Short Leg/ Scoliosis

Question 1

Spinal Biomechanics

Answer 1

biomechanics from osteopathic perspective has evolved into a dual study of the adaptive responses of the body to gravitational force and the effects of alterations in joint mechanics that results from injury or impaired function

Question 2

Spinal Biomechanics

Answer 2

biomechanics from osteopathic perspective has evolved into a dual study of the adaptive responses of the body to gravitational force and the effects of alterations in joint mechanics that results from injury or impaired function

Question 3

early postural compensation

Answer 3

longer single lumbar or lumbothoracic scoliotic curve, convex on side of low sacral base

Question 4

cranial movement in C shaped scoliotic curve

Answer 4

horizontal cephalad planes depressed on opp side the depressed pelvic horizontal plane

Question 5

chronic postural compensation

Answer 5

S shaped scoliotic curve

Question 6

shoulders and sacral location in S curve

Answer 6

shoulders and greater trochanteric planes typically depressed on same side as depressed sacral base

Question 7

functional or secondary curve

Answer 7

side bending that can reduce lateral curve

Question 8

a curve that is unable to be reduced by side bending

Answer 8

structural, fixed or primary curve

Question 9

management of spondylolisthesis has emphasis on what plane

Answer 9

sagittal plane strategies

Question 10

management of scoliosis has emphasis on what plane

Answer 10

coronal

Question 11

c scoliotic response

Answer 11

pelvic shift to L
internal rotation L leg
short R leg
depressed L shoulder 
elevated R shoulder

Question 12

S scoliotic response

Answer 12

short L leg
pelvic shifts to R
internal right leg rotation
elevated R shoulder
depressed L shoulder

Question 13

S scoliotic response

Answer 13

short L leg
pelvic shifts to R
internal right leg rotation
elevated R shoulder
depressed L shoulder

Question 14

Postural compensation is coordinated by

Answer 14

CNS with continuous feedback provided by visual information, vestibular information
kinesthetic/proprioceptive information from tendons and mm

Question 15

goal of postural compensation

Answer 15

minimized energy requirements to distribute and balance somatic stress while keeping eyes and semicircular canals as level as possible

Question 16

kyphotic curves or lordotic

Answer 16

normal postural curves in sagittal plane
forward bending kyphitc
lordotic backward

Question 17

pathological kyphotic or lordotic curves

Answer 17

kyphosis or lordosis

Question 18

kyphorotoscoliosis

Answer 18

all three planes involved

Question 19

rotoscoliosis

Answer 19

because rotation and side bending are inseparably linked

Question 20

kyphorotoscoliosis

Answer 20

all three planes involved

Question 21

kyphorotoscoliosis

Answer 21

all three planes involved

Question 22

crossover sites

Answer 22

named for vertebral level where group curves change direction

Question 23

where is the convexity in curve named rotoscoliosis right

Answer 23

right

Question 24

in sagittal plane which way does gravity cause sacrum and pelvis to move

Answer 24

sacrum ant
innominates post
L3 weight bearing gravitational line falls anterior to middle transverse sacral axis

Question 25

short leg syndrome misnomer

Answer 25

not due to discrepency of legs by because syndrome with variety of related biomechanical findings and Sx

Question 26

foot position on long leg side

Answer 26

pronation | so LE internally rotates

Question 27

Lumbar curve with R short leg

Answer 27

side bend L and Rotate R

Question 28

short leg syndrome misnomer

Answer 28

not due to discrepency of legs by because syndrome with variety of related biomechanical findings and Sx

Question 29

main bone involved in "short leg syndrome"

Answer 29

unlevel sacral base

Question 30

most common spinal response to an unlevel sacral base

Answer 30

rotoscoliosis | side bend lumbar curve away from low sacral base (short leg)

Question 31

preferred Dx for short leg syndrome

Answer 31

radiographic imaging

Question 32

spot that illicits most tenderness in a lumbopelvic curve

Answer 32

transverse L4 L5 or attachments of iliolumbar ligament to iliac

Question 33

mild to mod strain heel lift therapy

Answer 33

1/8 inch and increase no faster than 1/16 ea week or 1/8 every 2 weeks

Question 34

Tx short leg syndrome

Answer 34

lifting heel of leg side with depressed sacral base

Question 35

heel lift therapy for fragile patient

Answer 35

begin 1/16 lift and increase no faster than 1/16 inche every 2 weeks

Question 36

mild to mod strain heel lift therapy

Answer 36

1/8 inch and increase no faster than 1/16 ea week or 1/8 every 2 weeks

Question 37

Tx heel lift for sudden loss of leg length like hip prosthesis

Answer 37

lift full amount that was lost

Question 38

heel lift no higher than what if not lifting front of foot

Answer 38

1/2 inch

Question 39

heel lift in children

Answer 39

compressive force make bone grow faster | so closely monitor

Question 40

Sx scoliosis

Answer 40

``` arthritic Sx backaches chest pains neck pains HA Sx of organ dysfunction ```

Question 41

functional scoliotic curve

Answer 41

go away with side bending rotation or forward bending

Question 42

mild scoliosis Cobb method

Answer 42

5-15 degrees

Question 43

moderate scoliosis

Answer 43

20-45 degrees

Question 44

severe scoliosis

Answer 44

>50 degrees >50 affects respiratory function >75 affects CV

Question 45

majority scoliotic curves

Answer 45

idiopathic

Question 46

conditions that can lead to acquired scoliosis

Answer 46

``` osteomalacia response to inflammation or irradiation sciatic irritability psoas syndrome healed leg fracture following hip prosthesis ```

Question 47

curves more likely to decompensate

Answer 47

unbalanced

Question 48

second most common scoliosis

Answer 48

single thoracic

Question 49

most common scoliosis

Answer 49

double major | thoracic and lumbar combination

Question 50

single thoracic scoliosis

Answer 50

sidebent R rotated L | L paraspinal rib humps

Question 51

second most common scoliosis

Answer 51

single thoracic

Question 52

single lumbar scoliosis

Answer 52

assoc with arthritic change | third most common

Question 53

junctional thoracolumbar scoliosis

Answer 53

single curve resulting in arthritic change because tends to be a longer curve that functionally over-stresses the spine

Question 54

junctional cervicothoracic scoliosis

Answer 54

very uncommon

Question 55

who should be referred to a specialist with spine curvature

Answer 55

scoliosis more than 15-20 degrees that has progressive curvature intractable low back pain and irresponsive to conservative Tx

Question 56

back brace used in what patients

Answer 56

20-40 degree curves

Question 57

if electrical stimulation applied to lumbar curve

Answer 57

increases lumbar lordosis

Question 58

surgery for scoliosis

Answer 58

45-50 degrees | when resp and CV at risk