Midterm Greatest Hits Flashcards
How often should a wheelchair user be performing weight shifts for pressure relief?
2 mins every 30 mins
how can a C4 SCI unweight
dependent unless power tilt in space WC
how can a C5 SCI unweight
hook at elbow or forearm and lean forward or to side
how can a C6 SCI unweight
hook at wrist and lean forward or to side
how can a C7 SCI unweight
hook at wrist and lean forward or to side
OR WC push up (if strong enough)
when does d/c planning start?
at initial chart review
for many people, a ____ inch doorway is sufficient for WC
30”
how often will Medicare pay for new WC?
every 5 years (unless change in function or diagnosis)
WC rentals for Medicare vs. Medicaid
care - 13 months
caid - 6 months
what population is the Comprehensive Rehabilitation Services (CRS) for?
pt with TRAUMATIC BI or SCI
qualifications for Comprehensive Rehabilitation Services (CRS)
at least 15 yo
US citizen
participation in rehab
what must be presents for a diagnosis of post-polio syndrome?
new weakness
(+ cluster of other symptoms)
what is the hallmark of polio-related weakness?
no pattern
will PPS have motor, sensory or both deficits?
MOTOR ONLY (anterior horn cells affected)
4 main factors for dx of polio & PPS
spinal tap acutely
giant motor units
weakness w/o pattern
only motor deficits
for a dx of PPS, there must be a period of neurological recovery followed by a period of stability lasting at least ___
15 years
% of residual motor cells left w/ PPS dx?
5/5
4/5
3/5
2/5
1/5
0/5
5: 40%
4: 10-40%
3: 8-10%
2: 3-5%
1: 2-3%
0: 0%
what are the signs of muscle overuse in PPS?
muscle cramping AT REST or during activity
muscle twitching
progressive weakness
progressive atrophy
exercising general rule for PPS for muscle that are 3/5 or below
gentle stretching only
protect these muscles during exercise
exercising general rule for PPS for muscle that are 3+/5 or 4/5
exercise cautiously
exercising general rule for PPS for muscle that are 4+/5 or 5/5
exercise moderate to vigorously if no signs of overuse
start PPS pt at ____% intensity of a nonpolio survivor with ____ rest
50%
twice as much rest
golden rule of rehab for PPS
if anything causes fatigue, weakness, or pain, don’t do it! (or do much less of it)
most common type of MS
relapsing-remitting MS
type of MS?
steady decline since onset with super-imposed attacks
progressive-relapsing MS
type of MS?
initial relapsing-remitting MS then suddenly begins to have decline w/o periods of remission
secondary progressive MS
type of MS?
steady increase in disability w/o attacks
primary progressive MS
type of MS?
unpredictable attacks that may or may not leave permanent deficits followed by periods of remission
relapsing-remitting MS
unique signs and symptoms of MS
Lhemitte’s sign
Uhthoff’s phenomenon
Charcot’s Triad (scanning speech, intension tremor, nystagmus)
visual dysfunction
what signals the end of spinal shock?
return of anal and bladder reflexes
what is spinal shock?
transient, flaccid period
no reflexes below lesion level
SC ceases to function immediately after injury
what is a huge factor for vertical tolerance training for orthostatic hypotension?
cannot start vertical tolerance training by dangling legs at the edge of the bed
when will you perform a WC eval/order for a pt in acute care (post SCI)?
when pt can tolerate upright
key muscles for UE ASIA
C5 elbow flexion
C6 wrist extensors
C7 elbow extensors
C8 finger flexors
T1 finger abductors
key muscles for LE ASIA
L2 hip flexors
L3 knee extensors
L4 ankle DFs
L5 long toe extensors
S1 ankle PFs
special rule for scoring C5 & L1 motor for ASIA testing
if they are the 1st weak key muscles –> sensation at C4 & L2 can be used as substitute for motor function
ASIA A
complete
no sensory or motor function at S4-5
NOON sign
ASIA B
sensory incomplete
sensory but no motor function at S4-5
ASIA C
motor incomplete
more than 1/2 of key muscles below the neurological level have a grade LESS than 3
ASIA D
motor incomplete
more than 1/2 of key muscles below the neurological level have a grade GREATER than 3
ASIA B have a ____% chance to ambulate
33%
ASIA C have a ____% chance to ambulate
75%
____% of pts remain an ASIA A
80%
CPR for classification and prognosis post SCI
age 65+
motor score L3
motor score S1
light touch score L3
light touch score of S1
in order to use a universal cuff UE orthotic device, pts must have what muscle function?
wrist extensors
for SCI, which hand/finger position should be focused on for UE orthotics?
thumb opposition
what UE orthotic would most likely be used for C4-C6 SCI?
resting hand splint
what UE orthotic would most likely be used for complete C6 SCI?
short opponens splint
(work on tenodesis grasp)
what UE orthotic would most likely be used for C5-C6 SCI?
wrist/hand orthotic with utensil insert
(no wrist extensors but can use wrist flexion and shoulders)
which UE orthotics keep the wrist in a neutral position?
wrist stabilization brace
wrist cock-up splint
