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NPTE > Neuromuscular > Flashcards

Neuromuscular Flashcards

0
Q

Akinesia

A

The inability to INITIATE movement

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1
Q

Agnosia

A

The inability to recognize familiar objects with one form of sensation

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2
Q

Broca’s aphasia

A

Expressive. Severe difficulty in verbal expression, impairment and object naming and writing

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3
Q

Brokas aphasia is mostly found with what other comorbidity

A

Right hemiplegia

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4
Q

What is the most common form of aphasia

A

Global

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5
Q

Global aphasia

A

Characterized by reduced speech and comprehension; reading and writing are impaired as well

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6
Q

Astereognosis

A

The inability to recognize objects by touch alone

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7
Q

Asynergia

A

Inability to move muscles together In a Cordinated manner

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8
Q

Ataxia

A

Uncoordinated movements especially gait

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9
Q

Athetosis

A

Slow involuntary wormlike twisting motions. Usually seen in forms of cerebral palsy

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10
Q

Causalgia

A

Burning sensations which are painful. Associated with complex regional pain syndrome.

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11
Q

Complex regional pain syndrome used to be known as

A

Reflex sympathetic dystrophy

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12
Q

Cheyne-Stokes respiration

A

It’s a breathing pattern characterized by period of apnea lasting 10 the 60 seconds followed by gradually increasing and decreasing the depth and frequency of respirations

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13
Q

What are the pathologies associated with Cheyne-Stokes respiration

A

Severe cases of TBI or CHF

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14
Q

Chorea

A

Rapid involuntary jerking movement. Especially in Huntington’s

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15
Q

Clonus

A

Rhythmic oscillation of a muscle in response to sustain stretch in patients with upper motor neuron disease

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16
Q

Decerebrate rigidity

A

Contraction of extensor muscles of the upper and lower. Due to injury at level of brainstem

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17
Q

Decorticate rigidity

A

Contraction of flexors of uppers and extensors of lowers

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18
Q

Delirium

A

Temporary confusion and loss of mental function

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19
Q

Dementia

A

Loss of memory or intellectual functioning

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20
Q

Dysmetria

A

Inability to judge distances. Seen especially in cerebellar dysfunction

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21
Q

EMG or electromyography

A

Study of the contraction of a muscle as a result of electrical stimulation.

Used to evaluate voluntary electrical activity of a muscle

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22
Q

Glove and stocking anesthesia

A

Generalized peripheral neuropathies distal portions of nerves degenerate resulting in anesthesia of distal extremities as if gloves or stockings.

Occasionally seen in Guillain-Barré syndrome

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23
Q

Shingles or herpes zoster

A

Painful inflammation of posterior root ganglion caused by virus, formation of vesicles or fluid filled sacs a long course of nerve or Dermatome

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24
Q

Horner’s syndrome

A
  1. Ptosis of the eyelid
  2. Constriction of pupil
  3. Lack of feeling in the ipsilateral face
  4. Often accompanying stroke involving:

anterior inferior or
posterior inferior cerebellar arteries

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25
Q

Morton’s neuroma

A

Excessive pronation during stance. Compression between third and fourth metatarsal’s

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26
Q

NCV or nerve conduction velocity test

A

Determines the speed of propagation of an action potential along the nerve or muscle fiber

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27
Q

What is the latency of a nerve

A

The time the potential takes to travel between two points

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28
Q

If latency is increased what does this signify

A

The nerve is compressed or damaged

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29
Q

Reciprocal inhibition

A

Inhibition of muscles antagonistic to those being facilitated. Essential for coordination

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30
Q

Somatagnosia

A

Lack of awareness of the relationship of one’s own body parts or the body parts of others

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31
Q

Vegetative state

A

A deep coma, with abnormal posturing

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32
Q

Homonymous hemianopsia

A

A deficit of either the right or left halves of the visual field. Caused by damage to the contralateral optic tract

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33
Q

Bitemporal hemianopsia

A

A deficit of the temporal or peripheral visual fields. Caused by injury at the optic chiasm. Also known as Tunnel vision

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34
Q

What are the most common sites for lesions to occur with a cerebrovascular accident

A
  1. Bifurcation of the common carotid artery
  2. Main bifurcation of the middle cerebral artery
  3. Junction of the vertebral arteries with the basilar artery
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35
Q

