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7313/7333 Bringman > 3.2 Other SCI issues > Flashcards

3.2 Other SCI issues Flashcards

1
Q

apneic bradycardia

A
  • slow HR (rapid decrease) with some loss of breathing

- happens when we do tracheostomy cleaning

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2
Q

stages of getting a tracheostomy

A
  • first do oral intubation

- If it takes longer than 10-14 days to come off of the trach, they’ll do the tracheostomy hole through the throat

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3
Q

Why would they do a tracheostomy instead for prolonged cases?

A
  • oral intubation keeps the vocal cords open
  • prolonged opening can cause scarring and voice change

*partial or complete paralysis

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4
Q

cleaning secretions from trach

A
  • long tube you can put down the trachea and suction things out
  • bradycardia shouldn’t keep you from suctioning out
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5
Q

problems with a trach (nerve)

A
  • vagus nerve runs near it - might trigger a vagal
  • response that creates issues with heart
  • don’t actually know why
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6
Q

bradycardia and trach

A
  • just something that may happen, don’t freak out

- educate and monitor

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7
Q

Where do autonomics leave the spinal cord?

A

about at T6

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8
Q

injury below T6 and autonomics

A

wouldn’t affect autonomic nervous system

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9
Q

injury above T6 and autonomics

A

lesions from T6 and above are at risk for autonomic dysreflexia

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10
Q

What is autonomic dysreflexia?

A
  • something below the level of the lesion throws off sympathetic and parasympathetic systems off
  • body starts (somehow) perceiving sensation as noxious stimuli (they can’t feel it) and sends it up
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11
Q

What can cause autonomic dysreflexia?

A
  • could be caused by a kinked catheter, ingrown toenail, wrinkle
  • Sometimes, could be due to bladder distention, UTI, bowel impaction
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12
Q

BP and autonomic dysreflexia

A
  • super high blood pressure

- may stroke out and die

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13
Q

autonomic dysreflexia: do patients get this multiple times? Is it dangerous?

A
  • most patients who experience it will get it multiple times

- life threatening issue for patients

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14
Q

Where do s/s of autonomic dysreflexia start happening?

A

above the level of the lesion

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15
Q

s/s autonomic dysreflexia

A
  • sudden increase in BP
  • pounding headache
  • flushing and perfuse sweating
  • drippy nose
  • sweating and goosebumps below the lesion
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16
Q

What should be done if a pt is showing s/s of autonomic dysreflexia?

A
  • get help

- sit them up as soon as possible

17
Q

Why wouldn’t you lay a person down who is having autonomic dysreflexia?

A
  • opposite of orthostatic hypotension
  • If you lay them down, their BP will increase
  • do a full body exam to figure out what’s going on
18
Q

thermoregulation: below the level of lesion

A
  • below the level of the lesion, can’t sweat or shiver
  • can’t feel temperature-wise
  • no vasoconstriction/vasodilation

*typically cold

19
Q

thermoregulation: para vs. quad

A
  • paraplegics can do ok because core mass can help regulate

- quads are usually in warm clothes year round

20
Q

thermoregulation and treatment considerations

A
  • don’t want to treat them in a cold place

- burning a ton of calories to try to stay warm

21
Q

What type of lesions cause spasticity?

A

UMN lesions

22
Q

What can happen when patient repeatedly trigger spasticity to help control movement?

A
  • can get myositis ossificans in their muscles from hitting them to trigger spasms
  • lays down bone because it can’t heal tissue properly
23
Q

Can SCI pts get spasms in muscles they have no control over?

A

yes

24
Q

bad spasticity

A
  • scissoring creates pressure on bony landmarks, bowel and bladder difficulty, transfers, etc
  • If it’s really bad, will need med management
25
Q

What type of lesions cause flaccidity?

A

LMN lesions

26
Q

problems with flaccidity

A
  • muscle wasting
  • joint laxity
  • contracture
  • hypomobile or hypermobile
  • osteoporosis
  • fractures
  • core muscles
  • dependent edema
27
Q

flaccidity: osteoporosis considerations

A
  • lose bone mass (muscles no longer pulling on bones to strengthen)
  • also not WB
  • 1-1.5 years after injury, they typically lose 1/3 of bone mass
28
Q

flaccidity: core muscle concerns

A
  • breathing
  • posture
  • digestion
  • can get kyphotic or scoliotic
29
Q

flaccidity: dependent edema

A
  • don’t have a muscle pump

- LE may have more swelling

7313/7333 Bringman (56 decks)

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