Exam 2- SCI part 2 Flashcards
what is autonomic dysrelexia?
- ~it can kill your pt!!
- ~systemic
- ~massive autonomic system flare up
what level is of SCI is autonomic dysrelexia not a concern?
- ~By t6 the sympathetic trunk has desiccated
- ~if you are injured below T6 you should not have to worry about this (you can be safe and educate pts with SCI down to T10)
causes of autonomic dysrelexia
- ~Stimulus that is below the level of the lesion that the autonomic system picks up on (that the system normally does not pickup on)
- ~Noxious stimuli: Wrinkles in cloths, Infection, UTI, ingrown toenail, bug bit, pulling on catheter, a pebble in your shoe, kink in catheter, block in B/B
Details about c1/2 fractures
- ~there is a lot of space at C1/2
- ~there may be no s/s of a SCI at these level
- ~can just fracture the dens
s/s of autonomic dysreflexia
- ~Temp will increase
- ~blood vessels will dilate
- ~BP will increase (SHEPHERD CENTER)
- ~runny nose
- ~dizziness
- ~sweating below the level of lesion (will sweat both, but normally will only be able to sweat above) SHEPHERD CENTER SAID it is above level of injury
- ~HR will increase
- ~headache
- ~redness
Shepherd Center Reference: http://www.myshepherdconnection.org/sci/autonomic-dysreflexia
What to do when you think a pt is going into autonomic dysrelexia?
- ~Find out the cause
- ~DON’T LAY THEM DOWN!!! It looks like orthostatic hypotension; if you lay them down, you can kill them! Keep them sitting or standing.
- ~Get them nude and look for the cause
Number one cause is full bladder (Shepherd Center: http://www.myshepherdconnection.org/sci/autonomic-dysreflexia)
what will occur when a SCI occurs (the docs first do this)
- ~Give them something to decrease inflammation
- ~What to prevent more SC from getting injured
- ~SAID/ steroid (not NSAID)
- ~Use intravenous cooling to allow body to decrease inflammation (to research to back)
Braces
- ~CO
- ~TO
- ~LO
- ~SO
- ~TLSO
- ~LSO
- ~HALO
- ~Minerva
- ~Soma
- ~cervical collar
- ~aspen CO/CTO
- ~Jewett
- ~Knight Taylor
CO stands for
cervical orthotics
TLSO
thoracic lumbar sacral orthotic
HALO
- ~Very heavy CO
- ~Will drill hole into the skull, 4 bars the come down, will stop all movement of the cervical spine; weight a ton; very restrictive; but people with high level of cervical fractures
- ~c1,2 fracture
- ~Will be wearing this for 6-8 normal or 12 weeks for comorbidities (this is how long it takes bone to heal)
Minerva
- ~Prefabricated orthosis
- ~Has a chest plate; Will have a bar that comes up to the chin
- ~limits flexion
SOMA
- ~sterno-occipital mandibular immobilizer
- ~will stop flexion
Cervical collar
- ~Miami J and Philadelphia have a hole in the from so that there can be a trachea; soft collar doesn’t
- ~The collars are annoy to you and the pt
- ~Stopping flexion (a little roation and lat flexion)
Aspen CTO
the cervical collar with the thoracic extension
Jewett
- ~Has 3 points of contact
- ~Will allow extension (one point in the back and 2 point of contact in the back
- ~Good for osteoporosis, compression fracture, forward flexion injury, MVA with lots of force
Knight Taylor
Good for posture
*he said don’t worry about this one
LSO/ SO
~normally not for SCI; more for normal SC repairs
Problems when a person has SCI
- ~respiratory conditions
- ~decubitus ulcers
- ~orthostatic hypotension
- ~LE edema
- ~DVT
- ~PE
- ~apneic bradycardia
- ~autonomic dysflexia
- ~thermoregulation
- ~spasticity UMN lesion
- ~flaccidity LMN lesion
- ~pain
- ~DJD
- ~UTI
- ~heterotopic ossification
- ~contracture
- ~osteoporosis
- ~scoliosis/ kyphosis
- ~GI
- ~metabolic/ endocrine change
SCI- respiratory problems:
- ~pneumonia
- ~vent failure
- ~atelectasis
- ~C1-C4 vented
- ~coughing
*can lead to pulmonary emboli
SCI- help with respiratory
- ~need to use accessory muscle
- ~teach to breath deeply
- ~Frog breathing
- ~Sniff breathing
- ~segmental breathing
- ~clearing secretions (what we did in shappy’s class)
- ~abdominal binder
- ~quad cough
SCI- quality coughing levels
- ~functional cough
- ~weak functional cough
- ~nonfunctional cough
Functional cough
- ~loud forceful
- ~2 or more coughs with 1 breath
- ~independent in respiratory secretion clearance