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DPT 621 > SCI part 2 > Flashcards

SCI part 2 Flashcards

1
Q

order these from most to least common: incomplete paraplegia, incomplete quadriplegia, complete quadriplegia, complete paraplegia

A

incomplete quadriplegia

complete paraplegia

incomplete paraplegia

complete quadriplegia

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2
Q

what are the key ms at the C5 level?

A

Rhomboids, deltoids, biceps, brachialis, brachioradialis, partial RC innervation

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3
Q

what are the key ms fxns at the C5 level?

A

Scapular adduction, shoulder abduction (partial), some elbow flexion

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4
Q

what are the key ms at the C6 level?

A

SA, pec major (partial), biceps, extensor carpi radialis, RC (full innervation)

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5
Q

what are the key ms fxns at the C6 level?

A

Full rotation/abduction, full elbow flexion strength, wrist extension

**tenodesis for finger fxn

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6
Q

what are the key ms at the C7 level?

A

Lats, pec major (sternal head), triceps, pronator teres, flexor carpi radialis

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7
Q

what are the key ms fxns at the C7 level?

A

Elbow extension, forearm pronation, wrist flexion, adn some finger

**essentially no hand fxn, uses tenodesis grip

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8
Q

what are the key ms at the C8 level?

A

Flexor digitorum profundus and superficialis, flexor pollicis longus and brevis, abductor pollicus longus, opponens pollicus, adductor pollicus, partial lumbricles, flexor carpi ulnaris, extensor carpi ulnaris

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9
Q

what are the key ms fxns at the C8 level?

A

Finger flexion, thumb flex/abd/add/opposition; wrist flexion; full wrist extension

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10
Q

what is the tenodesis grip?

A

fxnal grasp/release for pts with no active finger fxn (C6/7) using passive insufficiency of finger flexors to grip

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11
Q

how is the tenodesis grip performed?

A

pt performs active wrist extension with reflexive finger flexion

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12
Q

how is the tenodesis grip maintained?

A

Prevention and avoidance of stretching finger flexors

Education on proper self-stretching techniques

Use of splints to maintain position

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13
Q

what adaptive equipment can be used to increase success with fxnal mobility in SCIs?

A

Leg loops

Transfer board/beazy board

Hospital bed

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14
Q

when would a beazy board be used over a transfer board?

A

when higher level assistance is needed

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15
Q

all SCI at level _____ and above will be dependent for bed mobility

A

C4

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16
Q

what ms motions can be used for rolling with a C5 SCI?

A

partial biceps, use of scapular protraction/retraction w/head movt

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17
Q

what ms motions can be used for rolling with a C6 SCI?

A

no triceps, must keep UEs below 90 deg elevation to avoid hitting face, utilize shoulder ER to maintain elbow extension

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18
Q

what ms motions can be used for rolling with a C7 SCI?

A

have triceps and can maintain elbow extension, can utilize push up, or cross body swing above 90 deg

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19
Q

can SCI C4 or C5 use triceps for transfers

A

nope

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20
Q

what SCI levels use C crawling in supine to long sit transfers?

A

C5-7

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21
Q

what is the c crawl method to get from supine to long sitting?

A

roll using momentum to land propped on forearm

UE “walk” to bring trunk towards knees

hook CL UE to BLE to pull upright (use active biceps)

think about ms innervation at each level to achieve

throw UE into posterior prop (ER to lock out)

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22
Q

what SCI levels use the rocking technique to get from supine to long sit?

A

C6 and below

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23
Q

what is the procedure for the rocking technique to get from supine to long sit?

A

initiate trunk lift from surface using wrist extension, elbow flexion, and cervical flexion

medial-lateral rocking motion using to prop onto forearms

throw one UE in full posterior prop

large shift over extended UE to throw CL UE into posterior prop position

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24
Q

what fxnal task involved long sitting?

