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216 final > SCI > Flashcards

SCI Flashcards

1
Q

potential causes of death that significantly affect life expectancy?

A

pneumonia, septicemia

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2
Q

susceptible regions of injury? why>

A

c1, c2, c5-c7, t12-L2 bc more rotation and large spinal cord

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3
Q

how do you name the injury?

A

boney spine segment involved then last spinal root innervated

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4
Q

tetraplegia

A

cervical–impaired UE, LE, trunk & pelvic organs

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5
Q

paraplegia

A

thoracic–UE spared, vary LE, trunk and pelvic organ

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6
Q

cauda equina injuries

A

at L1 or below

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7
Q

ASIA Scale neuro level

A

most caudal segment of the cord with intact sensation & antigravity (3 or more) muscle function strength, provided that there us normal intact sensory and motor function –partial innervation up to 3 levels below

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8
Q

ASIA normal muscle

A

lowest key muscle w/ mmt grade of fair (3.5)

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9
Q

cervical flexion & rotation

A

–most common

Post spinal lig/disc rupture, upper vert displaced on lower, rear end mva

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10
Q

cervical hyperflexion

A

ant compression wedgelike fx, stretch PLL, sever ant spinal artery, incomplete anterior cord syndrome–head on collision on blow to back

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11
Q

cervical hyperextension

A

w/ fall chin strikes and go back– rupture ALL, compress & rupture disc, sc ends up between lig falv & vert body w/ central cord injury

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12
Q

compression injury

A

vetrical force like dive–fc vert end plates& move nuleus into vert body–ligs stretch but stay intact. –if produced by osteoporosis, or ra can still cause sci

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13
Q

loss of function 2 levels above initial injury==?

A

sci damage in more than one place

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14
Q

spinal shock

A

flaccid–>areflex, loss of BBladder, auto deficits, dc art blood like poor temp reg. fro 24-48 hours–resolve & reflex activity below level will return 1-6 mths

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15
Q

ASIA IS

A

A-complete- no MS in S4-5
B-Sensory inc–only sensory function below level w/ no motor 3 levels below
C-Motor Inc–only motor below level, more than half key function have mmt less than 3
D-Motor Inc–only motor below level, more than hal key function at 3 or more mmt
E-normal-

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16
Q

complete injury

A

sc transection, sc compression or vascular compression

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17
Q

zone of partial preservation

A

caudal segenmt w/ some sensory/ motor only in complete

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18
Q

Incomplete injuries

A

partial preservation of motor/ sensory function–must have perianal sensation or voluntary contraction of external sphincter–usually have abnormal tone or spasticity (clonus, dtr)

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19
Q

Brown sequard

A

gunshot, stab–dc motor funcion, proprio, vibration on same side of injury–pain/temp lost on opp–> independent w/ adls

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20
Q

Ant Cord Syndrome

A

flex w/ fx dislocation of cervverts–dc motor, pain, temp, Bilateral below—position & vibration intact–> limited return since all voluntary control lost

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21
Q

central cord syndrome

A

stenosis, hyper/ injury–damage to all 3 tracts–ue more involved–sensory deficit–>can do functional adls

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22
Q

dorsal column syndrome/ post cord

A

compression of spinal artery–loss of proprioception/ vibration bilaterally—can move, feel pain

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23
Q

cauda equina injury

A

directtrauma beloe l1–affect upper/ lower neuros, flaccid loss of bowel bladder,

24
Q

conus medullaris

A

damage to sacral aspect of spinal cord & lumbar nerve roots–flaccid LE, bowel bladder dysfunction, sacral reflex intact in some

25
Q

root escape

A

preservation or return of function in nerve roots near site

26
Q

resolution of spinal shock

A

flexor spasticity than interruption of vestibulospinal tract thennn extesonr tone

27
Q

complications of SCI

A

pressure ulcer– 1 mine very 15-20
autonomic dysreflexia–SNS instability–uti sores, temp change
hypotension, pain (nociceptive vs nueropathic), contractures, heterotropic ossification, dvt(**2-3 mths), osteoporosis, respiratoryc ompromise, bB dysfunction, sexual dysfunction, spasticity

