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88 Cards in this Set
- Front
- Back
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Scoliosis |
Lateral curvature of spine, not a diagnosis |
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idopathic scoliosis |
diagnosis because define by xray, lateral curvature greater than 10 degrees, unknow etiology |
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Is scoli a three dimensional deformity? |
yes because of vertebral rotation |
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Two deformities of sagital plane that may be evident |
-rib hump -back prominence |
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complications of untreated scoliosis |
-uncosmetic appearance -respiratory complications -cardiac complications limit or decrease of activity levels due to pain or discomfort -may shorten life span
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congenital coliosis |
due to anomalous vertebral development present at birth |
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two classifications of vertebral development |
-failure of vertebral formation -failure of vertebral segmentation |
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examples of failure of vertebral segmentation |
block or bar vertebrae |
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three examples of failure of vertebral formation |
-wedge vertebrae -hemi-vertebrae -fused hemi vertebrae
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Can congenital scoli be fixed with orthotic intervention |
No. it needs surgical intervention. orhtotics can only hold the spine in place until surgery
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paralytic scoliosis |
curve that forms when there is a loss of spinal cord function early in life from disease or disorder. cause by gravity |
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neuromuscular scoliosis |
disorders of CNS, nerves, and muscles that can result in scoliosis. Bracing does not prevent progression. |
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What type of patients is paralytic and neuro scoli most severe in |
non ambulatory |
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Which is curve progression more frequent in...Idiopathic or neuromuscular |
neuro/paralytic |
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infantile scoli |
birth to 3 years |
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juvenile scoliosis |
4-10 years |
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adolescent scoliosis |
10 up to skeletal maturity |
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adult scoliosis |
develops after skeletal maturity is achieved |
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Structural changes stemming from AIS |
-loss of thoracic kyphosis -wedging of the vertebrae -narrowing of disc spaces of the concave side of the curve -ribs are pushing laterally and anterioly on the concave side and posterior and narrow on the convex |
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Which way do the vertebrae and spinous processes rotate? |
toward the concavity |
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Which side of curve does a rib hump occur on |
convex side of the curve
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ratio of curve prevalence F to M |
6.4 to 1 |
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Two hormones that could impact curve |
melatonin and growth hormone |
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Biomechanical reason for curve |
differential growth rates |
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most important problem related to scoliosis |
the progression of the deformity and the resulting collateral effects |
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Four risks factors that could influence progression |
-growth potential of individual -the magnitude of the curve -the type of curve (thoracic curves have higher progression) -the gender of patient (higher in female) |
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What does the Adams flexion test assess? |
Assesses rotation of each curve by degree of prominence over the apices patient can also flex laterally while bent forward to asses spinal flexibility |
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Risser sign |
a predictor of remaining skeletal growth |
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What are the "red flags" that could indicate another disease other than scoli? |
-left thoracic curve -hairy patches -cavus foot deformity (spina bifida) -inability to get hands down (muscular dystrophy) -Significant Back pain |
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How does the risser grading system predict the amount of growth left? |
by measuring the ossification of the ilac apophysis and giving it a numeric value 0 to 5 |
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Apex of the curve definition |
the vertebra that is the most laterally deviated |
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Apex of a thoracolumbar curve |
T12 or L1 |
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apex or cervical curve |
c1 - c6 |
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Most common double curve |
left lumbar right thoracic |
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The more rotation a curve has the less ___________ is is. |
flexible |
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What is the observation period prior to orthotic intervention? |
patients who's curves are less than 25 degrees and are still growing and patients whos curves are less than 45 degrees and have stopped growing |
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When should you proceed with orthotic intervention |
scoliotic curve between 20-45 of an immature skeleton |
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Patient with a curve greater than 45 degrees on initial diagnosis... what is the goal |
hold the curve and limit progression until skeletal maturity |
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When do curves progress the most rapidly? |
during growth spurts |
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when do curves slow their progression |
at the time of skeletal maturity |
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Lumbar vs. thoracic which progresses faster |
thoracic |
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how long should a full-time orthosis be work for |
20-23 hours per day |
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when are part-time orthoses worn |
when patient sleeps (8-10 hours) |
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What is the milwaukee brace indicated for? |
thoracic curve with apex superior to T7 and also kyphosis |
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Is the milwaukee brace a full time orthosis |
yup |
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5 advantages of the Milwaukee |
-it may be removed for activities -minimal restriction of respiration -good air circulation -adjustable for linear growth and curve changes -physical activities are permitted when wearing it
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4 disadvantages of the Milwaukee |
-worn full time -pt. can remove the brace -non cosmetic -not good for larger magnitude curves |
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The most prevalent brace used for AIS |
Boston Brace |
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indication of boston brace |
-curve apices at or below T8 - curves between 20-50
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three advantages of boston brace |
-more cosmetic than milwaukee -may be removed for activities -physical activities are permitted |
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4 disadvantages of the boston brace |
-worn full time -limited adjustment for vertical growth -heat may be an issue -respiration may be affected |
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Indications of Wilmington |
-similar to Boston -25 to 39 degree curve -lumbar thoracolumbar and low thoracic curves (apex below T7) -flexibility is necessary
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How is the Charleston bending brace fabricated? |
so that the curve is maximally corrected or even over |
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When is the charleston brace worn? |
at night |
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When in the providence brace worn? |
at night |
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What type of curve is the charleston best for? |
works best with a C curve |
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what is the posterior superior height of brace |
T9 |
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Vertebral level of spine of scapula |
T3 |
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Vertebral level of sternal notch |
t4-t5 |
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Vertebral level of inferior angle |
T7 |
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Vertebral level of xyphoid |
t9 |
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Vertebral level of waist |
L3 |
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Vertebral level of iliac crest |
L4 |
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Vertebral level of ASIS |
S1 |
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Vertebral level of PSIS |
S2 |
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What is a Jefferson fx? |
Burst fx of C1 due to axial load |
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is there nervous injury with jefferson |
no because there is no rotation |
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Ondontoid fx |
fx of ondontoid process of C2 caused by flexion |
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nuero injury with hangmans fx? |
rare because fx expands the conal |
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hangman fx |
pedicle fx of C2 |
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Facet FX |
cause by flexion rotation and causes neuro probs |
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compression fx |
fracture of anterior body no neuro |
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burst fx |
complete body fx, neuro involvement |
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What is spinal stenosis |
ligamenta flava becomes inflamed and the area for nerves to pass through gets smaller |
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what is Radiculopathy |
Radiating nerve pain due to nerve root being compromised, inflamed, pinched or crushed common causes: bulging disc or arthritis can have nonsurgical or surgical intervention burning pain |
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Osteoporosis |
Decrease in the bone mass decrease in height of the vertebral body common cause of back pain |
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Disc Disease |
Herniation exerts direct pressure on the nerves |
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most common disc herniation level |
most common is L4-L5 and L5-S1 |
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Goal of orthotics for spinal tumor |
decrease pain |
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Spondylolysis |
fx of pars with no slippage |
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Spondylolisthesis |
bilateral pars defect with forward slippage |
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Sheurmans kyphosis |
-wedging of 3 consecutive vertebra -thoracic kyphosis greater than 45 degrees |
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spondylosis |
-degeneration of IV discs and or vertebral bodies -spinal osteoarthritis |
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causes of spondy |
-age -genetics -lifestyle and smoking |
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Two subtypes of neuromuscular scoli |
myopathic and neuropathic |
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are upper motor neuron lesions progressive |
nah |
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is myopathic scoli progressive |
YAS |
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