What is the most commonly involves artery associated with a stroke

A

Middle cerebral artery

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36
Q

What are the signs and symptoms associated with a middle cerebral artery stroke

A
  1. Contralateral hemiplegia, mostly upper extremity involvement, loss of sensation primarily in arm and face
  2. homonymous hemianopsia
  3. Aphasia, apraxia, or global aphasia depending on site and severity of occlusion
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37
Q

Occlusion of which hemisphere well cause aphasia and apraxia

A

Dominant Left hemisphere

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38
Q

What can cause global aphasia

A

Occlusion of the main stem of the middle cerebral artery

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39
Q

What signs and symptoms are associated with anterior cerebral artery occlusion

A
  1. Rarely involved
  2. Lower extremity more frequently affected
  3. Contralateral hemiplegia and sensory loss
  4. Possible mental confusion, aphasia, and contralateral neglect if involvement is extensive on dominant side
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40
Q

What signs and symptoms are associated with posterior cerebral artery occlusion

A
  1. Persistent pain syndrome or contralateral pain
  2. Temperature sensory loss
  3. Possible Homonomous hemianopsia, aphasia, and thalamic pain syndrome
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41
Q

What signs and symptoms are associated with vertebrobasilar artery occlusion

A
  1. Often results in death from the edema associated with the infarct
  2. If lesion affects of the Pons, results in quadriparesis and bulbar palsy AKA locked in syndrome
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42
Q

What are the signs and symptoms associated with anterior inferior cerebellar artery occlusion

A
  1. Unilateral deafness
  2. Loss of pain and temperature on the contralateral side
  3. Paresis of lateral gaze
  4. Unilateral Horner’s syndrome
  5. Ataxia, vertigo, and nystagmus
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43
Q

What are the signs and symptoms associated with superior cerebellar artery occlusion

A
  1. Severe ataxia
  2. Dysarthria (Loss of muscle articulation control)
  3. Dysmetria (Finger to nose test)
  4. Contralateral loss of pain and temperature
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44
Q

Dysarthria

A

Loss of muscle articulation control

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45
Q

What are the signs and symptoms of posterior inferior cerebellar artery occlusion

A
  1. AKA Wallenburg’s syndrome
  2. Vertigo, nausea
  3. Hoarseness, dysphagia
  4. Ptosis, decreased impairment of sensation in ipsilateral face and contralateral torso and limbs
  5. Horner’s syndrome might also appear
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46
Q

What is stage one of recovery following a stroke

A

Flaccid, no limb movement

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47
Q

What is status two of recovery following a stroke

A

Synergies may appear. Spasticity begins to develop. Minimal voluntary movement

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48
Q

Stage III recovery following a stroke

A

Spasticity increases, may become severe. Voluntary control of movement synergies appear

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49
Q

Stage 4 recovery following a stroke

A

Some movement independent of synergies. Spasticity begins to decline

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50
Q

Stage five recovery following a stroke

A

Synergies no longer dominate and movement becomes more complex

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51
Q

Stage six recovery following a stroke

A

Spasticity is gone. Coronation a movement approach normal

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52
Q

How would you describe the upper extremity flexion synergy

A

Trying to scratch the back of your head with Your 5th MCP joint

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53
Q

How would you describe the extension synergy of the upper extremity

A

Trying to pull down your tail between your legs if you have one

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54
Q

What is usually the strongest component in the upper extremity flexion synergy

A

Elbow flexion

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55
Q

What is usually the strongest component in lower extremity flexion synergy

A

Hip flexion

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56
Q

How would you describe the lower extremity Flexion synergy

A

Trying to scratch the contralateral MCL with your heel

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57
Q

How would you describe lower extremity extension synergy

A

Ballerina Toe with kneecap facing contralateral MCL

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58
Q

What are some treatment ideas for Hypotonicity

A
  1. Avoid joint hyperextension
  2. Joint compression
  3. Resistance of functioning muscles, isometric holds
  4. Joint approximation facilitates co- contraction
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59
Q

What are some risks with hypertonicity

A
  1. Spastic high tone with hyperactive reflexes and decreased thoracic mobility
  2. Risk of contractures and deformity
  3. Changes in body position can affect tone
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60
Q

