Chapter 5 - Scoliosis and Short Leg Flashcards Preview

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Flashcards in Chapter 5 - Scoliosis and Short Leg Deck (20):
1

At what age should children be examined for scoliosis?

10-15

2

Steps to examine for scoliosis (3)

1. Examine levelness of occiput, shoulders, crests, PSIS, trochanters
2. Bend forward at waist and look for prominent rib angles
3. Screen for lumbosacral dysfunctions that may cause a short leg

3

Cobb angle - how to measure (3)

1. Draw "horizontal" lines along the vertebral body of the extreme ends
2. Draw perpendicular lines from each of those lines
3. Measure the angle of the intersection of those lines

4

Severity of scoliosis...
- Mild
- Moderate
- Severe

Mild = 5-15 degrees
Moderate = 20-45 degrees
Severe = 50+ degrees

5

Scoliosis - when is respiratory function compromised?

Scoliosis - When is cardiovascular function compromised?

50 degrees

75 degrees

6

Congenital cause of scoliosis

Progressive?

Malformation of vertebrae

Most often progressive

7

Neuromuscular causes of scoliosis (4)

Polio, Cerebral Palsy, Duchenne's, Meningomyelocele

8

Acquired causes of scoliosis (6)

Tumor, infection, osteomalacia, sciatica, psoas syndrome, short leg syndrome

9

Scoliosis 5-15 degrees - treatments

Goals?

PT, OMT, Konstancin exercises

Improve FLEXIBILIY and strengthen trunk and abdominal msuculature

10

Scoliosis 20-45 degrees - additional treatment?

BRACE W/ SPINAL ORTHOTIC

11

Scoliosis 50+% - treatment?

Surgery IF respiratory compromise OR progression

12

Definition of short leg syndrome

1. Sacral base unleveling
2. Vertebral SB and R dysfunction
3. Innominate rotation dysfunction

13

MC cause of anatomic short leg syndrome

Hip replacement

14

6 compensatory findings in short leg syndrome

1. Sacral base unleveling (lower on short leg side)
2. Anterior innominate on short leg side
3. Posterior innominate on long leg side
4. Lumbar SB away, R toward
5. Ferguson's angle increased 2-3 degrees
6. IL ligaments --> SI ligaments stressed on short leg side

15

Short leg syndrome - treatments

When is heel lift considered?

1. OMT at spine and LEs to remove SDs
2. Standing X-rays to assess femoral head heights

Heel lift IF femoral head difference is > 5mm

16

Heel lift - final lift height? (if chronic)

If acute/sudden?

1/2 - 3/4 of the measured discrepency

FULL discrepency amount

17

Heel lift - fragile people?

Who are these people? (4)

1/16 inch (1.5mm), then increase 1/16 every 2 weeks

Elderly, arthritic, osteoporotic, acute pain

18

Heel lift - flexible people?

1/8 inch (3.2mm), the increase 1/8 every 2 weeks

19

Heel lift - maximum inside the shoe?

1/4 inch

20

Heel lift - maximum TOTAL?

If more height is needed? Why?

1/2 inch

Ipsilateral anterior sole lift from heel to toe - to prevent pelvic rotation to opposite side