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scoliosis Flashcards

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1
Q

QL Origin insertion action and nerve

A

O-illiolumbar ligament and posterior illiac crest

I-12th rib (inferior border) and TVP L1-4

Action= lateral flexion bilateral extension and stabilizes 12th rib during insipration/depresses it upon forced expiration elevates coxal bone

Nerve Lumbar plexus L1-L4

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2
Q

Lattisumus Dorsi Origin insertion nerve action

Referral:
pain will be felt in the anterior part of the shoulder and the lower back.

A

O-SPT7-S5 via thoracolumbar fascia
posterior illiac crest; ribs 10-12 and inferior scapular border

I-floor of the bicipital groove of the humerus

Nerve is thoracodorsal nerve C(6)-8

Action:Adducts, extends and medially rotates the humerus

ASSISTS FORCED INSPIRATION

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3
Q

intercostals Origin; insertion nerves and action

A

External O-rib above (inf border)
I-rib below (sup border)
N-intercostal nerves (t1-12)
A-Elevates rib during INSPIRATION
Internal O-rib below (sup border)
I-Rib above (inf border)
N-intercostal nerves(T1-12)
A-decreases thoracic cavity volume during FORCED EXPIRATION (draws adjacent ribs together)

Innermost O/I= adjacent ribs in lateral curve of rib cage
***assists in both external and internal intercostals MORE forced expiration (internal)

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4
Q

What special test do you perform for scoliosis

A

Hemipelvis

Functional/structural test

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5
Q

What’s rom for thoracic spine

A

Flex 20-45
Ext25-45
Lat flex 20-40
Rotation 35-50

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6
Q

Rom of lumbar spine

A

Flex 40-60
Ext 20-40
Lat flex 15-20
Rotation 3-18

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7
Q

Thoracic spine review

What organs are located in the right upper quadrant?

A 
Liver 
Gallbladder
Duodenum 
Pancreas
Right kidney
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8
Q

What organs are located in the left upper quadrant

A 
Kidney left 
Spleen
Stomach
Pancreas
Splenic flexure
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9
Q

Right lower quadrant holds what organs

A

Cecum
Appendix
Right ovary and tube

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10
Q

Left lower quadrant holds the

A

Left ovary and tube

Sigmoid colon

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11
Q

Functional scoliosis may be due to

A

Poor posture or postural changes NOT positional

Are able to be corrected

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12
Q

Scoliosis curves are named for the side that the _____ occurs on.

A

Convexity

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13
Q

The _____ is the distance on the spine that the curve occurs

A

Span

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14
Q

The apex is the vertebrae that is _________.

A

Farthest away form midline

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15
Q

What is the major curve in a S scoliosis

A

The curve that is the largest with the greatest angulation

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16
Q

The minor curve in an S scoliosis is also referred to as the

A

Compensatory curve

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17
Q

What is the transitional vertebra in terms of scoliosis

A

The one that marks the end of one curve and beginning of the next

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18
Q

List the degrees in terms of severity
Mild
Moderate
Severe

A

0-20 degrees
20-50
Greater than 50

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19
Q

What refelex is likely responsible for secondary curves

A

Righting reflex

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20
Q

The fact that the entire body head to toe can be involved in a scoliosis is a example of what principal?

A

Wolffs principal
Over time bones remodel themselves along the line of force being applied to them ( applied also to connective tissues, muscles and viscera)

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21
Q

Causes of scoliosis

A 
Idiopathic 
Iatrogenic
Congenital
Functional 
Neuromuscular
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22
Q

Idiopathic scoliosis explain the differences in who is more apt to get it and when

A

Infantile idiopathic more common in boys (up to 3yrs old)
Juvenile scoliosis occurs equally boys to girls 4-9
Adolescent more common girls age 10-16

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23
Q

Which muscles may cause idiopathic scoliosis when spindle cells have abnormal response