What are some treatment ideas for hypertonicity

A
  1. Work to inhibit reflex activity via postures, positions
  2. Prolong static muscle stretch, inhibitory casting, slow repetitive rocking, very low-frequency vibration
  3. Limb movements emphasizing rotation
  4. Reciprocal inhibition (Facilitate non-spastic muscles to inhibit spastic muscles)
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61
Q

Define a Equinus gait

A

The heel does not touch the ground due to spasticity or contractures of gastroc-soleus

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62
Q

Spastic toe flexors can cause what gait deviation

A

Unequal step length due to hammertoes

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63
Q

Weak abdominal muscles can cause what in the swing phase

A

Insufficient forward pelvic rotation

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64
Q

A spastic anterior tibialis, weak peroneals, And toe extensors Would cause what in the swing phase

A

Varus position of the foot throughout swing phase

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65
Q

List seven problems associated with a stroke in the right hemisphere

A
  1. Left hemiparesis
  2. Problems with spatial relationships and hand eye Coordination
  3. Irritability, short attention span
  4. Poor judgment affecting personal safety
  5. Diminished body image with left-sided neglect
  6. Quick and impulsive
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66
Q

List seven problems associated with a stroke in the left hemisphere

A
  1. Right hemiparesis
  2. Apraxia
  3. Difficulty starting and sequencing tasks
  4. Perseveration
  5. Easily frustrated with high levels of anxiety
  6. Inability to communicate verbally
  7. Cautious and slow
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67
Q

Rancho level one

A

No response. Completely unresponsive to any stimuli

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68
Q

Rancho level two

A

Generalized response. Reacts inconsistently and non-specifically to stimuli

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69
Q

Rancho level III

A

Localized response. Reacts inconsistently but specifically to stimuli

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70
Q

Rancho level four

A

Confused/agitated.-State of activity, behavior is bizarre and not purposeful. Poor attention span and recall

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71
Q

Rancho level five

A

Confused/inappropriate. Responds to simple commands, can’t do complex tasks. Verbalization inappropriate

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72
Q

Rancho level six

A

Confused/appropriate. Dependent on external input, can perform consistently, memory improved

73
Q

Rancho level seven

A

Automatic/appropriate. Perform automatically and appropriately and structured environment. Judgment remains impaired

74
Q

Rancho level eight

A

Purpose/appropriate. Ask appropriately but not perfectly. May have some problems and stressful or unusual circumstances

75
Q

A Glasgow coma scale score of eight or less indicates what

A

Severe brain injury

76
Q

What three categories does the Glasgow coma scale test

A

Eye-opening. Best motor response. Verbal response.

77
Q

What are some signs and symptoms for ALS

A 
Muscle weakness is progressive. Affects muscle respiration. Weakness may appear in hands first. 
Dysphasia. 
LMN signs. 
UMN signs. 
Often no sensory changes
78
Q

What should treatment focus on for ALS

A

Maintain respiratory function and activity levels
PROM exercises
Prevent further deconditioning
Avoid overworking muscles and teach energy conservation

79
Q

What nerve is affected in Bell’s palsy

A

Facial nerve cranial nerve seven

80
Q

What signs and symptoms might you see you with Bell’s palsy

A
  1. Difficulty in reaching the four head, closing the eye tightly, smiling
  2. Uncontrolled salivation, one sided facial muscle weakness, NORMAL sensation
  3. Decrease taste sensation anterior two thirds of tongue
81
Q

What is Guillan-barré syndrome

A
  1. LMN DISEASE
  2. Polyneuropathy of probable immune-mediated viral origin
  3. Symmetric motor paralysis and progressive muscular weakness
  4. Ascending pattern, LE before UE
82
Q

What are signs and symptoms of Guillan-barré syndrome

A 
Sensory loss (stocking/gloves). Muscle weakness progresses from lower to upper extremities, distal to proximal. 
Recovery is slow of up to one year. 3% mortality rate
83
Q

What is thalamic pain and what is it associated with

A

Continuous intense pain occurring on contralateral hemiplegic side. Associated with a stroke involving the posterior cerebral artery

84
Q

What is the difference between CRPS 1 and CRPS 2

A

CRPS one causes tissue injury without nerve damage.

