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2010-03-28 21:35:40
General Orthopedics OP

OP study cards
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  1. Definition + Etiology
    • Exaggeration of the normal poserior curve of the spine. Often w/ head forward + protracted scaps.
    • Caused by: Prolonged poor posture
    • MM Str/length imbalances
    • Senile osteoporosis
    • DDD, DJD, Sheuermann's, Pott's, Hemivertebra, Anterior compression Fx
    • Compensation to trauma injury
  2. CIs + Precautions
    • Do not mobilize hypermobile jts
    • Do not stretch stabilizing fascia
    • Do not stretch hypotonic tissues
    • Structural kyphosis = pillow for support, not correction
  3. S&S
    • Exaggerated t/s curve
    • Head forward, increased cervical lordosis
    • Increased/decreased lumbar curve
    • Possible TOS, TMD, Add Cap, impingement syndrome
    • Short pecs
    • Decr lung capacity
    • Breast congestion + edema
    • Decr RoM in GH, c/s, t/s, ribs
    • Mild-severe pain from ligs and jts, taut ishemic MMs, or discogenic pain from vertebral wedging
  4. H
    • Location/timing of pain
    • ADLs, postural habits (work, home, driving)
    • Hx of disease, surgery, activity level
    • Meds, other Tx received
  5. O
    • Postural assessment
    • Assess by correcting posture (maybe supine, no gravity)
  6. P
    Hyper/hypotoned structures
  7. M
    • All applicable RoM
    • ADLs
    • Respiratory pattern and voloume
  8. N
    Possible impingement syndrome (brachial plexuse, intercostals)
  9. R
    • TrP
    • Viisceral referrals from stomach, liver, pancreas
  10. S
    • Respiratory volume measurements
    • Rib motion
    • Regional tests?
  11. Tx Goals
    • Decrease: Pain, adhesions, fascial shortening
    • Increase: postural awreness/edu, functional abilities, segmental mobility in t/s, regional inspiration
    • Improve MM balance
    • Balance breathing patterns
    • Remove cause if possible
  12. Tx
    • Fascial release, NMT, frictions, passive RoM to scap, c/s, g/h.
    • Jts mobes to GH, sternum/ribs, vertebrae
    • Swedish, intercostal stripping, diaphragmatic release, rib springing, towel roll, SCM
  13. Hydro
    • Heat to core if no CI before stretch
    • DMH steam, bath
    • Fascial steam (care w/ additives)
  14. RemEx
    • Weighted and non weight-bearing exercises
    • Pec stretch
    • Postural wall work
    • Str to involved MM (abs, glutes)