A

Paraspinals

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24
Q

The _____ in the inner ear if asymmetrical May influence spinal posture

A

Labyrinth

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25
Fun fact: Study found increase in labyrinth sensitivity on convex side and right eye dominance may be associated with left sided curves
;) the more you know
26
List some things you should check for in a functional scoliosis
Unilateral pes planus Short tibia,/small Hemipelvis (places sacrum on oblique angle in standing ) Fractured tibia and femur (can cause pelvis to be oblique and spine must compensate) ``` Short humerus (must lean to affected side) Torsion of the occiput on sphenoid (cranial sacral!!!!) ``` How the clients stands/sits (all weight to one side?)
27
Tps in what muscle may cause appearance of short leg?
Quadratus lumborum
28
Unilateral _____ shortening and ITB contracture can produce ____ pelvic tilt while unilaterally shortened _____ and ____ muscles lead to thoracic curving and lateral pelvic tilt
Tensor fascia lata Lateral Abdominal obliques Latissumus dorsi
29
List several neuromuscular causes of scoliosis
Cerebral palsy Freidreichs ataxia Muscular dystrophy Spinal cord lesions
30
Paralysis following polio can result in _____ scoliosis
Long C curve | On side of impairment
31
List some congenital causes that contribute to scoliosis
- Hemivertebrae( incomplete formation of 1/2 vertebra) - Vertebral wedging ( slows growth and occurs on concave side) -Vertebral bridging ( failure of segmentation bony bars occur btwn vertebra -malformed or absent ribs
32
Scoliosis is often associated with what two major spine deformities
Hyper lordosis | Hyper kyphosis
33
Vertebral bodies rotate toward the _____, tvps are ____ on convex side causing ________. Ribs are flattened and more closer together on the ______ side and tvps are ______.
Convexity ; posterior ; rib humping Concave; anterior
34
From an anterior view ribs appear more prominent on the _____ side and muscles appear bulkier on what side?
Concave | Convex
35
What muscles are shorter on the concave side
Multifidus Erector spinae Intercostals
36
Which muscles acting unilaterally will increase the severity of the curve
``` Abdominals Iliopsoas Lats Intercostals Erector spinae ```
37
The shoulder on the convex side will be _____ due to actions of ______ and _____.
Elevated Upper trapezius Levant or scapulae
38
What muscles and in what sequence together will maintain a pelvic obliquity
One side : Tight quadratus lumborum Iliopsoas Adductors Other side: Tight tfl and gluten medius
39
Origin and insertion gluten medius
Originates : between ant and posterior gluteal lines and gluteal aponeurosis Inserts: post lat surface greater trochanter Superior gluteal nerve Abduction primary assist medial rotation
40
Multifidus Origin/ insertion
Sacrum mammillary process L5-T12 Tvps all t spine Articular processes of all c spine Inserts on SPs L5-C2 (2-4 vertebrae above origin Extension lateral flexion CONTRALATERAL ROTATION
41
Levator scapulae origin insertion
Posterior tubercles C1-C4 Vertebra, border of scapula superior to spine Dorsal scap nerve C5 Cervical nerve C3/4 Elevates and rotates scapula inferiorly (glenoid fossa) Extension and lateral flexion if scapula fixed
42
Internal obliques origin insertion
Origin: Thoracolumbar fascia Anterior 2/3 illiac crest Lateral 2/3 inguinal ligament (external obliques) Insertion: Ribs 10-12 (Abdominal aponeurosis ) to Linea alba xiphoid process pubic symphysis Flexion Ipsilateral flex and rotation ***** Supports compresses abd viscera and assist forced expiration micturition parturition defecation Vomitting
43
External oblique origin insertion
Ribs 5-12 Abdominal aponeurosis to xiphoid process Linea alba pubic crest, tubercle Anterior 1/2 illiac crest CONTRALATERAL rotation **** Lateral flexion Flexion Supports compresses viscera and assists expiration (forced) micturition parturition defecation Vomitting
44
Illiopsoas origin insertion
Vertebral bodies discs and tvps T12 to L4 Lesser trochanter of femur Lumbar plexus L1-4 Primary flexion of hip If legs fixed flexes trunk
45
TFL origin insertion nerve
Anterior illiac crest (ASIS) Iliotibial band Superior gluteal nerve L4-S1
