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PT 942 Phys Rehab II > SCI Medical Management and Rehab > Flashcards

SCI Medical Management and Rehab Flashcards

1
Q

What is the potential for recovery with SCI?

A

Greater recovery with incomplete lesions

70% of patients with cervical lesions recover 1 level below level of injury

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2
Q

At 4 months, what is one thing that is associated with a good prognosis for motor recovery at 1 year?

A

Preservation of pin prick

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3
Q

At what time after injury does motor function generally plateau?

A

12-18 months

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4
Q

When is surgical stabilization required?

A

Unstable fracture site
Gross malalignment
Cord compression
Deteriorating neurological status

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5
Q

What is minerva?

A

Cervical orthosis that effectively limits motion in all planes

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6
Q

What are primary goals of PT in the acute stage following and SCI?

A

Prevent secondary complications
Provide patient education
Begin early mobilization when medical clearance received

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7
Q

What are some respiratory factors you want to evaluate?

A 
Observe strength of diaphragm
Respiratory rate
Chest excursion
Vital capacity
Cough Function
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8
Q

What are some ways you can encourage diaphragmatic breathing?

A

Can use light pressure just below sternum to facilitate inspiration and expiration
Use mirror for feedback

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9
Q

What is Glossopharyngeal Breathing?

A

Utilizae lips, pharyngeal muscles, and tongue to inhale air

Used with high cervical lesions

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10
Q

How can you help assist with respiration?

A 
Abdominal binder
Manual stretching (chest wall muscles)
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11
Q

What’s the most effective management of skin?

A 
Prevention!!!
Positioning
Pressure relief
Skin inspection
Education
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12
Q

When in bed, how often does a patient need to be re-positioned?

A

At least every 2 hours

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13
Q

How often should a patient perform pressure relief in a wheelchair?

A

Every 15 minutes

must be maintained for 2 minutes to be effective

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14
Q

Name some pressure relief techniques for a patient in a wheelchair.

A

Push-up
Leaning forward (>45 degrees)
Leaning to side
Tilt feature (at least 65 degrees)

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15
Q

How often should ROM be completed in the acute stage?

A

Daily

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16
Q

What are the precautions if a patient has an injury to the lumbar spine?

A

Straight leg raise

17
Q

What are the precautions if the cervical spine is injured?

A

Motion of head and neck contraindicated and caution when stretching shoulders (flexion and abduction

18
Q

Why is selective stretching important?

A

Some joints and muscles benefit from tightness to enhance function
(Tetraplegia = tightness of lower trunk may improve sitting posture)

19
Q

How much hamstring length is required for functional activities such as long sitting and dressing?

A

100 degrees

20
Q

What do you want to make sure of before any upright activities?

A

Fracture site is stable and patient is cleared

21
Q

How can you test aerobic capacity/endurance?

A

6-minute arm test
10-30 watts tetraplegia
30-60 watts paraplegia

22
Q

How many people who experience a traumatic SCI may also experience a TBI

A

60%

23
Q

True/False: Abnormal tone and spasms can cause involuntary muscle contractions or make it appear that a muscle moved or is stronger than it really is.

A

True

24
Q

What do you want to be careful of with MMT?

A

Watch out for substitution (supinate forearm to extend wrist)

25
Q

How can you assess self-care?

A

FIM
Spinal cord injury independence measure (SCIM) = reliable, vald, and may be more responsive than FIM
Quadriplegia index of function (QIF)
Capabilities of Upper Extremity Instrument (CUE)

26
Q

What factors affect functional outcomes?

A 
Motor level
Age
Concurrent injuries
Secondary complications
Body type
Psychosocial Support
27
Q

What are some key muscles innervated by C1, C2, C3, C4?

A

Face and neck muscles
Cranial nerve innervation
Diaphragm (Partial at C3 and C4)

28
Q

What are some available movements at C1, C2, C3, C4?

A 
Talking
Mastication
Sipping
Blowing
Scapular elevation
29
Q

What are some key muscles innervated by C5?

A 
Biceps
Brachialis
Brachioradialis
Deltoid
Infraspinatus
Rhomboid
Supinator
30
Q

What are some available movements with C5?

A

Elbow flexion and supination
Shoulder ER
Shoulder abd and flexion to 90 degrees

31
Q

What are some available movements with C6?

A

Shoulder flexion, extension, IR and add
Scapular abduction, protraction, and upward rotation
Forearm pronation
Wrist extension

32
Q

What are some available movements with C7?

A

Elbow extension
Wrist flexion
Finger extension

33
Q

What movements do you gain with C8?

A

Finger flexion

PT 942 Phys Rehab II (15 decks)

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