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OPP 4 FINAL TEST EVER > short leg CI and DSA > Flashcards

short leg CI and DSA Flashcards

1
Q

When does a C shaped scoliosis occur?

A

Early compensation pattern

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2
Q

What compensation happens in a C shaped scoliosis

A
  • Shoulder is higher on the short limb side
  • Pelvis side shifts and rotates toward the long limb
  • Anterior innominate rotates on the short limb side to functionally lengthen it, posterior innominate rotation on long limb side
  • Long leg is internally rotated and foot is pronated
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3
Q

When does a S chaped scoliosis occur?

A

Chronic postural compensation for a short limb

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4
Q

What compensation happens in a S shaped scoliosis?

A

A secondary compensatory curve develops more superiorly that sidebends the opposite way to counter balance - shoulder on short leg side is depressed

Rest is the same as C scoliosis:

  • Pelvis side shifts and rotates toward the long limb
  • Anterior innominate rotates on the short limb side to functionally lengthen it, posterior innominate rotation on long limb side
  • Long leg is internally rotated and foot is pronated
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5
Q

What will a pelvic side shift test?

A

Shows which leg is short by stabilizing the shoulders and allow the pelvis to shift-
Pelvis will shift to the side with the long leg because it is more stable

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6
Q

A 47 y/o M presents with upper thoracic pain and short left leg. What compensatory SD would you expect to find on structural exam?

A-	left posterior innominate
B-	lumbar group curve neutral sidebent left and rotated R
C-	L anterior innominate
D-	Pelvic sideshift L
E-	L lower extremity internal rotation
A

C- Left anterior innominate

Will expect- posterior innominate on the long leg side, sidebent away from the short leg, pelvic shift toward long leg, long leg will be internally rotated

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7
Q

When right sidebending is introduced to a group curve displaying type 1, neutral mechanics, the vertebrae will rotate:

A-	superiorly
B-	toward the concavity
C-	interiorly 
D-	toward the convexity
E-	posteriorly
A

D- toward the convexity

Will expect- Side bend into concave, rotate to convexity

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8
Q

A pt has a short L leg due to a recent femur fracture. On PE, you will find

A- r paravertebral mm elevation due to group curve convex L
B- Lumbar group curve neutral, SB R RL
C- L paravertebral elevation due to group curve convex R
D- Lumbar group curve extended, SR RR
E- L5 flexed, rotated L SB L

A

B

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9
Q

What are the typical curves of the spine?

A

Cervical- lordosis
Thoracic- kyphosis
Lumbar- lordosis

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10
Q

70 y/o F with a hx of osteoporosis and osteoarthritis is noted to have a L short leg and ¾ inch of sacral base unleveling on the L. The most appropriate heel lift to initially prescribe is?

A

1/16

patient is fragile- raise 1/16 inch

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11
Q 
A scoliotic curve is most likely to progess in which patient?
A-	neonate
B-	child
C-	adolescent
D-	adult
E-	senior citizen
A

C- adolescent

Going through a period of rapid growth. If they are progressing with the curve, you need to do something about it.

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12
Q 
Which thoracic curve measurement can seriously compromise cardiovascular function?
A-	5 degrees
B-	20
C-	40
D-	50
E-	75
A

E-75

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13
Q

Which of the following is most likely found in a pt with a L short leg?
A- Tenderness over the right sacroiliac ligaments
B- Shortening of the L paraspinal tissues
C- Tenderness over the L iliolumbar ligament
D- L posterior innominate
E- R groin pain

A

C- tenderness over the L iliolumbar ligament

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14
Q

Which of the following will be most likely associated with a thoracic scoliotic curve sidebent L and rotated right?

A- L paravertebral mm elevation
B- Elevated (superior) L AC joint
C- Depressed (inferior) L inferior angle of scapula
D- Shortened R thoracic paraspinal tissues
sidebending
E- R index finger more inferior (lower) than L

A

C- depressed L inferior angle of scapula

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15
Q

A pt has a short R leg. Which of the following compensatory changes would you expect to find?