CRPS 2 involves innervate injury

85
Q

Neuralgia

A

Pain occurring along the nerve

86
Q

Causalgia

A

Burning pain

87
Q

Radiculalgia

A

Neuralgia of nerve roots

88
Q

Asymmetrical tonic reflex ATNR

A

Birth
Integration: 4-6 months

Prolonged influence can result in scoliosis or hip subluxation

89
Q

If ATNR reflex is severe what must patient due to grasp objects

A

Look away from the object so that the extended arm has less influence from reflex

90
Q

Crossed extension reflex

A

Opposite lower extremity flexes then adducts and extends when noxious stimuli Is applied to ball of the foot

Onset: 28 wks
Integration: 1-2 mos

91
Q

Onset of equilibrium reaction in prone

A

Six months

92
Q

Onset of equilibrium reaction in supine

A

7 to 8 months

93
Q

Onset of equilibrium reaction in sitting

A

7 to 8 months

94
Q

Onset of equilibrium reaction in kneeling

A

9 to 12 months

95
Q

Onset of a equilibrium reaction in standing

A

12 to 21 months

96
Q

Palmer grasp

A

Onset: At birth
Integrated: 4-6 months

97
Q

Plantar grasp

A

Onset: 28 weeks gestation
Integrated: 9 months

98
Q

Landau’s reflex

A

Onset: three months
Integrated: two years

Superman, extend head first then legs

99
Q

Moro reflex

A

Onset: 28 weeks gestation

Integrated: 5 to 6 months

100
Q

Optical and labyrinthian righting reflexes

A

Eyes covered when testing labyrinthine reflex

Onset: birth - two months

101
Q

Positive supporting reaction

A

Onset: birth

Integrated: six months

102
Q

Protective extension reaction

A

Onset: arms four to six months

Legs 6 to 9 months

Integrated: persists

103
Q

Rooting reflex

A

Onset: present in premature infants

Integrated: three months

104
Q

Symmetrical tonic neck reflex STNR

A

Onset: 4-6 months

Integrated: 8 – 12 months

Note: can strongly influence the ability to assume a quadruped position as well as the ability to crawl

105
Q

Tonic labyrinthine reflex

A

Prone: increased flexor tone

Supine: increased extensor tone

Onset: birth

Integrated: six months

106
Q

Traction reflex

A

Onset: 28 weeks just station

Integrated: 2 – 5 months

107
Q

What should a one-month-old be able to do

A

Lifts head, follows a moving object and exhibits reflex stepping, positive support reflex, decreased flexion, hands fisted with indwelling thumbs most of the time, reciprocal and symmetrical kicking, neonatal reaching

108
Q

What should a two month old be Able to do

A

Lifts head 45° in prone, head lags on pull-to-sitting, smiles, begins prone on elbows with elbows behind shoulders, head bobs in supported sitting

109
Q

What should a three-month old be able to do

A

Prop self into prone on elbows with weight on forearms, coos, chuckles, takes weight with toes curled in supported standing, head elevation to 90°

110
Q

What should A four-month old be able to do

A

Prop head and chest for a long time pivot Prone, head no longer lags in pulled to sitting, sits with support, laughs out loud, rolls prone to side, supine to side, optical and labyrinthine head righting present, and ulnar Palmer grasp

111
Q

What should a five-month-old be able to do

A

Roll from prone to supine, head control and supported sitting, weight shifting from one forearm to the other in prone

112
Q

What should a six-month-old be able to do

A

Rolls from supine to prone, Independent sitting, pulls to stand, prone on hands with Elbows extended while weight shifting from hand to hand

113
Q

What should a seven-month old be able to do

A

Maintain quadruped, Pivots on belly, prone extension position (pivot prone), assumes Sitting from quadruped, trunk rotation in sitting, recognizes tone of voice

114
Q

What should and 8 - 9 month old be able to do

A

Belly crawls, quadruped creeping, side sitting, pulls to stand through kneeling, cruising sideways, can stand alone, has pincher grasp with thumb and forefinger, can transfer object from one hand to the other, moves quadruped to sitting

115
Q

What can a 10 to 15-month-olds do

A

Stands and begins to walk unassisted, begin self-feeding, searches for hidden toys, plays pattycake and peekaboo, imitates, reaches with supination, meet pincher grasp with release.

