Spinal Exam 2: Section VIII. Curvatures of the Vert. Column Flashcards
What are the curvatures of the vertebral column?
anterior, posterior, and lateral
What is the direction of the primary curve of the vertebral column?
posterior
Why is the posterior curve also called the primary curve?
it is the first curve to appear embryologically
What are the adult remnants of the primary curve along the vertebral column?
the thoracic or dorsal curve and the pelvic or sacrococcygeal curve
What are the names given to curves that form during development to reverse the direction of regions along the vertebral column?
anterior curve, secondary curve, compensatory curve
What are the names of the anterior curves, secondary curves, and compensatory curves?
cervical curve and lumbar curve
What segmental levels form the cervical curve?
C2-T1
What segmental levels form the lumbar curve?
T12 to L5
What is the earliest time of appearance of the cervical curve?
the third fetal month
What is the traditional time of appearance of the cervical curve said to be?
during the last trimester in utero
What is the time during which the “adult” cervical curve is said to appear?
within the first year after birth
What developmental events are indicated in the formation of the adult cervical curve?
- centers for vision and equilibrium will appear in the brain
- musculature attaching the skull, cervical region, and upper thorax together develops
- the head is held upright
- the intervertebral disc height becomes greater anterior than posterior
At what age will the infant begin to hold the head erect?
usually between the third and fourth month after birth
What is the name given to the integration of visual and motor pathways associated with holding the head erect?
the righting reflex
What is the location for the apex of the cervical curve?
typically between C4 and C5
What is the location for the cervical kyphosis?
between occiput and C1
What is the name given to the primary cervical curve?
cervical kyphosis
What is the vertebral relationships between the cervical curve and the cervical enlargement?
cervical curve C2-T1; cervical enlargement C3-T1
What is the time of appearance of the lumbar curve?
between 12 and 18 months after birth
What infant activities are associated with the development of the lumbar curve?
crawling and walking
What developmental events are indicated in the formation of the adult lumbar curve?
- crawling will cause the abdomen to put tension on the lumbar region and pulls it forward
- muscle development is promoted to compensate for the swayback of the lumbars
- intervertebral disc height will become greater anterior compared to posterior
- walking will further promote muscle and intervertebral disc development
What happens within the intervertebral disc to facilitate the lumbar curve development?
the nucleus pulposus of L4 will shift its position within the annulus fibrosis
Which sense is a requirement for holding the head erect, standing, sitting, and walking?
vision
What is the gender bias associated with lumbar curve convexity?
females have a greater convexity of the lumbar curve
What is the vertebral relationship between the lumbar curve and the lumbar enlargement?
lumbar curve T12-L5; lumbar enlargement T9-T12
What is the formation of the lateral curve often correlated with?
faster development of the muscles on the side of handedness
What is the time of appearance of the lateral curve?
they appear after 6 years old
What locations of lateral curves are recognized?
cervical, thoracic or dorsal, and lumbar
Which lateral curves are best developed?
thoracic or dorsal, and lumbar
What is the relationship between curve direction and handedness?
a right-handed person has a high probability for a right thoracic, left lumbar curve combination
What is the incidence of a right thoracic, left lumbar curve combination in the population?
about 80% of the population demonstrates this
What does the suffix “osis” mean?
a condition
Does “osis” infer a normal or an abnormal condition?
neither, it is non-judgemental
What generic names identified abnormal curves of the vertebral column?
lordosis, kyphosis, scoliosis
What is the definition of lordosis?
a forward bending condition
What is the definition of kyphosis?
a humpback or hunchback condition
What is the definition of scoliosis?
a warped or crooked condition
What is the direction of the curve deviation in scoliosis?
to the side (it is a lateral curve deviation)
Is there a locational bias for the classic definition of lordosis?
no, there would be:
- an increase in the anterior direction in the cervical spine,
- a decrease in the posterior direction in the thoracic spine,
- an increase in the anterior direction in the lumbar spine, and
- a decrease in the posterior direction in the pelvic or sacrococcygeal region
Is there a locational bias for the classic definition of kyphosis?
