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Figure 24-1. Kyphoscoliosis. Posterior and lateral curvature of the spine Figure 24-1. Kyphoscoliosis. Posterior and lateral curvature of the spine causing lung compression. Excessive bronchial secretions (A) and atelectasis causing lung compression. Excessive bronchial secretions (A) and atelectasis
(B) are common secondary anatomic alterations of the lungs. (B) are common secondary anatomic alterations of the lungs.
Kyphoscoliosis affects about 2% of the Kyphoscoliosis affects about 2% of the people in the United Statespeople in the United States Mostly young children going through growing Mostly young children going through growing
spurtsspurts
Rarely develops in adults—unless a worsening Rarely develops in adults—unless a worsening condition from childhoodcondition from childhood
Kyphoscoliosis may also develop in adults from a Kyphoscoliosis may also develop in adults from a degenerative joint condition in the spinedegenerative joint condition in the spine
EtiologyEtiologyAssociated with the following conditions:Associated with the following conditions: Congenital connective tissue and skeletal disordersCongenital connective tissue and skeletal disorders Hormonal imbalanceHormonal imbalance Neuromuscular disordersNeuromuscular disorders TraumaTrauma Extraspinal contracturesExtraspinal contractures Bone infections involving the vertebraeBone infections involving the vertebrae Metabolic bone disordersMetabolic bone disorders Joint diseaseJoint disease TumorsTumors
Sex—females are 10 times more likely than Sex—females are 10 times more likely than males to develop curvature of the spinemales to develop curvature of the spine
Age—the younger the child is when Age—the younger the child is when diagnosed, the greater the chance of curve diagnosed, the greater the chance of curve progressionprogression
Angle of the curve—the greater the curvature Angle of the curve—the greater the curvature of the spine, the greater the risk that the of the spine, the greater the risk that the curve progression will worsencurve progression will worsen
Location—in girls with lower back curvature, Location—in girls with lower back curvature, the curve is less likely to progress the curve is less likely to progress
Height—taller girls have a greater chance of Height—taller girls have a greater chance of curve progressioncurve progression
Spinal problems at birth—children with Spinal problems at birth—children with scoliosis at birth may experience a rapid scoliosis at birth may experience a rapid curve progressioncurve progression
EtiologyEtiologyClinically, scoliosis is commonly defined according toClinically, scoliosis is commonly defined according tothe following factors:the following factors: ShapeShape
Nonstructural scoliosis—a side-to-side curveNonstructural scoliosis—a side-to-side curve Structural scoliosis—a curvature of the spine associated Structural scoliosis—a curvature of the spine associated
with vertebral rotationwith vertebral rotation LocationLocation
Overview of the Cardiopulmonary Overview of the Cardiopulmonary Clinical Manifestations Associated Clinical Manifestations Associated
with KYPHOSCOLIOSISwith KYPHOSCOLIOSIS
The following clinical manifestations result from The following clinical manifestations result from the pathophysiologic mechanisms caused (or the pathophysiologic mechanisms caused (or activated) by activated) by Atelectasis Atelectasis (see Figure 9-7) and (see Figure 9-7) and Excessive Bronchial SecretionsExcessive Bronchial Secretions (see Figure (see Figure 9-11)—the major anatomic alterations of the 9-11)—the major anatomic alterations of the lungs associated with kyphoscoliosis (see lungs associated with kyphoscoliosis (see Figure 24-1). Figure 24-1).
Figure 2-47. Pitting edema. From Bloom A, Ireland J: Figure 2-47. Pitting edema. From Bloom A, Ireland J: Color atlas of diabetesColor atlas of diabetes, ed 2,, ed 2,London, 1992, Mosby-Wolfe.London, 1992, Mosby-Wolfe.
Figure 2-11. Figure 2-11. A short, dull, or flat percussion note is typically produced over areas A short, dull, or flat percussion note is typically produced over areas of alveolar consolidation.of alveolar consolidation.
Figure 2-16. Figure 2-16. Auscultation of bronchial breath sounds over a consolidated lung Auscultation of bronchial breath sounds over a consolidated lung unit.unit.
Figure 2-19. Figure 2-19. Whispered voice sounds auscultated over a normal lungWhispered voice sounds auscultated over a normal lungare usually faint and unintelligible.are usually faint and unintelligible.
ReviewReview A posterior curvature of the spine is called?A posterior curvature of the spine is called?
KyphosisKyphosis
A lateral curvature of the spine is called?A lateral curvature of the spine is called? ScoliosisScoliosis
Kyphoscoliosis affects approximately what Kyphoscoliosis affects approximately what percentage of the U.S. population?percentage of the U.S. population? 2%2%
What is the most common form of idopathic What is the most common form of idopathic kyphoscoliosis?kyphoscoliosis? Adolescent ScoliosisAdolescent Scoliosis
What is a nonstructural scoliosis?What is a nonstructural scoliosis? A side-to-side curve that results from a cause A side-to-side curve that results from a cause
other than the spine (poor posture, pain)other than the spine (poor posture, pain)
What is a structural scoliosis?What is a structural scoliosis? Curvature associated with vertebral rotationCurvature associated with vertebral rotation
True / FalseTrue / False Kyphoscoliosis is classified as an obstructive Kyphoscoliosis is classified as an obstructive
disorder.disorder. FalseFalse
Girl are 10 times more likely to develop Girl are 10 times more likely to develop curvature of the spine than boys.curvature of the spine than boys. True True
Kyphoscoloiosis causes the patient’s PEFR to Kyphoscoloiosis causes the patient’s PEFR to increase.increase. FalseFalse