116
Q

What can an 18 to 20 months old do

A

Walk up and down stairs with assistance, Ascends stairs with step-to pattern, sits on a small chair, begins to run more coordinated, jumps off the bottom step, plays make-believe

117
Q

What should a two-year-old be able to do

A

Runs well, can go upstairs one at a time reciprocal, active, restless, tantrums

118
Q

What should a three-year-old be able to do

A

Goes downstairs or reciprocally, rides tricycle, begins to catch a ball, Jumps with 2 feet, understands sharing, stands on 1 foot briefly

119
Q

What should be 3 1/2 year-old be able to do

A

Hops on 1 foot, kicks a ball

120
Q

What should a four-year-old be able to do

A

Hops on 1 foot several times, climbs, throws a ball overhand, stands on tiptoes, and relates to friends

121
Q

What’s a five-year-old be able to do

A

Skips, kick the ball well, dresses and undresses self

122
Q

What is Apgar scoring

A

The system to evaluate the status of a newborn.

Measured at birth then at one, five, 10, and 15 minutes after birth

123
Q

What is the range of an Apgar scoring

A

The total score of seven or more is normal.
5 to 6 require some care.
4 or less requires immediate care

124
Q

What nerve roots on involved with Upper Erb’s palsy

A

C5 and C6 nerve roots are stretched during the birth process

125
Q

What are classic signs and symptoms of upper Erb’s palsy

A

Weakness in shoulder abduction and external rotation, elbow flexion, supination.

Shoulder is abducted and internally rotated and presents with the “waiters tip” deformity

126
Q

What nerve roots are involved with Lower Klumpke’s Palsy

A

C8 and T1 stretched during birth.

Resulting in weakness of hand and wrist flexors. Common “claw hand” appearance

127
Q

Is cerebral palsy a progressive or nonprogressive disorder

A

Nonprogressive resulting from CNS damage

128
Q

List the major causes for cerebral palsy

A
  1. Hemorrhage below the lining of the ventricles
  2. Hypoxic encephalopathy
  3. Malformations
  4. Trauma of the CNS
129
Q

What are the four main syndromes of cerebral palsy

A
  1. Spastic: most common, UMN
  2. Athetoid: basal ganglia involvement
  3. Ataxic: Uncommon, results from cerebellar involvement
  4. Mixed forms: Spasticity and athetosis And less often ataxia and athetosis
130
Q

What are some signs and symptoms of spastic cerebral palsy

A

Spasticity affecting both limbs on one side hemiplegia both legs paraplegia, all four limbs tetraplegia, or intermediate form between Para and tetraplegia that affects mostly the legs diplegia.

Affected limbs have:
increased deep tendon reflexes, increased muscle tone,
abnormal postures,
Scissors gate and tell walking are characteristic

131
Q

What activity should be limited with a patient with Trisomy 21

A

Forceful neck flexion and rotation secondary to atlantoaxial ligamentous laxity and potential for subluxation or SCI

132
Q

Duchenne’s muscular dystrophy affects males or females; Progressive or nonprogressive; distal proximal; what age range?

A
  1. Males
  2. Progressive weakness
  3. Proximal to distal
  4. 3 to 7 years old

Exhibit waddling gait pattern, toe walking, Gower’s sign, difficulty climbing stairs secondary two weak Gluteal and quadriceps muscles
Quadricep muscles

133
Q

Charcot Marie tooth disease is also known as; pathology

A

Peroneal muscular atrophy

Hereditary disorder of the Peroneal and distal leg muscles

134
Q

What is the most common problems associated with Charcot Marie tooth disease

A

Footdrop and “stork leg deformity”

135
Q

What is Legg-Calvé-Perthes disease

A

Idiopathic aseptic necrosis of the femoral capital epiphysis

Usually unilateral, affecting mostly boys between five and 10 years

136
Q

Common treatment for Legg-Calvé-Perthes disease

A
  1. Special hip abduction orthosis
  2. Casting
  3. Mobile traction and slings
  4. Prolonged bedrest
137
Q

What percentage of spinal cord injuries are atraumatic

A

10%

138
Q

The most common areas injured for cervical spine cord injuries are

A

C5 and C7

139
Q

What is the most common site for Spinal cord injury in thoracic region

A

Less likely to be injured from traumatic causes due to rib cage and higher stability.