A: R posterior innominate
B: Lumbar group curve neutral SB R R L
C: L anterior innominate
D: Pelvic sideshift L
E: Right lower extremity internal rotation
A

D- pelvic sideshift L

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16
Q

Spine surgery and Harrington rod placement is the most appropriate treatment for progressive scoliotic curves that are already beyond?

A

45 degrees

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17
Q

When treating a pt with scoliosis, the primary goal of OMM is to:

A- straighten the curve
B- optimize motion and fxn of the existing structures
C- increased sidebending toward the concavity
D- stretch the mustlces on the side of the convexity
E- improve rotation toward the convexity

A

B- optimize motion and fxn of the existing structures

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18
Q

Where does the weight bearing line run through?

A

Runs midway between the feet, through the pubic symphysis, along the midline of the vertebral column, and bisects the center of the suprasternal notch and glabella.

19
Q

What is the optimal postural alignment in the sagittal plane?

A

Through the lateral maleolus, midknee, femoral head, anterior third of the sacral base, middle of the body of the L3 vertebrae, humeral head, and external auditory meatus.

20
Q

What is somatization of the psyche

A

Posture can be a somatic depiction of one’s inner emotions

EX- depression can cause a pt to hang from their soft tissues without the apparent energy to stand tall

21
Q

What is a functional or secondary curve

A

Motion such as sidebending can reduce a lateral curve- it is reversible

22
Q

What is a structural or primary curve?

A

The curve is unable to be reduced with side bending- is nonreversible

23
Q

When are curves considered pathological?

A

Coronal sidebending of more than 5 degrees –> scoliosis

24
Q

What happens to tissues on the convex side of sidebending?

A

They lengthen

25
Q

What happens to tissues on the concave side of sidebending?

A

They shorten

26
Q

How are group curves named?

A

Named for the convex side

Ex: left sidebending is named a R scoliosis

27
Q

Where does the L3 center of gravity fall and how does it effect the sacrum and innominates?

A

Falls anterior to the middle transverse sacral axis and behind the femoral axis.
Encourages the sacral base to rotate anteriorly and innominates posteriorly

28
Q

How much does the lumbosacral angle increase in short leg scoliosis?

A

2-3 degrees

29
Q

Significance of iliolumbar ligament and how does pain present?

A

The iliolumbar ligament on the side of the convexity of the lumbopelvic curve is often the first structure to react to added stress
- Point of maximal tenderness to palpation is at L4/L5 transverse processes

30
Q

How does pain of the sacroiliac ligament present?

A

Will refer pain down the lateral side of the leg

31
Q

How much do you lift in a fragile patient?

A

1/16 lift and lift no faster than 1/16 of an inch every 2 weeks

32
Q

How much do you lift in a flexible spine?

A

Begin with 1/8 lift and lift at a rate no fater than 1/16 inch per week or 1/8 every 2 weeks

33
Q

How much do you lift in a sudden loss of leg length?

A

If the patient had a level sacral base before a fracture or surgery, lift the full amount that was lost

34
Q

What is the true height of the lift?

A

It is measured from the bottom of the lift to a pint where the calcaneal bone strikes the lift

35
Q

How much lift can be used inside a shoe before the shoe no longer fits well?

A

1/4 inch

36
Q

How much lift can be placed between the heel of the patient’s foot and the floor before foot mechanics are significantly disturbed?

A

1/2 inch

37
Q

Adding a lift will make bone ____?

A

Grow faster

38
Q

Mild severity scoliosis classification

A

A curve of 5-15 degrees

39
Q

Moderate scoliosis curves measure?

A

20-45 degrees

40
Q

Severe scoliosis has a curve of more than?

A

50 degrees

41
Q

What does a curve of more than 50 degrees compromise?

A

Respiratory function

42
Q

What does a curve of more than 75 degrees compromise?

A

Cardiovascular function

43
Q

Acquired scoliosis may result from which conditions? (6)

A
  1. Osteomalacia
  2. Response to inflammation or irradiation
  3. Sciatic irritability
  4. Psoas syndrome
  5. Healed leg fracture
  6. Following a hip prosthesis
44
Q

When is a brace used?

A

In a growing patient with 20-40 degree curves. It works to control the scoliotic (lateral) curves until the spine matures, which is generally around age 21

OPP 4 FINAL TEST EVER (12 decks)

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