46
Upper traps origin
Superior nuchal line medial 1/3 EOP Ligamentum nuchae up to c7 then SPs c7 to t12 Inserts on spine of scapula acromion process lateral 1/3 clavicle ``` Accessory nerve (cnXI) Cervical nerve c3/4 ```
47
What is the action of upper traps
Elevate and rotate scapula superiorly Extend head and neck Rotate head and neck contralateral Laterally flex to same side
48
Latissumus dorsi origin and insertion and
SPs t7 to s5 Via thoracolumbar fascia Posterior illiac crest and inferior angle of scapula Floor of bicipital groove of humerus Extends adducts and medically rotates humerus Assist forces INSPIRATION
49
What muscles do we test often in scoliosis and what is often found
Abdominals weak | Any muscles in concave side (tight so usually weak) glute med test on high side
50
List 5 CIs to treating scoliosis
Jt mobs to fused or vertebra immobilized by rods Rib springing or jt play to hypermobile jts or ribs or history of subluxation Randomly treating fascia Heat over metal rods Longitudinal or stretching work to muscles of convex side
51
What secondary conditions may develop in scoliosis
Intercostal neuralgia Thoracic outlet syndrome May be result of pes planus
52
When recording a scoliosis the therapist lists what 5 important things
``` Span if curve Apex if curve(s) Transitional vertebra Functional or structural S or C curve ```
53
Person with leg length discrepancy will weigh bear on the ____ leg while they will ___ the hip and knee of the _____ leg or position it to the _____ or side.
Short Longer Front
54
If client has both knees fully extended and locked the pelvis is now _______ and _____ on the shorter leg side It is said a client weight bears more on the ____ side than the _____.
Laterally tilted Lower Convex Concave
55
With pelvic torsion: ___________ raises the innominate bones and sacrum on the same side while ________ lowers it on the same side With leg length differences people often ______ on the long leg side and _____ on the short to even them out
Anterior rotation Posterior rotation Posteriorly rotate Anteriorly rotate
56
Left thoracic pattern and cafe au lait spots or faux beard is most common with _______ scoliosis
Non idiopathic
57
What is the most common pattern for idiopathic scoliosis Where is the apex
Right thoracic curve t5-t11 and a compensatory lumbar curve from t12 to l4 Apex t8
58
Scoliosis resulting from neurological conditions generally appear as What will you see
Lumbar or thoracolumbar curve extending to the pelvis Pelvic obliquity Prominent hip and adduction of femur
59
Lateral view of C curve scoliosis you will see an increased _____ on the short leg side; Anteriorly the _____ is lower on the short limb side ribs on the ____ side will be prominent and if a small hemipevis is involved face bones on the ___ side may be found
Anterior tilt (5 to 10 degree women 0-5 degree men is normal) ASIS Concave Same
60
In a right thoracic left lumbar S curve scoliosis fill in the blank : May be a ____ compensatory cervical curve _____ AC joint is higher ____ scapula higher and possibly winged ___rib humping is present Asymmetrical skin folds with more on the ____ side Illiac crests higher on the ____ Lateral pelvic tilt PSISs are _____ on the ____ side while in a torsion they will be ____ on the ________side. Unilateral pes planus on the ____ is possible
``` Left Right Right Right Concave Right Lower Dropped Higher Anteriorly rotated shorter side Left or concave ```
61
From a superior view describe what you'd see in a unilateral torsion and what you'd see in a opposing torsion
Unilateral AC and ASIS anterior on one side Opposing AC on one side and ASIS on other are anterior
62
Homecare for scoliosis
Heel sitting exercises : Sits with knees bent heels under glutes bends forward abdomen rests on ant thighs and arms stretched above head Laterally walks hands to side of Convexity when fill stretch reached inhales and exhales and goes deeper into Convexity repeated several times Strengthening for weak convex muscles: Lie on concave side lift shoulder off ground hold 5-10 seconds and release repeat several times upper arm slides down lateral thigh

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