T12 – L1 Junction is most common site of injury

140
Q

What are the most common levels for spinal cord injury in the lumbar area

A

L1 or L2. Below these levels the cauda equina is less likely to sustain a complete injury.

Trauma usually incomplete due to large vertebral canal and relatively good vascular supply

141
Q

How is the spinal cord Usually damaged

A

Physical impingement on the cord or by interruption of the cord vascular supply.

Actual transection of the cord is rare

142
Q

What are some pathological changes that accompany trauma to the spinal cord

A
  1. Blunt trauma results and some primary destruction of neurons at level of injury
  2. Most damage is caused by secondary sequela (Progressive tissue destruction within the cord)
  3. Tissue damage may travel up and down the cord 1-3 segments
  4. The chronic tissue gradually reabsorbed replaced by scar tissue
143
Q

List three mechanisms of secondary tissue distruction of the spinal cord

A
  1. Ischemia
  2. Edema
  3. Demyelination
144
Q

Describe the mechanism of secondary tissue destruction via demyelination

A

Calcium ions accumulate in the injured cells. Abnormal concentration disrupts functioning and causes demyelination and destruction of cell membrane and axonal cytoskeleton

145
Q

Describe spinal shock

A

Temporary phenomenon occurs after trauma to spinal cord.
Cord ceases to function below lesion.
Usually resolves within 24 hours of injury with return of anal and bulbocavernosus reflexes.

146
Q

Designation of spinal level regarding spinal cord injury means what to a clinician

A

Spinal level is defined as the most caudal level of the spinal cord that exhibits INTACT sensory and motor functioning

Must be 3+/5

147
Q

Define A complete spinal cord lesion

A

Total and permanent functional (sensory and motor) destruction of the spinal cord more than THREE segments below the level of the lesion

148
Q

Describe spinal cord pathology with Brown Sequard syndrome

A

Hemi section of the spinal cord, usually from stab or gunshot wounds

149
Q

What are signs and symptoms of Brown Sequard syndrome

A
  1. IPSILATERAL side of lesion has weakness, Loss of proprioception, Vibratory sense, two point discrimination
  2. Decreased reflexes
  3. clonus, spasticity
  • Contralateral side has loss of pain and temperature starting a few levels below lesion
150
Q

Describe a spinal cord pathology with anterior cord syndrome

A

Trauma to anterior cord or damage of the anterior spinal artery usually related to flexion injuries of the cervical region

151
Q

What are signs and symptoms of anterior cord syndrome

A

Loss of motor function and pain and temperature below level of lesion

152
Q

Describe Spinal cord pathology with central cord syndrome

A

Commonly occurs from hyperextension injuries with minor trauma to cervical region

153
Q

Describes signs and symptoms with central cord syndrome

A

Absent UE sensation and motor functioning with normal LE functioning

154
Q

Describe signs and symptoms of posterior cord syndrome

A

Very rare. Deficits of kinesthesia (stereognosis, two point discrimination) and proprioception

Ataxic gait with wide base of support may result

155
Q

Describe sacral sparing

A

Refers to incomplete lesion where most central located Sacral tracts are spared.

Perianal sensation, rectal sphincter contraction, cutaneous innervation of saddle, and active contraction of sacral innervated toe flexors intact

156
Q

Paralysis of voluntary motor control occurs from damage to what tracts, cells or nerves?

A
  1. Descending motor tracts
  2. Anterior horn cells
  3. Spinal nerves
157
Q

After spinal shock resolves what happens to the effects of the reflexes

A

Reflexes return and progressively become stronger resulting in spasticity

158
Q

Spasticity is more prevalent with higher or lower lesions, complete or incomplete?

A

Higher lesions and incomplete lesions

159
Q

Quick stretching of the muscles elicits What from reflexive responses?

A

Exaggerated reflexive response

160
Q

Voluntary control of urination and defecation is controlled by which spinal cord levels

A

S2, S3, and S4

161
Q

Describe a reflexive bladder

A

Upper motor neuron.

Empties in response to a certain level of filling pressure

162
Q

Describe autonomous or non-reflexive bladder

A

Lower motor neuron.

Flaccid bladder emptying by increasing intra-abdominal pressure or manually compressing lower abdomen.

