Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro 2 > Functional Expectations post SCI & Treatment > Flashcards

Functional Expectations post SCI & Treatment Flashcards

1
Q

C5 key muscles available and movements

A
  • biceps and supinator - elbow flexion and supination
  • brachialis
  • brachioradialis
  • deltoid - shoulder abduction and flexion ~90 deg
  • infraspinatus - shoulder ER
  • rhomboids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

C6 muscles available

A
  • extensor carpi radialis
  • infraspinatus
  • lat dorsi
  • pec major
  • pronator teres
  • serratus anterior
  • teres minor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

C6 available movements

A
  • shoulder flexion, extension, ER, IR, and adduction
  • scapular abduction, protraction, and UR
  • forearm pronation, wrist extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

respiratory status of C6

A

weak cough and will require cough assist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can a C6 drive and live independently?

A

Drive with hand controls
- assist for slideboard transfer in car

May be able to live w/o assistance if well motivated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

C7 key muscles and available movements

A
  • extensor pollicis longus and brevis
  • extrinsic finger extensors, flexor carpi radialis - wrist flexion and finger extension
  • triceps - elbow extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

respiratory status of C7

A

independent with cough and secretion clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

C8 key muscles and available movements

A
  • extrinsic finger flexors, flexor carpi ulnaris
  • flexor pollicus longus and brevis
  • intrinsic finger flexors - finger flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T1-T12 key muscles

A
  • intercostals
  • long muscles of back (sacrospinalis, semispinalis)
  • abdominals (~T7 and below)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T1-T9, T10-T11, and T12 ambulation

A

T1-T9 - no functional ambulation
T1-T11 - short distance with assist H/KAFOs may be possible
T12 - may reach mod I short distances w/ H/KAFO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

L1-L3 key muscles and available movements

A
  • ilipsoas
  • gracilis
  • quadratus lumborum
  • rectus femoris
  • sartorius

Hip flexion and abduction
knee extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

L4 key muscles

A

quads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

L5 key muscles

A

anterior tibialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

L5-S1 key muscles

A

hamstrings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S1 key muscles

A

gastroc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

L5-S1 key muscles

A
  • glute max and med
  • extensor digitorium
  • posterior tib
  • flexor digitorium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Botox injections are good for which patients?

A

SCI with flexor spasticity and w/o fixed contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What level of innervation is needed to achieve tenodesis grip? What level SCI is this done with?

A

C6 = wrist extension
- use passive shortening of the finger flexors as the wrist is extended

  • done with C6 and C7 SCIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can provide stability and balance in short and long sitting positions? What ROM SLR must be maintained?

A

combo of lengthened hamstrings and adaptive shortening of back extensors
- Need to maintain 110-120 deg SLR without overstretching back muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of exercises should be prioritized if >/= 3/5 MMT?

A

closed chain and function-based activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are key muscles targeted for strengthening?

A
  • serratus anterior
  • lat dorsi
  • pec major
  • rotator cuff
  • triceps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

benefits of supine positioning during strengthening

A
  • gravity eliminated
  • easy to facilitate rest breaks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

considerations of supine positioning during strengthening

A
  • can be compromising for respiratory muscles - may need propping or wedge
  • least functionally relevant position
  • harder to facilitate closed chain activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

benefits of side lying positioning during strengthening

A
  • gravity eliminated
  • more comfortable than supine if vertebral fractures present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

considerations of side lying positioning during strengthening

A
  • don’t want to over-flexing trunk - can compromise respiration
  • difficult to incorporate LE closed chain
  • able to implement some function based UE tasks (side lying > elbow prop, side lying push up)
26
Q

benefits of prone positioning during strengthening

A
  • great way to extend back, hip flexors, even knee flexors
  • allows for full pressure relief of butt
  • can progress position (prone on elbows or elbows extended)
  • allow for neck extension strengthening
27
Q

considerations of prone positioning during strengthening

A
  • be cognizant of neck ROM - need to be able to move freely to allow for comfort and breathing
  • if neck ROM limitations - use towel rolls to prop chest and head
  • primarily a position to target UE
28
Q

What position is primarily a position used to target UEs when strengthening?

A

prone

29
Q

benefits of quadruped positioning during strengthening

A
  • great for functional position, closed chain UE/LE
  • challenges proximal muscles
  • incorporates trunk muscles and pelvic stabilizers
  • can allow for neck extension strengthening
30
Q

considerations of quadruped positioning during strengthening

A
  • challenging position
  • consider use of equipment to help patient maintain quadruped position
31
Q

benefits of high kneeling positioning during strengthening

A
  • great position for glutes, pelvic muscles, low back stabilizers, if intact
  • for higher levels - targets intact trunk muscles and can incorporate balance strategies
32
Q

considerations of high kneeling positioning during strengthening

A

watch leg positioning
- pelvis and hips need to be in neutral to avoid inappropriate load through hips and knees

33
Q

benefits of sitting positioning during strengthening

A
  • core stabilization
  • closed chain UE exercises
34
Q

considerations of sitting positioning during strengthening

A

great position to incorporate dual-task balance activity while strengthening targeted muscles

35
Q

benefits of (assisted) standing positioning during strengthening

A
  • great functional position, closed-chain UE/LE
  • challenges proximal muscles
  • incorporates trunk muscles and pelvic stabilizers
  • allows for neck extension strengthening
36
Q

considerations of (assisted) standing positioning during strengthening

A
  • challenging position
  • consider use of equipment to help patient maintain position
37
Q

With loss of trunk strength and variable UE strength, small perturbations would what muscles?

