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Neuromanagement > SCI > Flashcards

SCI Flashcards

1
Q

total absence of sensation in dermatomes below level of lesion

A

complete lesions

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2
Q

sensory loss related to damage within specific spinal tracts

A

incomplete lesions

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3
Q

C5 controls which myotome

A

elbow flexors

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4
Q

C6 controls which myotome

A

wrist extensors

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5
Q

C7 controls which myotome

A

elbow extensors

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6
Q

C8 controls which myotome

A

finger flexors

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7
Q

NEUROLOGIC level of injury is the lowest level on the spinal cord where key muscles test at least / and sensation intact for this level dermatome

A

3/5

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8
Q

FUNCTIONAL level lowest segment which strength of key muscles graded at / or higher and sensation intact

A

3+/5

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9
Q

A lesion to the centrally located structures of region, that produces sacral sparing and greater weakness in the upper limbs than in the lower limbs. Typically seen in older adults

A

central cord syndrome

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10
Q

Hemisection of the cord which produces ipsilateral (same-sided) proprioceptive and motor loss and contralateral (other side) loss of pain and temperature

A

Brown-Sequard syndrome

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11
Q

Rare, results from compression by tumor or infarction of the posterior spinal artery. Proprioception, stereognosis, two-point discrimination, and vibration sense are lost below the lesion.

A

posterior cord syndrome

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12
Q

A lesion that produces variable loss of motor function and of sensitivity to pin and temperature, while preserving proprioception, touch and vibration.

A

anterior cord syndrome

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13
Q

Injury of the sacral cord (conus) and lumbar nerve roots within the neural canal that usually results in nonreflexive bladder, bowel and lower limbs. Sacral segments may occasionally show preserved reflexes (bulbocavernosus and micturition reflexes).

A

conus medullaris syndrome

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14
Q

Injury to the lumbosacral nerve roots within the neural canal resulting in nonreflexive bladder, bowel and lower limbs.

A

cauda equina syndrome

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15
Q

what movement is possible if you have a C1-C3 SCI

A

neck flexion
neck extension
neck rotation

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16
Q

what movement is possible if you have a C4 SCI

A 
neck flexion
neck extension 
neck rotation 
scapular elevation 
inspiration
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17
Q

what movement is possible if you have a C5 SCI

A 
Shoulder flexion
Shoulder abduction
Shoulder extension
Elbow flexion
Supination
Scapular adduction & abduction
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18
Q

what movement is possible if you have a C6 SCI

A

Scapular protraction
Horizontal adduction (some)
Forearm supination
Radial wrist extension

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19
Q

what movement is possible if you have C7-C8 SCI

A 
Elbow extension
Ulnar wrist extension
Wrist flexion
Finger flexion & extension
Thumb flexion, extension, & abduction
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20
Q

what movement is possible if you have a T1-T4 SCI

A

Upper extremity
Limited trunk stability
Increasing lung capacity

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21
Q

what movement is possible if you have T10-L1 SCI

A

trunk stability

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22
Q

what movement is possible if you have L2-S5 SCI

A

trunk stability

partial to full control of LE

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23
Q

A L2 SCI is classified as motor function in what muscle

A

ilipsoas

24
Q

A L3 SCI is classified as motor function in what muscle

A

quadriceps femori

25
Q

A L4 SCI is classified as motor function in what muscle

A

tibialis anterior

26
Q

A L5 SCI is classified as motor function in what muscle

A

Extensor hallucis longus

27
Q

What education should you provide a patient with a SCI

A

Levels & Outcomes
Positioning to manage tone
Body mechanics to minimize injury (both to pt and family)
Use of adaptive equipment for independence
Sensory awareness
Handling architectural barriers (what does their home look like)
Managing complications (AD, OH)
Sexual counseling

28
Q

determines the L3 level of lesion

A

knee extensors

29
Q

determines the C6 level of lesion

A

wrist extensors

30
Q

determines the T1 level of lesion

A

small finger abductors

31
Q

determines the L2 level of lesion

A

hip flexors

32
Q

determines the C7 level of lesion

A

elbow extensors

33
Q

determines the L4 level of lesion

A

ankle dorsiflexors

34
Q

determines the C8 level of lesion

A

finger flexors

35
Q

determines the S1 level of lesion

A

ankle plantar flexors

36
Q

determines the C5 level of lesion

A

elbow flexors

37
Q

determines the L5 level of lesion

A

long toe extensors

38
Q

determines the C3 level of lesion

A

diaphragm

39
Q

what type of stimulus do you test with for a SCI patient

A

strong

40
Q

If a patient has a known complete lesion, should you test multiple sensory modalities

A

no

41
Q

If a patient has unknown or incomplete lesions, should you test multiple sensory modalities

A

yes

42
Q

When does sensory recovery typically happen

A

within the 1st year

43
Q

complete loss of neurological function that results in diminished reflex activity below level of injury. Lasts 1 day-6 weeks.

A

spinal shock

44
Q

what are symptoms of spinal shock in the affected area

A 
Decreased sensation
Decreased deep tendon reflex
Decreased blood pressure
Flaccid muscle function
Frequent loss of bowel & bladder control
45
Q

what is involved with acute management of SCI

A

♣ Positioning/Deformity Control
♣ Skin integrity
♣ Initial ADL skills
♣ Education but action is primary feature
♣ Start upright tolerance
♣ Building blocks * think about what are the skills you will need them to have in order to complete ADL’s*
♣ Strengthening/ROM- this also helps to start acclimating them to their body

46
Q

what is involved with inpatient rehabilitation

A 
♣	Upright tolerance
♣	Deformity control
♣	Skin issues become more directive
♣	ADL’s
♣	Strengthening/ROM
♣	Learning body in space skills
♣	Teach them their head controls body movements
♣	Functional mobility
♣	Spinal shock resolves
♣	Education
47
Q

what is involved with outpatient/home health

A 
Finishing what you started 
ROM/Strengthening
Body in space
ADL skills at higher level 
Functional mobility skills
Community access
Training family
48
Q

what are the prognosis factors for a SCI

A 
Type of injury
Motivation
Socioeconomic background
Education
Family support
Acceptance of disability
Problem solving abilities
49
Q

what are the symptoms of OH

A 
♣	Dizziness
♣	Loss of consciousness
♣	Nausea
♣	Pallor
♣	Sudden weakness
50
Q

what is the treatment of OH

A

♣ If sitting in chair tilt chair backwards
♣ If sitting EOB lie patient back down
♣ Coming to upright position slowly can help decrease incidents of orthostatic hypotension

51
Q

prevention of OH

A

Ace wraps
abdominal binder
gradual increases in sitting tolerance

52
Q

treatment of autonomic dysreflexia

A

Elevate to sitting position
♣ Take blood pressure in both arms – remember systolic BP can be in 90 – 110 mmHg range normally
♣ Check for blockage/kinks in bladder & bowel system
♣ Check for areas of restriction – tight clothing
♣ Relieve urinary pressure
♣ Seek medical attention

53
Q

risk factors of DVT

A

immobilization, post-op, age>40, cardiac disease, limb trauma, coagulation d/o, obesity, advanced neoplasm (abnormal growth), pregnancy

54
Q

clinical signs of DVT

A

Pain
Swelling
Superficial venous distention
Fever

55
Q

treatment of DVT

A

blood thinners – Coumadin, heparin
compression (more as a prevention—ie TED hose)
bed rest

Neuromanagement (5 decks)

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