28
Q

symptoms of autonomic dysreflexia

A

hypertension, severe pounding headache, bradycardia, vasoconstriction below the level of lesion, vasodilation( flush) sweating, constricted pupils, goose pumps, lurry vision, runny nose

29
Q

signs of heterotropci ossification

A

swelling,w armth , pain, limited ROM w/or w/o fever

30
Q

respiratory compromise

A

phrenic-c3-c5, external intercostals t1–
paraplegia below t12 can use 2 chest, 2 diaphragm breathing
upper abs t7-9, lower t9-12 (coughing limited)

31
Q

bladder

A

s2-4
hyper/spastic= scral reflex intact
nonreflex/ flaccid- no sacral reflex arc–manually empty
above s2-spastic or reflex bowel
s2-s4 flaccid or arereflex bowel=cant emty

32
Q

sexual issues

A

men cant ejaculate w/ upper or lower motor neuron injuries, women can get preggers

33
Q

spasticity

A

higher in pts w. cervical and incomplete injuries especially B & C on ASIAIS–can be good for muscle bulk, circulation, and increased anal sphincter tone

34
Q

c1-c3

A

Vent, totally dependent- WC with sip and puff unit

35
Q

C4

A

some diaphragm innervation- wc with chin cup or mouth stick, completely dept w/ adls

36
Q

c5

A

deltoid, rhoms,biceps (cant / elbow)–pressure releif, can give some help with slide board transfer, can perform son UE adls, drive with van and hand controls

37
Q

c6

A

wrist /, pecm joar, teres major–Ind w/ roll, feed, dressing uE. can propel wc w/ prjection, help for LE dress–can drive w/ adaptive controls

38
Q

c7

A

live indep. bc of triceps–releif, dressinf, slide board, can drive car iwth adaptivec ontrols

39
Q

c8

A

live indep, increase finger control, can do wheelies in wc for curbs

40
Q

T1-T9

A

increase trunk control, productive cough–operate maual wc-can stand and therapeticaluly ambulate

41
Q

t10-l2

A

therapeutic ambulation and home ambulation with orthosis

42
Q

l3-l5

A

quad function–independent with community amb & orthosis

43
Q

acuteb reathing exercises

A

epigastric rise–check this to ake sure theya re breathing
GLossopharangeal–high tetra->ah oops
lateral expand–(t1-t12)–expand chest lat
incentive spriometry-vital capacityt aken
chest wall stretch–manual–hand on rib and chest
postural drainage
cough

44
Q

rom acute intvn

A

shld flex, abd= 90, 60/, 90 ER

45
Q

tenodesis

A

passive insufficiencyc auses subsequent flexing of finger flexors to grip things–DONT OVER STRETCH!

46
Q

prom

A

HS range must be at 110 for long sit–stretch hip ext, flexs, rotators! need 100 flexionf or wc transfer, 45 extension of hip for dressing

47
Q

unstable lumbar spine range

A

hip flexion at 90w ith knees flexed and 60 with knees traight

48
Q

key muscles need to be strengthened for tetraplegia

A

ant deltoids, shlde xt, biceps

49
Q

key muslces to be strengthened for paraplegia

A

should depressors, triceps, lat dorsi

50
Q

c1-c4 transfers

A

completely dependent– 2 person lift (high tetraplegia), hoyer or depnt sit pivot transfer

51
Q

modified stand pivot

A

incomplete w/ le innervation even w/ extensor tone

52
Q

airlift

A

preferredf or significant low extremity extensor tone 9preventss hear force)

53
Q

slide board transfer

A

30degree angle–c6 tetraplegic can transfer Indepen.

54
Q

prone on elbows

A

c6 tetraplegic

55
Q

lateral push up transfer

A

c7 with goodt ricep can do this without sliding board

56
Q

independent self range motion

A

c7 tetaplegia should be instructed on seld range motion to lower extremitie in sitting

57
Q

hip sawyer

A

long sit, shift butt over

216 final (2 decks)

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