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Neuro II > Functional Implications > Flashcards

Functional Implications Flashcards

1
Q

High Cervical Injuries (C1-C4)

Key Muscles

A
  • Face and neck, CN innervation
  • Partial innervation of diaphragm (if C3-C4 injury)
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2
Q

High Cervical Injuries (C1-C4)

Functional Capabilities

A

Dependent
* ADLs
* Bed Mobility
* Pressure relief in bed

Mod I
* Pressure relief in chair
* PWC w/mouth controls

Independent to Direct Care
* ADLs
* Pressure relief in bed

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3
Q

High Cervical Injuries (C1-C4)

Available Movements

A
  • Talking
  • Mastication
  • Sipping
  • Blowing
  • Scapular elevation
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4
Q

High Cervical Injuries (C1-C4)

Required Equipment

A
  • PWC w/driving control adaptations
  • Portable vent (C1-2/3)
  • Hospital bed with air mattress
  • Hoyer lift
  • Bathroom DME (TIS shower chair)
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5
Q

High Cervical Injuries (C1-C4)

How do C1-C3 and C4 injuries differ in their vent requirements?

A

C1-3 will be ventilatory dependent.
C4 should be able to eventually weak off vent.

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6
Q

What is an important consideration when a patient is ventilatory dependent?

A

Removes their ability to vocalize, requires adaptive communication equipment.

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7
Q

What is a Phrenic N. Stimulator and what level SCI might opt in?

A

AKA “diaphragm pacing”
- Electrical stimulation of the phrenic nerve (C3-C5) with surgically implanted devices that causes rhythmic contraction of diagphragm to improve breathing function.

C1-C3

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8
Q

C5

Key Muscles

A
  • Biceps
  • Brachialis
  • Brachioradialis
  • Deltoid
  • Infraspinatus
  • Rhomboids
  • Supinator
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9
Q

C5

Functional Capabilities

A

Dependent
- Pressure relief in bed
- Transfers
- Bathing
- Bowel/bladder
- Outdoor WC mobility

MaxA
- Bed mobility

MinA
- Feeding and grooming w/adaptive equipment (set up)

ModI
- Pressure relief in PWC
- PWC mobility (hand controls)
- MWC short-distances/level and smooth surfaces

Ind to Direct Care
- Transfers
- Bed pressure relief

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10
Q

C5

Available Movement

A
  • Elbow flexion and supination
  • Shoulder ER, ABD, FLEX to 90º
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11
Q

C5

Required Equipment

A
  • PWC w/appropriate driving control adaptations
  • Lightweight MWC w/increased trunk supports (power assist push rims)
  • Hospital bed w/air mattress
  • Hoyer lift
  • Bathroom DME (TIS shower chair)
  • Mobile arm supports, adaptive ADL equipment, wrist supports with cuffs
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12
Q

C6

Key Muscles

A
  • ECR?
  • Infraspinatus
  • Latissimus dorsi
  • Pec major (claviclar portion)
  • Pronator Teres
  • Serratus Anterior
  • Teres Minor
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13
Q

C6

Functional Capabilities

A

ModA - MaxA
- Pressure relief with hospital bed

MinA - ModI
- Level surface transfers

Mod I
- ADLs with adaptive equipment
- Bed mobility with hospital bed components/leg loops
- Pressure relief in PWC
- PWC
- MWC on smooth surfaces and low-grade ramps

Assistance
- LE dressing
- Bowel/bladder
- Uneven surface transfers
- Uneven surfaces/D-curbs with MWC

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14
Q

C6

Available Movements

A
  • Shoulder FLEX, EXT, ER/IR, ADD
  • Scapular ABD, protraction, UR
  • Forearm pronation, wrist extension
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15
Q

At what level could you teach a patient the tenosynovitis grip?

A

C6

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16
Q

C6

Required Equipment

A
  • PWC with adaptive driving controls
  • Lightweight MWC
  • Hospital bed w/air mattress
  • Slideboard
  • Bathroom DME (upright shower chair)
  • Adaptive ADL equipment, universal cuffs, tenodesis splints
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17
Q

C5-C6

What is an important part of C5-C6 training as it relates to the respiratory function?

A

Cough is weak - requires cough assist

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18
Q

At what level can a pt with SCI return to driving, what adaptations are needed?

A

C5-C6; van with hand controls + adaptive electronics, slideboard for transfers (assistance)

19
Q

At what level might a patient be able to live alone if they are motivated?

