

23
Q

WHat are some indications for Ortho referral?

A
  • Cobb angle greater than 20
  • progression of Cobb angle >5 deg
  • Some will make referral for baseline eval for Cobb greater than 10 degrees
24
Q

How would you treat idiopathic scoliosis of 0-10 degrees, asymptomatic, in skeletally immature pt.

A
  • OMT

- Observation with follow up (every 4-6 mos) if curve increase > 5 degrees refer to ortho

25
Q

How would you treat idopathic scoliosis of 10-20 degrees, asymptomatic, in skeletally immature pt.

A

OMT

after initial ortho eval, PCP can follow. Clinical exam and x rays q 4-6 months until mature skeltally

26
Q

How would you treat idopathic scoliosis of >20 degrees, asymptomatic, in skeletally immature pt.

A

Ortho referral for f/u and tx

OMT

27
Q

How would you treat idopathic scoliosis of 0-30 skeletally mature pt.

A

-OMT
-Follow clinically .
Curves with

28
Q

Progression of scoliosis to what degree are you likely to see cardiopolm problems?

A

50 degrees.

29
Q

What is the goal of bracing?

A

to halt progression (usually at 20-45 degrees) not effective for greater curve

30
Q

Which type of brace would you use for 20-40 deg curves in an adolescent?

A

Milwaukee

31
Q

What kind of brace would you use for someone with deformaities such as lordosis and rotation as well as scoliosis, with apex of curve below T10.

A

Boston brace

32
Q

If a child refuses to wear brace outside, which type of brace would you recommend.

A

Charleston Nighttime brace

33
Q

Surgery is required at greater than 75% to prevent _

A

cardiac compromise

34
Q

Surgery is required at angle greater than 50% to prevent _

A

pulmonary compromises

PCM II (11 decks)

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