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SCI Flashcards

1
Q

does bony spinal injury equal SCI

A

no

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2
Q

primary injur

A

initial mechanical insult

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3
Q

secondary injury

A

post injury process - shock, electrolyte disturbances, toxicity

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4
Q

early management goals SCI

A

stabilise
limit deficit
promote recovery

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5
Q

non surgical options

A

bedrest
cervical collar
thoraclumbar colar

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6
Q

unstable spine goals

A

neutral spine, HOB at 0

prevent wounds and clear chest

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7
Q

stable spine goals

A

progression of mobility to upright / functional postures

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8
Q

T/f unstable spine is a 2-3 person turn at all times

A

true

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9
Q

stable but requires protection goals

A

turn and be neutral independently

must be neutral at all times

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10
Q

t/f patient may flex ext rotate within limits if no limts

A

yes

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11
Q

can you teach patient role to maintain neutral spine if no restrictions

A

yes

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12
Q

is sympathetic or parasympathetic chain longer

A

para - it starts higher - so initially after SCI people are para dominant

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13
Q

acute management - patient may be unable to manage their

A

BP
HR
temp

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14
Q

after SCI resting BP is __ than normal

A

lower

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15
Q

SCI clients don’t get __ but they have __

A 
true tacky (>100bpm)
relative tacky from baseline
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16
Q

need to watch if patients have __ due to __

A

fever

infection/sepsis

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17
Q

what can a change in reflexes indicate

A

no longer in spinal shock

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18
Q

S234 keeps

A

the poo off the flow

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19
Q

abomdinal function comes at

A

T6- LUMBAR

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20
Q

diaphragms comes at

A

C345

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21
Q

spinal shock

A

suppression of reflexes

may last weeks to months

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22
Q

neurogenic shock

A

loss of sympathetic control

injuries above t6

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23
Q

__ vasomotor tone causing __ in neurogenic shock

A

decreased
hypotension
hypotheremia

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24
Q

unopposed vagal nerve stimulation leads to __

A

bradycardia

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25
Q

untreated neurogenic shock can lead to __

A

metabolic acidosis

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26
Q

leading cause of death in acute SCI

A

respiration

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27
Q

__ of patients with C5 or higher require mechanical venticlation at some time , although most wean

A

95%

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28
Q

T/f respiratory failure is evident intially

A

no may develop over 3-5 days due to fatigue

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29
Q

External / internal intercostal

A

T1-11

30
Q

SCM, scalene, traps, pecs, lats, erectors spinal, subalvis

A

CN X1, C1-8

31
Q 
C1-3 cough function
C4
C5-T1
T2-4
T5-10
T11 and below
A 
absent
non functional 
non functional
weak
poor
normal
32
Q 
C1-3 acute vital capacty
C4
C5-T1
T2-4
T5-10
T11 and below
A 
0-5%
10-15
30-40
40-50
75 to normal
normal
33
Q 
C1-3 long term vital capacty
C4
C5-T1
T2-4
T5-10
T11 and below
A 
ventilator
50% of normal
60-70
60-70 
nearly normal
normal
34
Q

how breathing different in SCI

A

paradoxical breathing

vital capacity and inspiratory volume greater in lying

decrease in all lung volume except residual volume

35
Q

T/f easier for some Sci to breath laying down

A

yes

36
Q

treatment options for trouble breathing

A 
ventilator
CPAP/BIPAP
MIE
stacked breathing
secretion clearnce
binders
phrenic pacing
37
Q

monitoring __ is important during acute stages to see changes in respiratory status

A

vital capacity
Peak expiratory flow
FEV1

38
Q

a pounding headache is __ and light headache is

A

autonomic dsy

hypotension

39
Q

ortho hypo

A

sudden 20 SBPdrop

10 drop in DBP

40
Q

What to do for ortho hypo

A

stocking
binders
slow
meds

41
Q

AD is cursed by __

A

sympathetic discharge

42
Q

Ad is triggered by

A

noxious or non noxious stimulate below level of SCI

43
Q

AD due to loss of __

A

supra spinal control

44
Q

AD occurs in injury __

A

T6 and above

45
Q

more commonly AD occurs in

A

chronic Sci, complete

46
Q

symptoms of AD

A 
increase in BP of 20-30
Brady
poudnign headache
cramps
blurred vision
paresthesia
47
Q

signs of AD

A 
dilated pupils
goosebumps above injury
pilorection 
sweating above
dry cool below
48
Q

common caused AD

A 
full bladder
wounds
tight clothes
sex
painful stimuli
49
Q

how to treat AD

A

upright
check BP
find triggers
loosen clothes

50
Q

sensory exam scoring

A

2 normal
1 impaired
0 absent

51
Q

motor exam scorin

A

0-5

52
Q

neurological level of injury

A

most caudal segment with sensory and Motor antigravity mm function - with a 5 above it across both sides of the body

53
Q

sacral sparing test

A

anal sensation s4/5
deep anal pressure
voluntary anal contraction 3 or more

if ANY of above, its incomplete

54
Q

can physio do sacral sparing test

A

if you have training for internal exams

55
Q

sensory incompleye

A

sacral sparing of lowest sacral segments s45

Asia B

56
Q

motor incomplete

A

sacral spring of motor function
OR
motor function sparing more than 3 levels below with intact sensory sparing S45

57
Q

key prognostic test

A

pin prick LE - 75% can walk a year later

58
Q

Central cord syndrome

A

UE more effected than LE
hyperextension injury
low velocity injury

59
Q

anterior cord syndrome

A

loss of motor function / pain below lesion

60
Q

brown squared

A

ipsilaterally
paralysis, proprioception, vibration

contralterally
pain and temperatue

61
Q

corticopsinal and dorsal cross at

A

brain

62
Q

spinthalmic tract cross over at

A

SC

63
Q

conus medularris you might get

A

mixed presentation ofUMN an LMN (flaccid and spastic)

64
Q

cauda equina syndrome

A

injury below conus

LMN

65
Q

c1-3 injury

A

qventilator dependent
overuse neck mm
dependent

66
Q

c4 injury

A

may be able to breath without ventilate
bed mobility/ADL dependent
power w/c independent

67
Q

c4 and above goals

A

inspirtaroy mm training

68
Q

C5 injury

A

manual w/c possible

bed mobility / ADL some assist required

69
Q

goals for c5

A

inspiratory mm training

ADL adaptive equipment

70
Q

C6

A

have anti gravity wrist extention

may need some assistance, but can be ADL and ind

71
Q

highest SCi level with some ind with or without equipment

A

c6

72
Q

problem with c6

A

no triceps so to need to lock elbows for transfer

tendonesis grip

564 (16 decks)

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