163
Q

Describe what happens when an injury blocks communication between the brainstem and thoracolumbar cord

A
  1. Sympathetic import to the heart is lost but parasympathetic input remains
  2. Results and bradycardia, peripheral vasodilation and hypotension
164
Q

Describe what happens when a cord injury interrupts communication with the hypothalamus

A

Thermoregulation is altered. Causes hypothermia due to peripheral vasodilation.

Reflexive tone returns and prevents peripheral vasodilation.

Later hyperthermia occurs secondary to loss in sympathetic control of Sweat glands

Sweating does not occur below lesion. To compensate diaphoresis occurs above lesion

165
Q

What is autonomic dysreflexia and what are the signs and symptoms

A

Medical emergency. Severe increase in blood pressure, bradycardia, pounding headache, Flushing, diaphoresis and anxiety.

Occurs in lesions above T6. Prevalent in the first three years after SCI

166
Q

What is the most common cause of autonomic dysreflexia

A

A distended bladder

167
Q

If the patient is supine and starts to exhibit signs and symptoms of autonomic dysreflexia what should you do next

A

Sit the patient up to lower blood pressure And check for a kink in Foley catheter

168
Q

What is the main reasons SCI injury patients experience orthostatic hypotension

A

Lack of muscle tone and loss of sympathetic vasoconstriction causes venous pulling in the periphery.

Immobilization of 6 to 8 weeks results and postural hypotension

169
Q

What is heterotopic bone formation

A

Different from myositis ossificans. Occurs in 16 to 53% of all patients with SCI

Appears 1 to 4 months post injury.

Treatment consists of drug therapy and regular exercise during early stages of ectopic bone formation

170
Q

A SCI C1-C3 is capable of what and has which key muscles?

A
  1. Requires ventilator; can use sip-n-puff WC

2. Face and neck

171
Q

A SCI C4 is capable of what and has which key muscles?

A
  1. Ind Respiration, scap elevation, drive WC c chin control

2. Diaphragm & trapezius

172
Q

A SCI C5 is capable of what and has which key muscles?

A
  1. Elbow flexion, supination, shldr ER, abduction to 90, ltd shldr flex
  2. Biceps, brachialis, brachioradialis, deltoid, infraspinatus, rhomboids, supinator
173
Q

A SCI C6 is capable of what and has which key muscles?

A
  1. Shldr flex/ext/IR/ADDuction, scapular abduction/upward rotation, pronation, wrist ext, TENODISIS GRIP
  2. ECR, infraspinatus, Lat dorsi, Pec major, SA, teres minor
174
Q

A SCI C7 is capable of what and has which key muscles?

A
  1. Elbow extension, wrist flexion, finger extension

2. EPL,EPB, FCR, TRICEPS!

175
Q

A SCI C8 is capable of what and has which key muscles?

A
  1. Can use all UE except INTRINSICS of hand

2. FCU, FPL, FPB, extrinsic finger flexors

176
Q

A SCI T1-T5 is capable of what and has which key muscles?

A
  1. Ind UE, better trunk control, inc resp reserve
    * can use wheelie technique
  2. Top half of: intercostals, long muscles of back, intrinsic finger flexors
177
Q

A SCI T6-T8 is capable of what and has which key muscles?

A
  1. Inc trunk, inc resp reserve
  2. Sacrospinalis, semispinalis

*Ind swing to gait in II bars c KAFOs (short distances)

178
Q

A SCI T9-T12 is capable of what and has which key muscles?

A
  1. Inc endurance, inc trunk control
  2. Lower abs, all intercostals

*ind swing through gait c B KAFOs (household dist)

179
Q

A SCI T12-L3 is capable of what and has which key muscles?

A
  1. Hip flexion/ADDuction, knee ext
  2. Gracilis, iliopsoas, quadratus lumborum, rectus femoris, sartorius

*ind swing to/through/4 point c B KAFOs (ind home ambulators)

180
Q

A SCI L4-L5 is capable of what and has which key muscles?

A
  1. Strong hip flex & knee ext, weak knee flex, inc trunk control
  2. Low back muscles, medial ham weak, posterior tibialis, quads, tibialis anterior
  • ind home ambulator
  • *can be community ambulators

NPTE (8 decks)

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