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Neuro Rehab Test 1 > SCI E&I > Flashcards

SCI E&I Flashcards

1
Q

how do the abdominals help with inspiration

A

they indirectly support the diaphragm by holding the abdominal contents preventing paradoxical breathing

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2
Q

what muscles are most important in implication of paradoxical breathing

A

external intercostals

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3
Q

normal chest expansion

A

2.5-3 inches

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4
Q

talk about how vital capacity changes in tetraplegics. paraplegics?

A

VC is typically 5 L, but decreased 40% in tetras and 20% in paras

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5
Q

what do you know about ventilatory reserve and how might it impact your treatment

A

VR is VC/TV so if its narrow then patients will not tolerate changes in oxygen demand readily

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6
Q

FEV1 predicts ____

A

potential for effective cough

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7
Q

other than numbers on the spirometer, how can we use it to measure breathing

A

ask the pt to count or recite the alphabet

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8
Q
A

C

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9
Q

therapist/caretaker assist for cough training happens at what level of injury? why?

A

C5 - doesn’t have enough GH IR force to do self heimlich

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10
Q

what is the relationship between C1-3 patients and ventilators

A

pts require vent or phrenic nerve pacer

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11
Q

what is the relationship between C4 patients and ventilators

A

can frequently wean from vents

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12
Q

what is a helpful technique to assist in weaning pts from ventilators

A

biofeedback

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13
Q

what is glossopharyngeal breathing

A

an air “gulping” technique for high tetras

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14
Q
A

B

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15
Q

what is pressure relief Rx

A

1 minute for every 15 minutes of sitting

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16
Q

in a tilt-in-space/recline WC, what degree of tilt is needed for pressure relief

A

65 degrees

17
Q

what is mandatory during teaching pressure relief strategeis

A

must palpate the ITs

18
Q

what are effective strategies against orthostatic hypotension

A

midodrine, e-stim, and compression

19
Q

what is beevor’s sign

A

umbilicus displacement when a pt with a thoracic level injury is asked to curl up

20
Q

define the modified ashworth scale

A

0 = no increase in tone

1 = slight increase in tone (catch and release)

1+ = slight increase in tone (catch and resist)

2 = tone increase, but moves easily

3 = passive movement difficult

4 = rigid in flexion or extension

21
Q

what is the tardieu scale

A

R1 is the first catch and R2 is the available range

22
Q

what is the reflex scoring scale

A

0 = absent

1+ = hypo

2+ = normal

3+ = brisk

4+ = 1-3 beat clonus

5+ = sustained clonus

23
Q

what are the reflex locations of the UE

A
  • biceps C5-6
  • triceps C6-7
24
Q

what are the reflex locations for the LE

A
  • patellar L2-4
  • hams L5-S2
  • achilles S1-2
25
Q

define spasticity

A

velocity dependent increase in resistance of a muscle or group to passive stretch (UMN)

26
Q

clasp knife phenomenon

A

a type of spasticity defined as increasing resistance followed by a sudden release of resistance (snapping into full ROM)

27
Q

baclofen

A

most common antispasmodic given orally or intrathecally via subdermal pump

28
Q

What are the ASIA UE motor exam points

A
  • C5: elbow flexion
  • C6: wrist extension
  • C7: elbow extension
  • C8: DIP flexion
  • T1: pinky abduction
29
Q

what are the ASIA LE motor exam points

A
  • L2: hip flexion
  • L3: knee extension
  • L4: ankle DF
  • L5: great toe ext
  • S1: ankle PF
30
Q

what are some muscle groups you will prioritize in MMT?

A

scapular stabilizers

31
Q

what is an EXCELLENT position to train/test scapular stretch

A

PoE

32
Q

what is a great combo activity for muscle re-education

A

FES and biofeedback

33
Q

what are three common findings during a sitting posture exam

A
  • PPT (sacral sitting) to increase BoS and stability
  • T kyphosis and compensatory C lordosis
  • scoliosis
34
Q

describe functional mobility at the C7 level

A

pts may achieve independence though energy energy expenditure may be a concern

35
Q

describe functional mobility at the C6 level

A

pts MUCH LESS LIKELY to be independent (than C7) and will probably require assistance

36
Q

describe functional mobiilty at C5 and above

A

will require assistance

37
Q

rolling training ideas for C6 tetras (5)

A
  • LE progression - 2 flexed, 1 flexed, legs crossed
  • cuff weight on wrist for momentum
  • head/neck to initiate roll
  • start 45 deg prop, 30 deg prop, etc
  • elbow flexion to pull on rail
38
Q

supine to sit ideas for C6 tetras (4)

A
  • biceps with hands in pockets/under thighs
  • rolling effort with quick throw of UE behind (req high GHROM)
  • roll to side and walk elbows to pull with biceps
  • train the activity in reverse (long sit to supine)
39
Q
A

B

Neuro Rehab Test 1 (8 decks)

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