SCI 7 - Tone Management Flashcards

1
Q

is tone conscious

A

no

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2
Q

does tone define ms power and strength

A

no - can mask strength

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3
Q

is ms tone present all the time

A

yes - resting tone

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4
Q

how can tone impact functional mobility

A

inc tone –> help w balance and transfers

impact stability –> feed on floor allows stability in sitting

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5
Q

how are corticospinal tracts impacted in a SCI

A

impaired in incomplete
absent in complete

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6
Q

does the reflex arc below NLI remain intact

A

yes - there doesn’t have to be mediation from brain, reflex is separate from the brain

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7
Q

what impact does a SCI have on reflex arc

A

reflex arc firing w/o modification from higher centers in cortex
–> results in spasticity (spastic hypertonia)

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8
Q

where and what input does reflex arc receive

A

from ms spindle & GTOs

enhanced excitatory synaptic input

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9
Q

what are disadvantages to spastic hypertonia

A

dec ROM
inc pain
unwanted bowel/bladder release
dec postural control
dec skin integrity
inc healthcare costs
dec ability to perform ADLs, functional mobility, and leisure activities

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10
Q

what are advantages to spastic hypertonia

A

maintain ms tone & mass
dec bone loss
inc metabolic requirements
inc bowel/bladder function
inc ability perform ADLs
inc detection of impairments

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11
Q

how could spastic hypertonia inc detection of impairments in body systems

A

autonomic dysreflexia can notify someone they have UTI or skin breakdown

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12
Q

how can spastic hypertonia dec risk of osteoporosis

A

ms contraction creates tendon pull on bone

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13
Q

how can spastic hypertonia dec skin integrity

A

drive bony prominences into surfaces

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14
Q

what are exacerbating factors for tone

A

infections
pressure sores
DVT
temp
fatigue
positioning
bladder distention
bowel impaction

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15
Q

what are 4 medical management options for spastic hypertonia

A

pharmacological mgmt
motor point block injections
surgical procedures
intrathecal pump (ie baclofen)

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16
Q

when are surgical procedures seen to manage spastic hypertonia

A

last resort
- nothing else has worked

17
Q

what is a consideration with the use of baclofen to manage spastic hypertonia

A

systemic
- too much = hypotonic
- have to balance how much

18
Q

what is a good PT strategy if a pt starts experiencing clonus

A

approximation or tendon pressure can stop the beating

19
Q

what are 7 PT interventions/strategies to managing spastic hypertonicity

A

stretching/PROM
wt bearing / approximation
modalities (heat, ice, estim)
paraffin
serial casting / splinting
positioning
apply tendon pressure

20
Q

what are 5 principles of compensatory strategies

A

head hips relationship
momentum
ms substitution
task modification
work in and out of task

21
Q

what is the head hips relationship

A

head opposite to direction you want to move so hips can move over

head opposite way offloads hips to move them over

22
Q

what is an example of ms substitution in someone w no triceps

A

closed chain ant delt and ERs

23
Q

how does ms substitution work

A

use of neuroplasticity teaching ms how to work differently than before