WVSOM -- OPPI

Description:	Scoliosis and Postural XRays
Category:	Osteopathic Principl
Created by:	null on 2008-11-12

Question	Answer
What Dysfunctions are in the sagittal plane?	Kyphosis and Lordosis
What dysfunctions are in the coronal plane?	Scoliosis
What dysfunction is in the transverse plane?	Rotation
What is a diagnosis of kyphosis based on?	a constellation of history and physical findings that must be confirmed radiographically.
How many degrees must the sidebending be for it to be classified as scoliosis?	The spinal lateral curvature in question must exceed 10 degrees as measured by the Ferguson or Cobb methods.
How should scoliosis be described to a patient?	As a lateral curve or spinal curve
How many school age children get scoliosis by age 15?	5%
How many of patients with scoliosis present with clinical symptoms?	10%
Ratio of females to males with scoliosis?	4:1
Idiopathic Scoliosis	no known reason for this type of scoliosis to occur. 70-90%
Congenital scoliosis	75% are progressive. 2nd most common type of scoliosis
Acquired scoliosis caused by: (7)	Osteomalacia Response to inflammation or irradiation Sciatic irritability Psoas syndrome Healed leg fracture Following a hip prosthesis Short leg syndrome
Short leg syndrome	condition in which an anatomical or functional leg length discrepancy results in: 1)Sacral base unleveling 2)Vertebral sidebending and rotation 3)Innominate rotation
Idiopathic scoliosis is passed on by?	genetics, usually sex linked
What is the most common scoliotic spinal pattern?	thoracic curvature convex on the right.
In Type I, rotation and sidebending are ______.	opposite
Apex of the curve	vertebrae of maximum rotation, which rotational mechanics change
Cross over point	The conjuncture of two curves, where side-bending mechanics change
A curve that is sidebent left is classified as what kind of scoliosis?	right scoliosis or Dextroscoliosis
How do you name the scoliosis?	The side of convexity
Left scoliosis is known as ____________.	Levoscoliosis
What does the line pass between in a structural postural exam?	Knees Gluteal fold Spinous processes Midline of head
In the structural postural exam observe for horizontal levelness of: (6)	Popliteal creases Greater trochanters Iliac crests Inferior angles of scapula Tops of shoulders Mastoid processes
What are the lateral points of the structural posture exam?	Anterior aspect of lateral malleolus Middle of tibial plateau Greater trochanter Body of L3 Middle of humeral head External Auditory Meatus
Adam's Forward Bending Test	1. Stand behind your patient and ask them to bend forward with legs straight 2. Rib hump that is convex to the side of fullness possible scoliosis 3. If the rib hump is present ask the patient to bend to the side of fullness 4. If the hump goes away w
What is the Cobb's method for measuring scoliosis?	1. Lines are drawn along the endplates of the upper and lower vertebrae that are maximally tilted into the concavity of the curve 2. A perpendicular line is drawn to each of the earlier-drawn lines 3. The angle of intersection is the Cobb angle.
What is mild scoliosis?	5-15 degrees
What is moderate scoliosis?	20-45 degrees
What is severe scoliosis?	> 50 degrees
When is respiratory function compromised?	> 50 degrees
When is cardiovascular function compromised?	> 75 degrees
What x-rays are taken for scoliosis?	Anteroposterior postural radiographs and Erect Lateral Lumbopelvic
Sidebending automatically induces?	rotation
What is checked in AP thoracic and lumbar xrays?	Notice the vertebral rotation and side-bending.
What is checked in AP Lumbopelvic?	Iliac crests Sacral base Femoral heads
What is checked in the Erect Lateral Lumbopelvic xray?	Ferguson's angle
What is Ferguson's angle?	Lumbosacral angle Angle between sagittal line from sacral base and line parallel to ground
What is normal lumbosacral angle?	40 degrees + or - 2 degrees
If a lumbosacral angle is greater than 42 degrees results in?	Excessive Strain on ligamentous structures Shearing forces on intervertebral discs
Lumbosacral Angle less than 38 degrees results in:	Flattened lumbar lordosis Compressive forces on articular facets
What is treatment goal of scoliosis?	to maintain function and prevent further complications
What is NOT the goal of treating scoliosis?	To straighten the spine
What is the treatment goal for mild scoliosis?	goal is to improve flexibility and strengthen the core muscles
What is the treatment of mild scoliosis?	OMT Functional orthotics Heel lift therapy Patient and family education
What is the treatment of moderate scoliosis?	OMT Functional orthotics Heel lift therapy Patient and family education Bracing
When is surgery indicated for scoliosis?	If there is visceral compromise.
OMT treatment options	Passive and active stretching Group Curve Mobilization Stabilization
What are the stabilization exercises?	Back extension exercises Torso curls exercises Reverse curls exercises
What are examples of group curve mobilization?	Articulation HVLA Muscle Energy
Why is group curve mobilization done?	Used to enhance spinal motion and keep Type 1 curve flexible. Useful for curves with apices from the mid-thoracic region through the lumbar spine.
Why is group curve mobilization done?	Used to enhance spinal motion and keep Type 1 curve flexible. Useful for curves with apices from the mid-thoracic region through the lumbar spine.