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PTA 202 > Midterm > Flashcards

Midterm Flashcards

1
Q

More than half of all SCI occur among those who are how old?

A

16-30

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2
Q

How long is the average LOS in acute care and rehab for SCIs now?

A

Acute care: 11 days
Rehab: 25 days

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3
Q

Which direction do sensory and motor impulses travel?

A

sensory impulses travel up the spinal cord and motor impulses travel down the spinal cord.

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4
Q

What are afferent vs. efferent impulses?

A

Afferent are sensory impulses and efferent are motor impulses.

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5
Q

What are the types of afferent tracts and what impulses do they carry?

A

-Dorsal Column: position sense, vibration, 2 point discrimination, deep touch
-Spinothalamic Tract: Pain and temperature

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6
Q

What is the type of efferent tract and what impulses does it carry?

A

Corticospinal tract: skilled movement of extrimities

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7
Q

What is the type of efferent tract and what impulses does it carry?

A

Corticospinal tract: skilled movement of extremities

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8
Q

What is the difference between white matter and grey matter?

A

The grey matter is where all the synapses occur and the white matter is the “highway system” that connects the different parts of grey matter to each other.

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9
Q

What are the 3 horns of the grey matter and what type of synapses occur there?

A

-Anterior horn: motor
-Posterior horn: sensory
-Lateral horn: Autonomic nervous system

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10
Q

What is Central Cord Syndrome and what does it affect?

A

It is an incomplete lesion where the center of the spinal cord is the only thing injured due to hyperextension or narrowing of the spinal canal. UEs are most affected and ambulation is possible for many patients.

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11
Q

What is Tetraplegia?

A

Paralysis in the upper and lower parts of the body.

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12
Q

What is Paraplegia?

A

Paralysis in the lower parts of the body

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13
Q

What is Quadriparesis?

A

Weakness in all 4 limbs

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14
Q

What is Paraparesis?

A

Weakness in lower extremities

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15
Q

What does the ASIA Impairment Scale do?

A

It determines the severity of a spinal cord injury by assigning it a grade.

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16
Q

What are the ASIA Impairment Scale grades? Which is best? Which is worst?

A

The grades are A-E. A is the most severe. E is the best.

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17
Q

What are the ASIA key muscles for UEs and LE’s?

A

C5- Elbow flexors
C6- Wrist extensors
C7- Elbow extensors/wrist flexors
C8- Finger flexors
T1- Finger abductors
L2- Hip flexors
L3- Knee extensors
L4- Ankle dorsiflexors
L5- Big toe extensors
S1- Ankle plantar flexors

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18
Q

When does spinal shock occur and how long can it last for?

A

It occurs 20-60 minutes after trauma and can last from 24 hours to weeks

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19
Q

What happens with spinal shock?

A

Muscle flaccidity

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20
Q

What are to types of medical management for an SCI and what are their sub-catagories?

A

-External Stabilization
-Crutchfield tongs
-Halo traction
-Cervical collars
-Jewett brace
-TLSO
-Surgical Interventions
-Laminectomy (for stenosis)
-Spinal fusion (for pressure relief and stabilization)
-Harrington rod (to stabilize a fracture)

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21
Q

What are the 5 stages of grief and depression?

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Adaptation
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22
Q

What causes Autonomic Dysreflexia?

A

A noxious (painful) stimuli below T6 or the level of the lesion.

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23
Q

These are all symptoms of what in a SCI patient?
-Hypertension
-Severe headache
-Vasoconstriction increases BP
-Baroreceptors in heart respond to slow HR
-Vasodilation then occurs above the level of the lesion, and slowing of HR
-Profuse sweating, goose bumps
-Blurred vision

A

Autonomic Dysreflexia

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24
Q

What should you do if your patient is showing signs of Autonomic Dysreflexia?

A

-Look for the source of the noxious stimuli
-Lower BP by sitting or standing the patient

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25
Q

What is the difference between sympathetic and parasympathetic nervous systems?

A

-Sympathetic: responsible for fight or flight responses
-Parasympathetic: responsible for rest and digest reponses

26
Q

What level lesion would require an SCI patient to need a ventilator to breathe?

A

C3 or above

27
Q

Which nerve roots control the diaphragm?

A

C3-C5

28
Q

What should BP not go below for SCI patients?

A

70/40

29
Q

What are the 3 types of spasticity?

A

-Extensor spasm: rigid knees and PF
-Flexor withdrawal: UEs flexed
-Clonus: a rhythmic oscillating stretch reflex

30
Q

What are the pharmacological treatments for spasticity?

A

-Muscle relaxers: Valium
-Anti-spasmatics: Baclofen (most effective when given intrathecally)
-Botulinum toxin A

31
Q

What are the surgical treatments for spasticity?

A

-Neurectomy: nerve removal
-Tenotomy: tendon incision
-Rhizotomy: spinal root incision

32
Q

How can PTs treat spasticity?

