Phys Med #3

Question 1

Define Postural Dysfunction/syndrome

Answer 1

a condition that is usually due to poor posture, where normal spine curvature can become excessive and thus increase gravitational stress and cause undue wear and tear on joints. This causes pain in the lumbar and cervical regions.

Question 2

ddx of postural dysfuntion/sydrome

Answer 2

• headache (cluster, migraine, tension)
• spinal deformaties (structural)
• neoplastic, traumatic
• osteochondrodystrophies (a disease of bone and cartilage)

Question 3

what are the types of postural dysfunction?

Answer 3

lordosis (increased/absent)
kyphosis (increased/absent)

Question 4

what are the 2 main types of excessive lordosis?

Answer 4

pathological lordosis and sway back

Question 5

what is the pelvic angle of the pathological lordosis?

Answer 5

increased pelvic angle to 40 degrees (normal is 30)

Question 6

what is tight and weak for pathological lordosis?

Answer 6

tight hip flexors and weak abdominal muscles

Question 7

explain sway back?

Answer 7

pelvic in neutral or posterior tilt and increase in kyphosis at lumothoracic junction
- pelvic shifts anteriorly

Question 8

what are the types of excessive/decreased kyphosis?

Answer 8

• Sheuermann’s disease
• humpback (Gibbus deformity)
• flat back
• Dowager’s hump
• Congential kyphosis

Question 9

what is flat back?

Answer 9

pathological reduction in the normal kyphosis

Question 10

what is sheuermann’s disease?

Answer 10

• usually occurs in adolescence
• vertebrae are wedge shape instead of cylindrical causing kyphosis
• usually between T10-L2
• inflammation of the bone and cartilage occurs around the ring epiphysis of the vertebral body

Question 11

what is humpback?

Answer 11

usually a sharp angulation of the spine at a single vertebral level

Question 12

what is dowager’s hump?

Answer 12

• often in older patients
• caused by osteoporosis
• thoracic vertebral bodies degenerate and wedge anteriorly

Question 13

what is congenital kyphosis?

Answer 13

• curvature present at birth
  vertebral bodes are triangular and often fuse anteriorly

Question 14

what are the special tests for postural dysfunction/syndrome?

Answer 14

no special tests, simple observation/history of posture

Question 15

what is rib subluxation/slipping rib syndrome?

Answer 15

when abnormal movement of a rib, usually a false rib, occurs due to an unstable cartilaginous attachment. This can cause impingement of an intercostal nerve

Question 16

rib subluxation/slipping rib syndrome can also be known as:

Answer 16

• clicking rib
• displaced rib
• painful rib syndrome

Question 17

what is scoliosis?

Answer 17

a lateral curvature of the spine within the vertebral column
- described according to the side of the CONVEXITY

Question 18

how is scoliosis labelled as?

Answer 18

labelled as C-curves (1 curve) or S-curve (2 curves)

Question 19

for scoliosis, primary curvature is…

Answer 19

where the vertebrae become misaligned

Question 20

for scoliosis, secondary curvature is…

Answer 20

where above and below the curve tries to compensate to maintain normal head and pelvis position

Question 21

what is structural curves?

Answer 21

fixed due to bony changes resulting in asymmetric side bending

Question 22

what is functional curves

Answer 22

not fixed and mainly due to posture/muscle imbalances resulting in symmetric side bending
can be corrected with voluntary effort

Question 23

what is a special test for scoliosis?

Answer 23

adam’s sign (test)

Question 24

explain adam’s sign

Answer 24

when bending makes curve more obvious = structural
when bending makes curve go away = functional

Question 25

list out the different degrees of Cobb Angle

Answer 25

- <25 degrees, observe only - >25 defrees, bracing (many types) also controversial - >45 degrees, surgical correction (rods or spinal fusion)

Question 26

what is thoracic outlet syndrome?

Answer 26

a collection of syndromes that cause compression of the neurovascular bundle - brachial plexus - C8 and T1 nerve roots - subclavian artery

Question 27

where can the brachial plexus and its accompanying artery be compressed at for thoracic outlet syndrome?

Answer 27

between the anterior and middle scalenes between the coracoid process and pec minor between the clavicle and the first rib

Question 28

what are the vascular symptoms of thoracic outlet syndrome?

Answer 28

- swelling and puffiness in the arm/hand - bluish discolouration of the hand - feeling of heaviness in the arm/hand - pulsating lump over the clavicle - deep, boring toothache-like pain in the neck and shoulder region, that increases at night - superficial vein distention in the hand

Question 29

what are the neurological symptoms of thoracic outlet syndrome?

Answer 29

- paresthesia along the inside forearm and palm - muscle weakness and atrophy of gripping muscles and small muscles of the hand - difficulty with fine motor tasks of the hand - cramps of the muscles of the inner forearm - pain in the arm and hand - tingling and numbness in the neck, shoulder region, arm, and hand

Question 30

what is compression fracture?

Answer 30

a fracture or break in bone that is due to compressive forces

Question 31

what are the causes of compression fracture?

Answer 31

- osteoporosis - compression type injury - tumours

Question 32

what is vertebral subluxation?

Answer 32

the alteration of the normal dynamic, anatomic, or physiologic relationships of contiguous (touching) articular structures. A motion segment in which alignment, movement integrity, or physiologic function is altered, although the contact between the joint surfaces remains intact