class 6: SCI continued Flashcards
what are thee muscle of inspiration
SCM
scalenes
external intercostal
pec major
serratus anterior
what are the muscle of expiration
internal intercostals
abdominals - external oblique, TA, rectus abd
UMN bladder also known as
spastic bladder
reflexic bladder
UMN bladder characteristics
Seen in patients with injury
above S2
a condition where the bladder contracts involuntarily, causing a person to feel the need to urinate even when there is little or no urine in the bladder
what is the treatment for spastic bladder
̶Require intermittent catheterization every 3-6 hours
̶ Suprapubic tapping (S=S)
what are the other names for Flaccid Bladder
LMN
Areflexic Bladder
what is a Flaccid Bladder
Seen in patient with injury at
or below S2 sacral segments
a condition that occurs when the bladder muscles are relaxed and don’t contract enough.
This can lead to urine retention and overflow incontinence, where the bladder leaks urine.
what can we do for a arelexic bladder
̶Require intermittent catheterization every 3-6 hours
valsalva or crede’s maneuver
what is valsalva or crede’s maneuver
Credé maneuver - applies direct pressure to the suprapubic area
Valsalva - involves bearing down by tightening abdominal muscles
C1-C4 injury transfer level
Transfers - Mechanical lift
WC - power with head/mouth/chin control
C5 injury transfer level
Transfers - Dependent sliding board transfer
WC - Manual WC – Plastic coated hand rims
C6 injury transfer level
Transfers - Independent sliding board transfer
WC - Manual WC – Plastic coated hand rims
C7-C8 injury transfer level
Transfers -
Even: Independent without sliding board
Uneven: Dependent on sliding board
C8: May be able to do Floor to WC
WC - Manual WC – Plastic coated hand rims
C7 - Independent on even surfaces; not
independent on ramps, curbs
C8 - Independent on ramps, curbs
T1 injury transfer level
Transfers - Floor to wheelchair
WC - Independent
T4 injury transfer level
Transfers - Sitting pivot
WC - Independent
L3 injury transfer level
Transfers - Standing pivot
WC - Independent
what is Rancho Los Amigos (RLA) Scale used for
a medical tool used to assess the cognitive and behavioral recovery of brain injury patients
RLA Levels - 1
No Response, Coma
RLA Levels - 2
Generalized response
Non-purposeful whole body, vocal
Inconsistent
RLA Levels - 3
Local response
Purposeful
Local and specific
Inconsistent
Follows simple commands –
close eyes, squeeze hands
RLA Levels - 5
Confused Inappropriate
- Responds consistently to simple commands
- Responds inconsistently to complex commands
- With structure, able to socialize for short period
Memory: Memory impaired. Inappropriate use of objects. Can’t learn new task.
RLA Levels - 6
Confused Appropriate
- Follows simple instruction consistently
- Goal oriented behavior with external input
Memory: Carryover of previous skills present (self-care)
RLA Levels - 7
Automatic appropriate
- Oriented in home and hospital
- Daily routine - automatic but robot-like
- Judgement impaired
- Able to initiate social or recreational activity with structure
RLA Levels - 8
Purposeful appropriate
- Carryover of new skills present
- Impaired judgement in emergency situation, abstract reasoning and reduced tolerance for stress
How to Manage Levels VII, VIII?
- Focus on re-entry to work and community
- Emphasize skills related to problem solving, social interaction
- Trial period of independent living
- Adaptation at work or school to return to normal life
how to remember the RLA levels
RCA
R - repsonse
1- no response
2 - generalized response
3 - localized response
C - confused
4 - confused and agitated
5 - confused and inappropriate
6 -confused and appropriate
A- appropriate
7 - automatic appropriate
8 - purposeful appropriate
should a gait belt be held in a pronated or supinated position
supinated
how long do we hold each position for the CSTIB
30 secs
how many positions are there for CSTIB
6
for brown sequard syndrome - how do we remember
BROWN POT
pain and temp opposite
pressure ulcer: bed, sitting
bed - 2 hours
wc- 15 mins
with AD how much does the BP increase
20 - 30 mmhg
what is the function of the lateral spinal tract
pain and temp
