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DPT 830 Neuromuscular Rehab > Neuromuscular II SCI Unit Exam > Flashcards

Neuromuscular II SCI Unit Exam Flashcards

1
Q

what is SCI?

A

damage to the spinal cord resulting in symptoms below the level of injury

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2
Q

SCIs are most common between what age range?

A

16-30

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3
Q

what age do most SCIs occur? why?

A

19, frontal lobe development and myelination

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4
Q

do SCIs occur more in males or females?

A

males (80%)

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5
Q

what are the most common traumatic mechanisms of injury with SCIs?

A

MVA
falls
violence
sports related injuries

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6
Q

what are some non-traumatic mechanisms of injury of SCIs?

A

AVM
thrombus, embolus, hemorrhage to arterial supply
infection
tumor
MS lesions
ALS
spinal stenosis

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7
Q

incomplete SCIs have a _______ life expectancy than complete

A

longer

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8
Q

paraplegia has a ______ life expectancy than tetraplegia

A

longer

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9
Q

higher cervical tetraplegia has a ________ life expectancy than lower cervical tetraplegia. why?

A

shorter (innervation to vital organs)

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10
Q

________ rate is highest in the first year after spinal cord injury

A

mortality

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11
Q

happens immediately after SCI

A

spinal shock

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12
Q

a period of _______ lasts around 24 hours after spinal cord injury where everything is flaccid

A

areflexia

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13
Q

how many days does it take for reflexes to gradually return after spinal shock?

A

1-3 days

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14
Q

__________ may be present for 1-4 weeks after reflexes return following injury

A

hyperreflexia (high tone)

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15
Q

when is the ideal timeframe to administer an asia exam?

A

1-3 days

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16
Q

looks at motor and sensory levels bilaterally as well as sacral tone and sensation to determine SCI level, etc.

A

asia exam

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17
Q

asia exam determines what 5 naming categories of SCI

A

motor level of injury
sensory level of injury
neurologic level of injury
complete or incomplete
zone of partial preservation

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18
Q

asia C5 motor level

A

elbow flexors

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19
Q

asia C6 motor level

A

wrist extensors

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20
Q

asia C7 motor level

A

elbow extensors

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21
Q

asia C8 motor level

A

finger flexors

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22
Q

asia T1 motor level

A

finger abductors

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23
Q

asia L2 motor level

A

hip flexors

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24
Q

asia L3 motor level

A

knee extensors

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25
Q

asia L4 motor level

A

ankle dorsiflexors

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26
Q

asia L5 motor level

A

long toe extensors

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27
Q

asia S1 motor level

A

ankle plantar flexors

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28
Q

no voluntary anal contraction or deep anal pressure

A

noon sign

29
Q

what does the noon sign indicate?

A

complete SCI

30
Q

no motor or sensory function is preserved in the sacral segments S4 to S5

A

asia A complete

31
Q

sensory but not motor function is preserved below the neurological level and includes the sacral segments S4 to S5

A

asia B incomplete
(motor complete)

32
Q

more than half of the key muscles below the neurological level have a muscle grade less than 3 (all 1s and 2s)

A

asia C incomplete

33
Q

at least half of the key muscles below the neurological level have a muscle grade of 3 or higher

A

asia D incomplete

34
Q

asia level where motor and sensory function is normal

A

asia E

35
Q

what is the motor level of injury?

A

lowest level that has a grade of 3 or higher if the level above it is a 5

36
Q

what is the sensory level of injury?

A

lowest level of intact sensation (light touch and pink prick) (all 2s)

37
Q

what is the neuralgic level of injury?

A

lowest level with normal motor and sensory function both on the right and left sides of the body (all 5s and 2s)

38
Q

what is the zone of partial preservation?

A

levels below the motor or sensory level of injury that may be partially innervated

39
Q

B loss of corticospinal and spinothalamic tracts

A

anterior cord syndrome

40
Q

UEs more affected than LEs with varying degrees of sensory impairment, sacral sparing

A

central cord syndrome

41
Q

ipsilateral DCML and corticospinal tract loss and contralateral spinothalamic tract loss

A

brown sequard syndrome

42
Q

B loss of DCML

A

posterior cord syndrome

43
Q

injury to this part of the spinal cord presents as mixed LMN and UMN signs

A

conus medullaris

44
Q

injury to this part of the spinal cord presents with LMN signs, flaccid paresis, and saddle anesthesias

A

cauda equina

45
Q

above conus medullaris

A

UMN

46
Q

below conus medullaris

A

LMN

47
Q

below which level generally presents as LMN?

A

T12

48
Q

below T12
hyporeflexia
flaccidity
decreased tone

A

LMN

49
Q

LMN bowel and bladder

A

flaccid

50
Q

LMN sexual function

A

psychogenic responses

51
Q

above T12
hyperreflexia
spasticity
increased tone

A

UMN

52
Q

UMN bowel and bladder

A

spastic or hyperreflexive

53
Q

UMN sexual function

A

reflexogenic arcs

54
Q

ICU/floor setting that lasts for 1-3 weeks, working on upright tolerance and basic mobility

A

acute care

55
Q

in this setting for 4-12 weeks learning ADLs, mobility, wheelchair training, and bracing

A

acute rehab

56
Q

patients with higher level SCIs with complications, vents, or flap surgeries go to this setting

A

LTACH

57
Q

setting that works on community integration, MSK injury prevention, and sports

A

outpatient

58
Q

cardiopulmonary secondary complications

A

pneumonia (PNA)
aspiration
diaphragmatic muscle impairment
PE/DVT
BP management

59
Q

what is autonomic dysreflexia?

A

sympathetic stimuli ascends to the brain but parasympathetic response cannot descend past the level of injury

60
Q

autonomic dysreflexia can occur wits SCIs above what level? why?

A

T6 and above
sympathetic chain

61
Q

if BP is skyrocketing in a patient with autonomic dysreflexia, what should the PT do?

A

sit the patient up to induce orthostasis

62
Q

autonomic secondary complications

A

autonomic dysreflexia
BP management
sweating response
lack of higher center inhibition
loss of descending control of ascending sympathetic reflexes

63
Q

symptoms of autonomic dysreflexia

A

hypertension
bradycardia
headache (severe + pounding)
profuse sweating
increased spasticity
vasodilation above LOI (flushing)
constricted pupils
nasal congestion
pilorection
blurred vision
dry pale skin below LOI (vasoconstriction)

64
Q

what is hypertension characterized by?

A

raise of 20-30mmHg systolic

65
Q

autonomic dysreflexia typically occurs how many months after injury?

A

3-6 months
may be chronic

66
Q

neurologic secondary complications

A

tone/spasticity chances (UMN vs LMN)
neuropathic pain
sensory loss

67
Q

musculoskeletal secondary complications

A

motor loss
osteoporosis
osteomyelitis
secondary overuse injuries
heterotropic ossification (HO)

68
Q

why are patients with SCIs at an increased risk of developing osteoporosis?

A

not enough load through joints

69
Q

why are standing frames so important for patients with SCI?

A

DPT 830 Neuromuscular Rehab (4 decks)

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