A

head/neck, upper shoulder and upper trunk muscles

38
Q

What are some guidelines available for cardiorespiratory fitness and strengthening post SCI?

A
  • 20 min moderate to vigorous intensity aerobic exercise 2x/wk
  • 3 sets of strength exercises 2x/week for each major functioning muscle group
    o Moderate to vigorous intensity
39
Q

What are some guidelines available for cardiometabolic health and strengthening post SCI?

A
  • 30 min 3x/week of moderate to vigorous intensity aerobic exercise
40
Q

Precautions to exercise testing and training in SCI patients

A
  • Autonomic dysreflexia
  • Sever or infected skin on weight bearing surface
  • Symptomatic hypotension
  • UTI
  • Unstable fractures
  • Uncontrolled hot/humid environments
  • Insufficient ROM to perform exercises task
41
Q

Contraindications to exercise testing and training in SCI patients

A
  • Episode of dysreflexia = stop exercise
  • Unstable fx
  • If hypotension is symptomatic
  • UTI – monitor closely if symptomatic
  • Do not push patients past their contractures
42
Q

_______ control of respiration is needed for normal speech productions. How can a patient practice this?

A

eccentric
- Patient inhales maximally and then counts or says, “ah” or “oh” for as long as possible before taking another breath
- goal is 10-12 sec

43
Q

What is the ideal posture for enhanced respirations

A
  • anterior pelvic tilt
  • erect trunk
  • adducted scapulae
  • neutral head and back alignment
44
Q

how to train diaphragmatic breathing

A
  • belly breathing
  • supine: Place a large, light object (ex: box of tissues) on abdomen and instruct the patient to watch themselves breathe
  • can progress with more resistance
45
Q

What is upper chest strengthening good for? How is it done?

A
  • increasing inspired air to enhance coughing
  • improve breath support for speech or during increased activity
  • Therapist places hands on upper chest and asks patient to push against them while breathing deeply
  • Quick stretch to SCM, Pec Major, and Scalenes by pushing the upper chest in and caudally just before asking the patient to inhaling
46
Q

What is glossopharyngeal breathing?

A

Use of tongue and pharyngeal muscles; force air in lungs through series of “gulps”

47
Q

for a normal cough, how many coughs per breath out should there be

A

2 coughs per 1 breath out

48
Q

Factors that reduce vent weaning potential in C3 or lower SCI

A
  • respiratory or other medical complications
  • pre-existing respiratory conditions
  • > 50 years old
  • VC < 1000
  • max negative inspiratory pressure < 30 cm H2O
  • hx of smoking
49
Q

What is independent application of FES? Example?

A
  • use of FES for a finite time period to minimize impairments and to encourage motor relearning in context of function
  • expectation is the patient will be weaned off FES

ex: FES over anterior tib to improve foot drop during ambulation

50
Q

What is FES dependent application? Example?

A
  • enables the patient to perform functional activities that wouldn’t otherwise be possible

ex: FES on LE musculature of patient with paraplegia while peddling on leg ergometer

51
Q

T/F: FES should only be done on UMN injuries

A

true - peripheral nerves are still intact which is needed for FES

52
Q

Indications for FES

A
  • UMN injury
  • absent or diminished motor function in arms, trunk, or legs
  • demonstration of active contraction when e-stim is provided over motor point of muscle belly
  • pt able to tolerate FES
53
Q

Precautions of FES

A
  • absent sensory
  • severe spasticity
  • heterotropic ossificans (bone formation in muscle)
  • severe osteoporosis
  • chronic pain syndrome
54
Q

Contraindications of FES

A
  • LMN injury
  • cardiac pacemaker
  • pregnancy
  • unhealed fx
  • skin breakdown
  • internal stimulator in area
  • DVT
  • malignancy
  • uncontrolled autonomic dysreflexia
55
Q

What FES Bioness is used for foot drop? Knee instability?

A

L300: foot drop, poor foot clearance
L300+: knee instability, poor foot clearance

56
Q

Indications for use of FES bike

A
  • relaxation of muscle spasms
  • prevention or reduction of disuse atrophy
  • increasing local blood circulation
  • maintaining or increasing ROM
  • improve muscle endurance with intact innervation
57
Q

Considerations of FES bike

A
  • risk of raising unrealistic expectations
  • difficult to predict outcome
  • insufficient evidence for duration and dosage of treatment
58
Q

contraindications of lokomat training

A
  • fixed LE contractures
  • reduced bone density
  • bone instability (fractures, unstable spinal column, severe OP)
  • significant cardiac disease
  • behavioral concerns
  • pregnancy
  • > 300 lbs, > 6 ft 1 in
59
Q

prerequisites for ReWalk

A
  • hands and shoulders can support crutches or walker
  • healthy bone density
  • no unhealed fractures
  • adequate standing tolerance
  • no cardiac, respiratory, autonomic comorbidities
  • height between 160-190 cm (5”3 - 6”2)
  • < 100 kg (220 lbs)
60
Q

What gait pattern is done with ReWalk?

A

4 point gait pattern

61
Q

frequency and duration of bodyweight supported treadmill training

A
  • high frequency (4 days a wk)
  • moderate duration - 20-30 min
  • typically for 8-12 weeks
62
Q

required ramp length

A

1 ft in length for every 1” of height needed

Neuro 2 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions