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Neuro Rehab 2 > SCI 3 - Expected Outcomes > Flashcards

SCI 3 - Expected Outcomes Flashcards

1
Q

what is the potential for recovery in people w a complete injury

A

often regain 1 or 2 levels below level of injury
- means you often regain control of 1 or 2 levels of ms mvmt

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2
Q

what is the potential for recovery in an incomplete injury

A

more likely than people w complete injury to regain control of more ms mvmt
- no way to know how much, if any

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3
Q

what are general rules for predicting chance of improvement

A

longer you go w/o seeing improvement, chances are lower

as long as seeing some improvement (like regaining ms mvmt), chances are better

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4
Q

C1-3: breathing

A

ventilator dependent

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5
Q

C1-3: ADL care

A

total assist

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6
Q

C1-3: pressure relief

A

total assist except w equipment

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7
Q

C1-3: bed mobility/transfers

A

total assist

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8
Q

C1-3: wc mobility

A

total assist w manual

(I) driving power chair and performing pressure relief (tilt/recline) w head, chin, mouth or breath control

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9
Q

C1-3: home health aide needs?

A

requires 24hr attendant care

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10
Q

C4: breathing

A

may be able to w/o ventilater
total assist to clear secretions
- depends on strength of diaphragm

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11
Q

C4: ADL care

A

total assist

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12
Q

C4: pressure relief

A

total assist except w equipment

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13
Q

C4: bed mobility / transfers

A

total assist

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14
Q

C4: wc mobility

A

total assist w manual

(I) driving power chair and performing pressure relief (tilt/recline) w head, chin, mouth or breath control

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15
Q

C4: home health aide needs?

A

requires 24 hr attendant care

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16
Q

C5: key muscles innervated

A

biceps
brachialis
brachioradialis
deltoid
infraspinatus
rhomboid
supinator

key ms: elbow flexors, shoulder and scap mvmt

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17
Q

C5: breathing

A

(I)

may need (A) to clear secretions
help w self- assist cough techniques

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18
Q

C5: ADL care

A

some to total assist
(esp w dressing)

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19
Q

C5: pressure relief

A

total assist except w equipment
- may be able to use bicep strength for lateral wt shifts

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20
Q

C5: transfers

A

assisted w transfer board
may be able to become (I) w SB depending on function, body habitus, etc.

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21
Q

C5: bed skills

A

assistance required, able to participate in positioning

use of UE on bedrail, use of momentum for rolling/repositioning

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22
Q

C5: wc mobility

A

(I) driving power chair and performing pressure relief w hand control

able to propel manual wc on uncarpeted indoor surfaces (I) or w (A), benefits from plastic coated hand rims or power assist
- using biceps, delt

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23
Q

what is a concern of use of manual wc in C5 functional level

A

worry about repetitive injury/trauma to shoulder
- RC and scap

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24
Q

C6: key ms

A

extensor carpi rad
infraspinatus
lat dorsi
pec major (clavicular)
pronator teres
serratus anterior*
teres minor

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25
Q

what specific ms innervated by C6 have important functional implications

A

serratus anterior
- use in bed mobility and other functional mvmts

teres minor can also kick in and be used w these mvmts

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26
Q

C6: breathing

A

(I)
may need (A) to clear secretions

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27
Q

C6: ADL care

A

some to total (A)
- esp bathing, dressing

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28
Q

C6: bed mobility

A

some assist to (I) w adaptive equipment

ex: rings on bed - use of biceps and wrist ext

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29
Q

C6: transfers

A

some assist to (I) w SB

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30
Q

C6: wc mobility

A

(I) driving power chair w hand control
- may require tilt/recline for pressure relief

(I) w indoor manual wc propulsion
- partial to total (A) outdoors w manual wc
- benefit from power assist wheels

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31
Q

C6: driving

A

(I) car/van w adaptive control

32
Q

C6: home health aide needs?