A

-E-stim
-ROM
-Positioning
-Orthotics

33
Q

What is Neurogenic Heterotopic Ossificans?

A

Abnormal Bone Growth

34
Q

How often should a patient weight shift when in a wheel chair?

A

Every 15-20 minutes

35
Q

What is a Spastic Bladder vs. a Flaccid Bladder?

A

-Spastic Bladder: will empty itself when it reaches a certain level of fullness or when it is stimulated
-Flaccid Bladder: requires manual emptying at predetermined times

36
Q

What kind of activities are focused on in the Acute phase of SCI rehab?

A

Positioning, ROM, stretching

37
Q

What kind of activities are focused on in the Intermediate phase of SCI rehab?

A

Progression to functional activities, transfers, how to use a wheelchair, head/hip and relationship

38
Q

What kind of activities are focused on in the Advanced phase of SCI rehab?

A

Gait training, balanced standing, KAFO use to stabilized legs for ambulation, and appropriate gait patterns

39
Q

What level spinal lesion makes walking possible with the use of a KAFO?

A

T1-T4

40
Q

What are Service Based Codes?

A

Codes which can only be used once per Tx no matter how long it took

41
Q

What are the Service Based Codes?

A

-PT eval/re-eval
-Hot packs
-E-stim

42
Q

What is the 8 Minute rule?

A

It is a rule for Medicare patients which states that you must perform a treatment for at least 8 minutes to bill for it and every 15 minutes after that is an additional unit.

43
Q

What happens if a patient has a low WBC value?

A

They will have trouble fighting off infection

44
Q

Why would a patient have a high WBC value?

A

Their body is fighting an infection or reacting to some sort of stress

45
Q

Why would a patient have a low Hgb value?

A

From blood loss

46
Q

What happens if a patient has a high Hgb value?

A

They may experience dehydration, kidney/heart/lung dx, or shock-like symptoms (tachycardia, hypotension, sweating, HA, bruising)

47
Q

What is Hematocrit?

A

The percent of RBC in the blood

48
Q

What would you expect to see in a patient with low Hct values?

A

Fatigue, decreased endurance, edema, decreased BP, dyspnea, fainting, tachycardia

49
Q

What is the worry for patients with low PLT values?

A

Bleeding out

50
Q

What is the worry for patients with high PLT values?

A

Blood clots

51
Q

Do patients with hypo or hyperglycemia have a high risk for developing ketoacidosis?

A

Hyperglycemia

52
Q

What type of burn is classified by…
-cell damage to the epidermis only
-skin appears red
-surface is dry without blisters

A

Superficial burn

53
Q

What type of burn is classified by…
-epidermis is destroyed along with the papillary layer of the dermis
-there will be intact blisters
-extremely painful
-heals within 7-10 days with minimal to no scarring

A

Superficial Partial Thickness burn

54
Q

What type of burn is classified by…
-Epidermis is destroyed and the dermis down to the reticular layer
-most of the dermal layers are destroyed: hair follicles, nerve endings, sweat ducts
-appear mix red or white and waxy
-heals withing 3-5 weeks with scar formation

A

Deep Partial Thickness burn

55
Q

What type of burn is classified by…
-All epidermis and dermis layers are destroyed completely
-damage to underlying tissue (fat, muscle, nerves, bone, etc.)
-characterized by eschar formation

A

Full Thickness burn

56
Q

What do 1st, 2nd, and 3rd degree burns mean?

A

1st = Superficial burn
2nd = Partial Thickness burn
3rd = Full Thickness burn

57
Q

Rule of 9’s from head to toe

A

Entire head = 9%
Anterior thorax = 9%
Posterior thorax = 9%
Anterior abdominal region = 9%
Posterior abdominal region = 9%
Genital region = 1%
1 UE = 9%
Anterior LE = 9%
Posterior LE = 9%

58
Q

What does FCE stand for in terms of Industrial Rehabilitation?

A

Functional Capacity Evaluation

59
Q

What are the 4 major components of an FCE and what are they for?

A

-Weighted activities: to see how much weight you can safely move through differing ROM
-Tolerances: to see how long a client can withstand different postures or activities
-Participation levels: to see how compliant or cooperative the client is with his/her duties
-Postural examination: to analyze the client’s posture during work related activities

60
Q

What is the FCE for?

A

To evaluate clients doing tasks similar to tasks they do at their job

61
Q

What is the difference between work conditioning and work hardening?

A

-Work Conditioning: involves the PT/OT, is 2-4 hrs/day, and simulates job tasks
-Work Hardening: is much more intense, involves a mulit-disciplinary team, is 4-8 hrs/day, and involves specific job simulation tasks

62
Q

Arterial vs. Venous wounds

A

-Arterial wounds: lateral ankle/dorsum of foot, round, smooth defined edges, deep, blood cannot get to the area
-Venous wounds: medial malleolus, irregular shaggy edges, shallow, pink or red, blood is not flowing back to the heart

PTA 202 (4 decks)

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