Acute Care

Question 1

What are spine precautions

Answer 1

No flx, Ext, or rotation 
Log roll only
Head of bed no more than 30 degrees
No lifting greater than 8 lbs 
Radiological clearance

Question 2

What are respiratory complications for lesions above c4?

Answer 2

Diaphragm is paralyzed, become ventilator dependent and phrenic nerve stimulator

Question 3

What respiratory complications arise from lesions between c5-T12?

Answer 3

Loss of innervation to muscles of inspiration like abdominals and intercostals
Poor position of diaphragm

Question 4

What is paradoxical breathing?

Answer 4

Breathing movements in which the chest wall moves in on inspiration and out on expiration, in reverse of the normal movements

Question 5

Tenodesis grip occurs at what level?

Answer 5

C6

Question 6

What general muscles should be focused on increasing strength?

Answer 6

Rotator Cuff

Muscles of respiration/Airway clearance

Question 7

Why should head of bed height not exceed 30 degrees?

Answer 7

Greater than 30 may cause shear forces on skin and increases pressure on sacrum

Question 8

What are the steps to perform manually assisted cough?

Answer 8

Place both hands beneath ribcage supporting diaphragm
Patient deep breath and cough
Push inward and upward as patient coughs

Question 9

Describe the effects of position on respiration for SCI?

Answer 9

Trendelenberg best so diaphragm doesn’t have to fight against gravity.