no, there would be:
- a decrease in the anterior direction in the cervical spine,
- an increase in the posterior direction in the thoracic spine,
- a decrease in the anterior direction in the lumbar spine, and
- an increase in the posterior direction in the pelvic or sacrococcygeal region
What clinical abnormal curvatures of the vertebral column were stressed in class?
military neck, humpback or hunchback, and swayback
What is military neck?
a decreased anterior curve in the cervical region, a straight neck
What is humpback or hunchback?
an increased posterior curve in the thoracic region
What is swayback?
an increased anterior curve in the lumbar region
What is a classic classification of military neck?
a kyphosis
What is classic classification of humpback or hunchback?
a kyphosis
What is classic classification of swayback?
a lordosis
What does the use of the term lordotic try to imply?
a normal cervical and normal lumbar anterior curve
What does the use of the term kyphotic try to imply?
a normal thoracic or dorsal and normal pelvic or sacrococcygeal posterior curve
What prefixes are used to convey abnormality in curve patterns?
hyper and hypo
What does the term hyperlordotic infer?
an increase in the anterior curve of the cervical or lumbar region
What does the term hypolordotic infer?
a decrease in the anterior curve of the cervical or lumbar region
What does the term hyperkyphotic infer?
an increase in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region
What does the term hypokyphotic infer?
a decrease in the posterior curve of the thoracic/dorsal or pelvic/sacrococcygeal region
What are the curve classifications for military neck?
a kyphosis or hypolordotic curve
What are the curve classifications for humpback or hunchback?
a kyphosis or hyperkyphotic curve
What are the curve classifications for swayback?
a lordosis or hyperlordotic curve
What is the more complete, accepted definition of scoliosis?
an abnormal lateral curve coupled with axial rotation
What is the radiological test for skeletal maturity?
the Risser sign, an indication of bone maturity in the iliac apophysis
What are the classifications of scoliosis according to the Scoliosis Research Society?
magnitude, location, direction etiology, structural scoliosis and non-structural scoliosis
What does magnitude of scoliosis refer to?
the length and angle of the curve deviation on x-ray
What is often used to measure the magnitude of scoliosis?
the Cobb Method
What does location of scoliosis infer?
the location of the vertebral segment forming the apex of the curve deviation
What does direction of scoliosis refer to?
the side the convexity of the curve will bend toward
What does etiology of scoliosis mean?
the cause of the scoliosis
What is structural scoliosis?
a more radical form of scoliosis, it may worsen, associated with structural deformities of the vertebra or intervertebral disc, frequently has a fixed angle of trunk rotation
What is nonstructural scoliosis?
a mild form of scoliosis, unlikely to worsen, not associated with structural deformities of the vertebra or intervertebral disc and lacks a fixed angle of trunk rotation
What is the classification of scoliosis that is unique to the individual patient?
idiopathic scoliosis
What does idiopathic scoliosis infer?
the scoliosis is unique to the individual, it has no known cause, unknown etiology
What is the incidence of idiopathic scoliosis in the population?
1% to 4% of the population
Based on age of onset, what are the types of idiopathic scoliosis?
infantile, juvenile, and adolescent
What is the age range for infantile idiopathic scoliosis?
from birth to 3 years old
What is the age range for juvenile idiopathic scoliosis?
from 3 years old to 10 years old
What is the age range of adolescent idiopathic scoliosis?
over 10 years old
Identify curve direction, location, gender bias, and incidence of infantile idiopathic scoliosis.
left thoracic, male, less than 1% incidence
Identify curve direction, location, gender bias, and incidence of juvenile idiopathic scoliosis.
right thoracic, females over 6 years old, and 12% - 21% incidence
Identify curve direction, location, gender bias, and incidence of adolescent idiopathic scoliosis.
right thoracic or right thoracic and left lumber, females, and 80% incidence
What is the genetic factor associated with adolescent idiopathic scoliosis?
an autosomal dominant factor that runs in families
What is the relationship between curve deviation, incidence, and curve worsening?
the greater the deviation, the lower the incidence, and the more likely to worsen