A

C6

20
Q

C7

Key Muscles

A
  • Extensor pollicis longus + brevis
  • Extrinsic finger extensors
  • Flexor Carpi Radialis
  • Triceps
21
Q

C7

Functional Capabilities

A

MinA- ModI
- Transfers (uneven surface)

ModI
- ADLs
- Bed mobility
- Transfers (even surface)
- MWC household/community (may need Assist with high-grade ramps/curbs)

Independent
- Pressure relief

22
Q

C7

Available Movements

A
  • Elbow extension
  • Wrist flexion
  • Finger extension
23
Q

C7

Required Equipment

A
  • Lightweight MWC
  • May not need hospital bed, but justifiable
  • Slideboard (uneven surfaces)
  • Bathroom DME (upright shower chair)
  • Adaptive ADL equipment
24
Q

C7

Respiratory Considerations

A

Independent with cough and secretion clearance

25
Q

C7

Driving

A
  • Can progress to standard auto with hand controls and specialized electronics
  • Slideboard for car transfers, assist required
  • Can get w/c in and out of car.
26
Q

C8

Key Muscles

A
  • Extrinsic finger flexors, Flexor Carpi Ulnaris
  • Flexor Pollicus Longus and Brevis
  • Intrinsic Finger Flexors
27
Q

C8

Functional Capabilities

A

MinA-ModI
* uneven transfers

ModI
- ADLs
- Bed mobility, even transfers
- MWC household/community (assist with high-grade ramps/curbs)

Assistance
- Floor to W/C transfers

Independent
- Pressure relief

28
Q

C8

Available movements

A

Finger Flexion

29
Q

C8

Required Equipment

A
  • Lightweight MWC
  • May not need hospital bed, but justifiable
  • Slideboard (uneven surfaces)
  • Bathroom DME (upright shower chair)
30
Q

C8

Driving

A

Independent with hand controls alone, slideboard to transfer

31
Q

Thoracic T1-T12

KEY Muscles

A
  • Intercostals
  • Long muscles of back (sacrospinalis, semispinalis)
  • Abdominals (~T7 and below)
32
Q

Thoracic T1-T12

Functional Capabilities

A

ModI/Ind
- ADLs

ModI
- Bed mobility, even and uneven transfers
- MWC household and community, including ramps/curbs

Light Assist to ModI
- Floor transfers

Indep
- Pressure relief

33
Q

Thoracic T1-T12

Ambulation Abilities

A

T1-T9: no functional amb.
T10-T11: short distance with assist (H/KAFOs)
T12: May reach ModI short distances with H/KAFO

34
Q
A
35
Q

Thoracic T1-T12

Available Movements

A
  • Improved trunk control with more caudal SCI
  • Increased respiratory reserve
  • Pec girdle stabilization for lifting
36
Q

Thoracic T1-T12

Required Equipment

A
  • Lightweight MWC
  • Orthotics (H/KAFO)
  • AD (RW/ forearm crutches)
  • Bathroom DME (tub chair, shower bench)
37
Q

Lumbar Injuries L1-3

Key muscles

A
  • Iliopsoas
  • Gracilis
  • Quadratus Lumborum
  • Rectus Femoris
  • Sartorius
38
Q

Lumbar Injuries L1-3

Functional Capabilities

A

ModI
- Ambulation short distances with KAFO, RW/FC (largely non-functional)
- Often prefer MWC (esp in community)

39
Q

Lumbar Injuries L1-3

Available Movements

A
  • Hip FLEX/ABD
  • Knee EXT
40
Q

Lumbar Injuries L1-3

Required Equipment

A
  • Lightwieght MWC
  • Orthotics (H/KAFO)
  • AD (RW/FC)
41
Q

Lumbar/Sacral: L4 down

Key Muscles

A
  • Quadraceps (L4)
  • Anterior Tibialis (L5)
  • Hamstrings (L5-S1)
  • Gastrocnemius (S1)
  • Glute Max/Med, Extensor Digitorium, Posterior Tib, Flexor Digitorium (L5-S1)
42
Q

Lumbar/Sacral: L4 down

Functional Capabilities

A

Mod I
- Ambulation household/limited community (L4 may still use MWC for community)

43
Q

Lumbar/Sacral: L4 down

Available Movements

A
  • Strong hip FLEX
  • Strong knee EXT
  • Knee FLEX
  • Ankle DF/PF
  • Ankle Eversion
  • Toe extension
44
Q

Lumbar/Sacral: L4 down

Required Equipment

A
  • Lightweight MWC
  • Orthotics (AFO)
  • AD (FC/Cane)

Neuro II (17 decks)

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