A

most people require at least 10hrs/day of personal/home care

33
Q

C7 key ms

A

extensor pollicus long & brev
extrinsic finger ext
flexor carpi rad
triceps**

34
Q

what specific ms innervated by C7 have significant functional implications

A

triceps
- elbow ext
- WB using triceps w/o compensatory techniques

35
Q

C8 key ms

A

extrinsic finger flexors
flexor carpi ulnaris
flexor pollicus long and brev
intrinsic finger flex

36
Q

why are functional outcomes improved significantly at C7 and C8 levels

A

greater UE ms capabilities
- can more easily pressure relieve

37
Q

C7-8: breathing

A

(I)
may need (A) to clear secretions

38
Q

C7-8: ADL care

A

some assist to (I)

39
Q

C7-8: pressure relief

A

(I)

40
Q

C7-8: transfers

A

(I)
may require assist b/w uneven surfaces
- ex: “pop over transfer”

41
Q

C7-8: bed skills

A

(I)
may require adaptive equipment
- bed rail, leg loops

42
Q

C7-8: wc mobility

A

(I) in pressure relief
(I) manual wc propulsion indoors and level outdoors

partial (A) uneven terrain
benefit from plastic coated rims and/or power assis

assist need dictated by contextual factors

43
Q

C7-8: standing/amb

A

some (A) to (I) standing
amb not indicated
- would need orthoses and hang on Y ligs

not necessarily functional

44
Q

C7-8: driving

A

(I) w adaptive controls

45
Q

C7-8: home health aide needs?

A

may need up to 8hrs /day of personal/ home care

46
Q

T1-12 key ms

A

intercostals
long ms of back
- sacrospinalis
- semispinalis
abs (T7-12)

47
Q

T1-12: breathing

A

clearing secretions (I)
compromised vital capacity and endurance

48
Q

T1-12: ADL care

A

(I)

49
Q

T1-12: bed mobility

A

(I)

50
Q

T1-12: transfers

A

(I) level and non level
(I) floor to chair

51
Q

T1-12: wc mobility

A

(I) w manual indoors and outdoors

52
Q

T1-12: standing

A

(I)

53
Q

T1-12: amb

A

physiological standing and amb for exercise in home w lofstrand and KAFO
- typically not functional

54
Q

why would we do standing/amb in a pt T1-12 if it isn’t funcitonal

A

mental health and emotional
physio benefits
- WBing –> loading bone
- improved circulation
- stretch and dec tone

55
Q

T1-12: driving

A

(I) w hand controls

56
Q

T1-12: home health aide needs?

A

may need up to 3hrs / day of personal/home care

57
Q

L1-3. key ms

A

gracilis
iliopsoas
quad lumborum
rectus fem
sartorius

(hip flexors)

58
Q

what is a key funcitonal implicaiton of L3 innervation

A

knee ext (rectus fem)

59
Q

L1-3: breathing

A

intact respiratory function

60
Q

L1-3: transfers

A

(I)

61
Q

L1-3: wc mobility

A

(I) manual indoors and outdoors

62
Q

L1-3: standing

A

(I)

63
Q

L1-3: amb

A

some (A) to (I) amb for home short distances w loftstrand crutches and KAFO or AFO depending on innervated ms

64
Q

L1-3: driving

A

(I) w hand controls

65
Q

L1-3: home health aide needs

A

may need up to 2hrs / day of personal/home care

66
Q

what is a consideration of the AFO chosen for L1-3

A

depends on ms innervation
- AFO vs KAFO

if have rectus fem, can use an AFO set to ensure stability of knee by positioning ankle so that knee isn’t hyper-ext

67
Q

when would someone w L1-3 opt for a manual wc over amb

A

to keep up
preserve energy
prevent injury to legs
community setting

have to weigh benefits vs energy expenditures

68
Q

L5-S1 key ms & specific level of innervation

A

quad (L4)
hamstring (L5-S1)
gastroc (S1)
glut med and max (L5-S1)
extensor digitorum
post tib
peroneals
flexor digitorum (L5-S1)

69
Q

what functional implications do the key ms innervated by L4-S5 have

A

hip ext & ankle ms –> more functional amb

could opt for cane bc more control of hip ext ms and don’t have to hang on Y ligs

70
Q

L4-S5: transfers

A

(I)

71
Q

L4-S5: wc mobility/usage

A

(I) L4 may elect to use wc for long distances

72
Q

L4-S5: standing

A

(I)

73
Q

L4-S5: amb

A

functional
inc ability for community distance

(A) to (I) w amb home and community w loft strand crutches, cane, and AFOs

74
Q

L4-S5: driving

A

(I) w hand controls
some functional w foot controls

75
Q

L4-S5: home health aide needs?

A

may not be in need of any personal / home care

Neuro Rehab 2 (48 decks)

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