2.29 SCI 2 Flashcards
How do we classify SCI?
ASIA
ASIA
American Spinal Injury Association
incomplete SCI
- has sacral sparing (sensation and/or motor at S4-S5 - anus)
- tested with gloved finger inserted
After a pt survives an SCI, what generally happens?
surgeons will typically stabilize the injury (bones)
surgical stabilization: c-spine
- ACDF (anterior cervical disc fusion)
- may do a PLIF (posterior lumbar interbody fusion) if ACDF doesn’t work
c-spine stabilizaztion: post surgical issues (c-spine specific)
- low speech volume
- pain
- difficulty swallowing
- raspy voice
should not have voice issues weeks later
surgical stabilization: thoracic/lumbar
- typically start with PLIF
- put as much metal in the back as possible if there’s bone to screw into
What happens if the SCI pt is hypermobile after a PLIF?
- they’ll do an ALIF (anterior)
- hugely invasive, going through viscera
general post-surgical issues
abdominal swelling, bloating
gastric issues during surgery
- sepsis
- lack of peristalsis
ileus
- peristalsis stops
- stomach doesn’t process anything into the intestines
reverse peristalsis
- start vomiting like crazy
- can get reverse peristalsis from intestines and vomit feces (usually circling death’s door)
tx for an ileus?
NG tube to suck up stomach acid and other crap from the stomach
How could a PT dx an ileus?
- ask if they’re having bowel movements or farting
- listen to bowel sounds (rumbling, grumbling
What will you hear if there’s an ileus with bowel sounds?
won’t hear anything
