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Neuromuscular > SCI > Flashcards

SCI Flashcards

1
Q

At which spinal cord levels (and below) is estim going to be ineffective?

A

L1/L2 and below

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2
Q

T/F using estim for a peripheral nerve injury is an ineffective treatment.

A

True

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3
Q

The spinal cord has 2 enlargements: ________ and ________.

A

Cervical and lumbosacral enlargements

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4
Q

The spinal cord terminates at the _______________.

A

conus medullaris

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5
Q

What does the DCML pathway mediate (3)?

A

Proprioception
Vibration
discriminative touch

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6
Q

What does the spinothalamic tract mediate (3)?

A

Pain
Temperature
Non-discriminate touch

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7
Q

Which gender is at a higher risk of SCI?

A

Male

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8
Q

What age group is at a higher risk of SCI?

A

16-30

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9
Q

What underlying bone disorders are risk factors for SCI?

A

Osteoporosis
Rheumatoid arthritis

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10
Q

70% of SCI are caused by ________ and _________.

A

accidents and falls

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11
Q

___% of SCI are traumatic and ___% are non-traumatic.

A

95%; 5%

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12
Q

What is the most common motion that leads to an SCI?

A

Flexion

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13
Q

Identify three ways to classify an SCI:

A

Level of injury
Degree of impairment (complete or incomplete)
Syndromes associated with injury

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14
Q

Define paraplegic

A

Loss of lower extremities

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15
Q

Define tetraplegic

A

Loss of all 4 extremities (quadriplegic)

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16
Q

How is the level of the injury classified?

A

The most caudal level of the spinal cord with normal function bilaterally.

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17
Q

Define a complete SCI

A

No sensory or motor function in the lowest sacral segments S4-S5.

Therefore no voluntary control over the sphincter and no anal sensation.

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18
Q

Asia impairment scale: A

A

Complete. No sensory or motor function preserved in sacral segments S4-5

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19
Q

Asia impairment scale: B

A

Incomplete. Sensory but not motor preserved below the neurological level and includes sacral segments S4-5.

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20
Q

Asia impairment scale: C

A

Incomplete. Motor function preserved below neurological level, and more than half of key muscles below the level have a muscle grade less than 3.

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21
Q

Asia impairment scale: D

A

Incomplete. Motor function is preserved below neurological level, and at least half of key muscles below level have a muscle grade greater than or equal to 3.

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22
Q

Asia impairment scale: E

A

Normal. Sensory and motor function is normal

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23
Q

What is the period immediately following an SCI termed?

A

Spinal shock

24
Q

During spinal shock what happens to reflex activity?

A

Absence of all reflex activity.

25
Q

What are the 3 phases of spinal shock?

A

Loss or weakening of reflexes
return of some reflexes
Hyperreflexia

26
Q

One of the first indicators that spinal shock is resolving is the presence of a positive ____________ reflex.

A

bulbocavernosus

27
Q

T/F tetraplegia and paraplegia can be either complete or incomplete.

A

True

28
Q

Describe the consequences of Brown-Sequard syndrome

A

Ipsilateral weakness and loss of position and vibration.
Contralateral loss of pain and temperature.

29
Q

Describe the consequences of cord syndrome

A

Below injury level, motor paralysis and loss of pain and temperature sensation.

Proprioception, touch, and vibratory sensation preserved.

30
Q

Describe the consequences of cord syndrome

A

Loss of proprioception, two-point discrimination, graphesthesia, stereognosis.

Normal motor, pain and light touch function.

31
Q

Describe the consequences of central cord syndrome

A

Early loss of pain and temperature. Upper extremities and cervical tracts affected.

Lumbar and sacral preserved.

32
Q

What is the most common cause of Brown-Sequard?

A

Penetration trauma (i.e. knife)

33
Q

Based on the following symptoms, identify the syndrome:

Bowel/bladder incontinence
Low back pain
Radicular pain down the legs
Lower extremity paralysis
Diminished reflexes

A

Cauda Equina syndrome

34
Q

Autonomic dysreflexia typically occurs in lesions above ___.

A

T6

35
Q

T/F autonomic dysreflexia subsides over time.

A

True

36
Q

Identify some symptoms of autonomic dysreflexia (5):

A

HTN
dizziness
headache
bradycardia
sweating

37
Q

If you suspect a patient has autonomic dysreflexia, what’s the first thing to do?

A

Put them in a seated position. DO NOT place them in supine.

38
Q

Describe the type of pain: Acute pain that subsides with healing.

A

Traumatic pain

39
Q

Describe the type of pain: Caused by damage to the nerve roots.

A

Nerve root pain

40
Q

Describe the type of pain: Phantom pains below the level of the lesion.

A

Spinal cord dysesthesia

aka neuropathic pain

41
Q

Describe the type of pain: Pain above the level of the lesion.

A

Musculoskeletal pain

42
Q

List three treatment considerations for orthostatic hypotension:

A

Slow progression to vertical position

Monitor vital signs

Use compression stockings and abdominal binders

43
Q

It’s common for SCI patients to have on-going LOW/HIGH BP levels

A

Low

44
Q

Define maceration

A

Skin that becomes wet. Impairs blood flow.

i.e. band aid after shower

45
Q

There is an increased risk of _______ and death due to pressure sore infections going untreated.

A

Sepsis

46
Q

Three treatments for pressure ulcers:

A

Bed rest (stay off wound)
Alternating pressure mattress
Wound clinic attendance

47
Q

Weight shifting should be performed every ___ - ___ minutes in sitting for ___ minutes.

A

15-20; 1 minute

48
Q

Describe an abdominal binder and what it helps with.

A

Goes from below ribs to top of pelvis.

Assists with BP
Assists with inspiration

49
Q

When worried about skin integrity, what motion should be avoided?

A

Shearing. Lift over slide

50
Q

How often should patients change position in bed?

A

every 2 hours

51
Q

Why are splints used?

A

to prevent contractures

52
Q

Optimal ROM for SCI patient: Lumbar spine

A

mild extensor tightness

53
Q

Optimal ROM for SCI patient: Shoulder extension

A

Greater than normal

54
Q

Optimal ROM for SCI patient: Wrist

A

90 degrees of extension

55
Q

Optimal ROM for SCI patient: fingers

A

Mild tightness of the long finger flexors.

56
Q

Optimal ROM for SCI patient: hamstrings

A

SLR 110-120 degrees

57
Q

Optimal ROM for SCI patient: Ankle DF

A

0 degrees if non-ambulatory

Neuromuscular (15 decks)

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