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Advanced Procedures > Mod 4: SCI > Flashcards

Mod 4: SCI Flashcards

1
Q

some causes of SCI: trauma from-

A

damage to vascular supply, ligaments, discs, vertebral bodies, nerve roots
SC swelling
ischemia in surgery
trauma w/ too much movement to head/trunk

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2
Q

non-trauma causes of SCI:

A

transverse myelitis (infection/inflamm of whole SC)
spinal stroke
vascular malformation: hemorrhage, thrombus, embolus
spina bifida,
hysterical paralysis (conversion disorder)
arthritis or spondylolysis can force SC into ext & compress

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3
Q

where does SC terminate? (vertebral level)

A

L1/L2

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4
Q

impairment or loss of motor/sensory in cervical segments d/t damage of neural elements within spinal canal
-damages trunk, UE, LE

A

tetraplegia

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5
Q

impairment or loss of motor/sensory fxn of thoracic, lumbar or sacral (not cervical) segments of SC
-includes cauda equina & conus medullaris

A

paraplegia

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6
Q

partial preservation of sensory/motor fxn is found below the neuro level & includes the lowest sacral segment

A

incomplete SCI

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7
Q

If its an L2 complete injury: which nerve segments are functional? which LE myotome is still functional?

A

L2- hip flexion functions
L3 & below doesn’t

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8
Q

dermatomes & myotomes caudal to the neurological level that remain partially innervated
-trace levels in complete injuries

A

Zone of Partial preservation

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9
Q

spinal levels of tetraplegia: high, middle, Low

A

high: C1-C5
mid: C6
low: C7-8

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10
Q

spinal level of paraplegia

A

T1 & below

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11
Q

Asia scale: no sensory/motor in S4/5

A

Asia A Complete

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12
Q

Asia scale: has sensory but no motor fxn (lowest sacral intact)

A

Asia B Incomplete

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13
Q

Asia scale: has motor & sensory fxn, greater than half of key mm below neuro level & MMT grade <3 (gravity min)

A

Asia C Incomplete

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14
Q

Asia scale: has motor fxn, greater than half of key mm below neuro level & MMT greater or equal to 3 (against gravity control)

A

Asia D Incomplete

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15
Q

Asia scale: sensory/motor fxn are normal though SCI

A

Asia E Incomplete

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16
Q

UE weakness > LE weakness
-injured by cervical hyperext
-damage to spinothalamic, corticospinal & dorsal columns
-motor deficits (fine motor) > sensory
-most common

A

Central Cord Syndrome

17
Q

loss of corticospinal & dorsal columns on injured side (ipsilat)
loss of spinothalamic on contralat side

A

Brown Sequard Syndrome

18
Q

loss of corticospinal & spinothalamic tract below the level of injury
-retains dorsal columns below level of injury
-cervical flexion injury

A

Anterior Cord Syndrome

19
Q

loss of dorsal columns below level of injury
-retain corticospinal & spinothalamic tract below level of injury

A

Posterior Cord Syndrome

20
Q

LMN injury to lumbosacral nerve roots below L1
-saddle anethesia, areflexic bladder, flaccidity

A

Cauda Equina Lesion

21
Q

Stabilization methods for SCI

A

laminectomy- remove bone for decompression
fusion- stability
internal fixation- Harrington rods
closed techniques w/ wear schedeul: TLSO, HALO, Philly collar

22
Q

techniques for self-pressure relief

A

forward lean
side lean (weight shift)
w/c push-ups

23
Q

active insufficiency of finger flexors position
-a functional position for cervical SC (>C7)

A

tenodesis

24
Q

autonomic dysreflexia:
SC level
s/s
response

A

T6 & above
high BP, low pulse, sweating below level
Sit them up! & find stimulus
(kinked catheter, bladder distension, wrinkled sock etc)

25
Q

spasticity tx techniques

A

positioning
aquatic therapy (w/ neutral warmth)
WB* & co-contraction
functional e-stim
ROM
splinting

26
Q

precautions for unstable cervical spine

A

no shoulder flex/abd > 90*

27
Q

precaution for unstable lumbar spine

A

no SLR >60*
no hip flexion >90*

28
Q

calcium deposits in large mm that can develop weeks after SCI
-caused by trauma, immobilization, over stretching
-maintain functional ROM

A

heterotopic ossification

29
Q

Functional ROM for
hamstrings-
shoulder ext-
elbow ext-
wrist-

A

hams: 110*
shldr: 120*
elbow; full ext
wrist: 90* & ext

30
Q

spastic/reflexive bladder (T12 or higher) incontinence pattern

A

infrequent, sudden unexpected incontinence
-empty w/ catheter

31
Q

flaccid/areflexic bladder (below T12)

A

continuous incontinence induced by exercise or stress
-overstretched detrusor mm
-empty through Valsalva

32
Q

how to achieve POE

A

active triceps
-use weight shifting to get them under

33
Q

which pts?
I w/ basic cares/min A but may need assist to leave homes

A

low tetraplegia (C7/8)

34
Q

which pts?
can verbally direct cares but max/mod A with all others

A

high tetraplegia (C1-5)

35
Q

which pts?
can use manual w/c short distances though power chair more functional
-consider manual w/c for pts with ___ or lower

A

C6
C7

Advanced Procedures (7 decks)

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