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CP3 @ UoN - Musculoskeletal & MDD > Rehabilitation Medicine > Flashcards

Rehabilitation Medicine Flashcards

1
Q

What is the ICF?

A

International classification of functioning, disability and health

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2
Q

What is the ICF definition of capacity?

A

A person’s fullest potential

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3
Q

What is the ICF definition of performance?

A

The level a person is currently at

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4
Q

What is the ICF definition of impairment?

A

When a person’s bodily functions are reduced

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5
Q

What is the ICF definition of activity?

A

Activities of daily living e.g. walking, cooking a meal, driving a car etc.

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6
Q

What is the ICF definition of activity limitation?

A

When a person cannot perform certain activities

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7
Q

What is the ICF definition of participation?

A

Participating in society the way the person wants

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8
Q

What is the ICF definition of participation restriction?

A

When participation is lost/reduced

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9
Q

What is the ICF definition of rehabilitation?

A

Development of a person to their fullest potential, within the limitations of their underlying condition & the resources available

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10
Q

What is the REPAIR model?

A

MDT approach to identifying interventions that could take place to enable rehabilitation

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11
Q

What areas make up the REPAIR model?

A 
Review of pathology/impairment
Environment
Participation
Activity
Important others
Risk
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12
Q

What is an orthosis?

A

Externally applied device used to control motion of a body segment

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13
Q

What are the common indications for lower limb amputation?

A

Dysvascularity (73%)
Infection (8%)
Trauma (7%)
Neoplastic disease (3%)

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14
Q

What are the two major amputation levels?

A

Transfemoral (above-knee, common in severe vasc)

Transtibial (below-knee, twice as common)

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15
Q

What is the goal of amputation?

A

Amputate at most distal level to remove diseased tissue while preserving functional residual limb length & creating the best environment for the rapid return of mobility/function

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16
Q

How many patients will walk post amputation?

A

Transtibial (70%)

Transfemoral (40%)

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17
Q

What is stump pain?

A

Pain in residual portion of limb

-resolves w/ wound healing (70-85%)

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18
Q

What is phantom pain?

A

Painful sensation of missing limb

  • occurring in 55-85%
  • develops a few days post amputation
  • usually improves w/ time
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19
Q

What are the management options for phantom pain?

A

Prevention = pre-op epidural
Antidepressants/established anticonvulsants
Massage of contralateral limb
Psychological support

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20
Q

What is a prosthesis?

A

A device which replaces a missing limb or segment

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21
Q

What factors determine suitability for prosthetic rehabilitation?

A 
Cognitive ability
Motivation
Expectations/goals
Physical strength
Co-morbidities
22
Q

What are the associated complications of prosthesis?

A 
Pressure sores
Skin rashes/allergies
Neuroma development
Contralateral joint issues
Poor pt acceptance
23
Q

What is the ASIA?

A

Scoring system that helps determine whether a spinal cord injury is complete/incomplete
-assesses myotome/dermatome function

24
Q

What factors suggest an incomplete spinal cord injury?

A

Preservation of myotome/dermatome function in S4/S5

  • anal tone/feeling of pressure
  • potential for recovery
25
Q

What is the Barthel Index?

A

Scale used to assess performance in 10 ADLs, including feeding, grooming, transfers & mobility

26
Q

What is neurogenic bladder?

A

Bladder dysfunction due to neurological damage

-presents w/ a range of sx

27
Q

What type of bladder problem does injury above T12 cause?

A

Reflex/spastic bladder

28
Q

What is a reflex/spastic bladder?

A

Autonomic control but no voluntary control

-bladder contracts when reaching a certain level of fullness

29
Q

How should a reflex/spastic bladder be managed?

A

Regular tapping/intermittent catheterisation

30
Q

What type of bladder problem does injury below L1 cause?

A

Flaccid (acontractile) bladder

31
Q

What is a flaccid bladder?

A

No bladder tone

Looks like overflow incontinence

32
Q

How should a flaccid bladder be managed?

A

Intermittent self-catheterisation

33
Q

What is neurogenic bowel?

A

Bowel dysfunction due to neurological damage

-presents w/ a range of sx

34
Q

What type of bowel problem does injury above T12 cause?

A

Reflex bowel

35
Q

What is reflex bowel?

A

Feeling of rectal fullness lost

-reflex movements causing bowel emptying at inconvenient times

36
Q

What type of bowel problem does injury below L1 cause?

A

Areflexic bowel

37
Q

What is areflexic bowel?

A

Defecation reflex & sphincter contraction lost

38
Q

How are reflex & aflexic bowel managed?

A 
Keep correct stool consistency
Routine defecation at set times of the day
   -enema
   -digital stimulation
   -postural changes
   -abdominal massage
39
Q

What is Autonomic Dysreflexia?

A

Potentially dangerous clinical syndrome, developing in individuals w/ spinal cord injury at T6 or above. Results in acute, uncontrolled HTN due to sympathetic overactivity

40
Q

What can cause Autonomic Dysreflexia?

A

Any noxious stimulation below level of injury

41
Q

What are the sx of Autonomic Dysreflexia?

A

Pounding headache
Sweating
Blotching of skin (above injury)
Cold, clammy skin (below injury)

42
Q

What are the signs of Autonomic Dysreflexia?

A

HTN (200/100)

Bradycardia

43
Q

What is a pressure ulcer?

A

Localised injury to skin/underlying tissue, usually over a bony prominence as a result of pressure +/- shear

44
Q

What are the four grades of pressure ulcers?

A

Grade 1 = Non-blanching erythema
Grade 2 = Partial thickness skin loss
Grade 3 = Full thickness skin loss
Grade 4 = Full thickness tissue loss

45
Q

What are the intrinsic risk factors for pressure ulcers?

A 
Sensory impairment
Malnutrition
Immobility
Vascular disease
Multiple co-morbidities
46
Q

What are the extrinsic risk factors for pressure ulcers?

A

Pressure
Shear
Friction forces

47
Q

What are the exacerbating risk factors for pressure ulcers?

A

Skin moisture

Medications (diuretics/steroids)

48
Q

What is the SSKIN bundle?

A

Five-step model to promote pressure ulcer prevention

  • surface
  • skin inspection
  • keep moving
  • incontinence/moisture
  • nutrition/hydration
49
Q

What are the common causes of brain injuries?

A 
Trauma
Stroke
Tumour
Infection
Hypoxia
Drugs/alcohol
50
Q

How are traumatic brain injuries classified?

A

Mild - GCS 13-14, LoC <15mins
Mod - GCS 8-12, LoC <6hrs
Sev - GCS <8, LoC >6hrs

51
Q

What are the physical consequences of brain injuries?

A 
Pressure ulcers
Heterotropic ossification
Pain
Neuro-endocrine dysfunction
Fatigue
Epilepsy
52
Q

What are the cognitive-behavioural consequences of brain injuries?

A 
Memory/concentration difficulties
Executive dysfunction
Mood changes
Disinhibition
Sleep disorders

CP3 @ UoN - Musculoskeletal & MDD (26 decks)

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