A

dressing

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25
when dressing, should we start on the stronger or weaker side first?
the weaker side first
26
t/f: dressing can be easier by having the right posture using pillows, blankets, and towels can help get the right position
true
27
what might make dressing easier?
using pillows, blankets, towels adding straps or bedrails using a reacher or dressing stick
28
what is the technique involved in supine to short sit?
from long sit, use biceps (C5) with wrist ext (C6), and elbow ext (C7) to push leg closest to the edge towards the edge, keep weight on the opposite hand or elbow utilize same techniques to maneuver opposite leg towards edge of mat until off the mat push trunk upright from propped elbow position to come to short sit
29
how can we use momentum to get from short sit to supine?
from sitting at the edge of the bed/mat, use rocking momentum while holding LEs and quickly “throw” LEs onto the bed can use leg straps to keep the legs together and to hook onto
30
how can we lower from LSP to supine?
after moving from SSP to LSP, can slowly lower from LSP into supine w/BUE support use of bed rails and/or lower onto bed with head elevated to make easier when training
31
what is an important thing to use in transfers for all cervical levels C5 and below?
momentum!!!
32
what is the expected outcome for bed mobility for SCI C1-4?
Dependent for all bed mobility
33
what is the expected outcome for bed mobility for SCI C5?
Max-dependent
34
what is the exceptional outcome for bed mobility for SCI C5?
Min-mod A using leg loops
35
what is the expected outcome for bed mobility for SCI C6?
Min-mod I with leg loops
36
what is the exceptional outcome for bed mobility for SCI C6?
Independent with no adaptive equipment
37
what is the expected outcome for bed mobility for SCI C7?
Mod I for all bed mobility
38
what is the expected outcome for bed mobility for SCI C8?
Mod I for all bed mobility
39
what is the expected outcome for transfers for SCI C1-4?
Dependent, usually require mechanical lift
40
what is the expected outcome for transfers for SCI C5?
Max-dependent with slide board
41
what is the exceptional outcome for transfers for SCI C5?
Min-mod A with slide board on even surfaces
42
what is the expected outcome for transfers for SCI C6?
Min-mod I with slide board
43
what is the exceptional outcome for transfers for SCI C6?
Independent on even surfaces w/o slide board
44
what is the expected outcome for transfers for SCI C7?
Independent on even surfaces no slide board
45
what is the exceptional outcome for transfers for SCI C7?
Independent on all uneven surfaces with no slide board
46
what is the expected outcome for transfers for SCI C8?
Independent with all even and uneven surfaces
47
for WC propulsion, what is the ideal technique?
using a semi-circular technique
48
t/f: when propelling a WC, you should use long, smooth strokes with a large contact angle
true
49
what shoulder motions should be avoided with WC propulsion?
shoulder IR and abduction with fw flexion
50
why does WC use increase chance of injury and pain in the shoulder?
WC propulsion is a highly repetitive, BL WBing activity that places high demand on the upper limbs
51
what are the ideal stroke patterns for WC propulsion?
Semicircular (goal) Arc Single loop over Double loop over
52
how do we perform a wheelie?
start with your hands at the 10 o’clock position on the wheel push the rear wheel fwd quickly by moving your hands to the 2 o'clock position this quick movt will lift the caster wheels of the ground
53
how is a wheelie maintained?
maintain the center of mass utilize fw/bwd trunk lean to remain over COG
54
how can a pt ascend a curb in a WC?
approach the curb with high speed prior to reaching curb, pop into wheelie to get front casters on curb lean trunk fwd, place hands on back of handrims and push fwd to get drive wheels up onto the curb
55
how can a pt descend the crub in a WC?
prior to reaching the curb, pop up into a wheelie while maintaining the wheelie and let the handrims slowly glide through your hands to control the descent
56
what are the types of pressure relief?
dependent fwd lateral push up
57
when is dependent pressure relief usually performed?
in a power WC or tilt in space
58
when doing dependent pressure relief, the WC should be tilted back how many deg for how long?
about 45 deg for 2 min
59
how is fwd pressure relief performed?
max fwd lean with elbows on their knees, or hands to ankles, to fully off weight the sacrum, and ischial tuberosities to return to sit, it may require that a pt walk their hands back up their legs, or hook on the handle of the chair to pull up with their biceps
60
when is lateral pressure relief used?
for pts with limited spinal mobility or ROM restrictions
61
how is lateral pressure relief performed?
lateral lean over the WC to relieve pressure on the opposite ischium can use surface beyond armrest to further the weight shift to return, the pt can hook onto the opposite arm rest or push handle
62
how long should lateral pressure relief be performed?
2 min each side
63
what ms must have adequate strength to perform push-up pressure relief?
triceps
64
how is the push-up pressure relief performed?
hands are placed lateral to the buttocks on seat, armrest, or rims elbow extension and should depression until the buttocks is cleared, and held
65
how often should we be telling our pts to perform pressure relief techniques?
2 hrs
66
every ms of the trunk is both a ____ ms and a ______ ms
respiratory, postural
67
what abdominal ms is very important in the soda pop model for postural control?
the diaphragm
68
when faced with conflict, will the diaphragm always choose respiration or posture?
respiration
69
t/f: when their is an increased need for respiratory fxn, posture will decrease
true
70
postural control is required for what things?
strengthening of residual abdominals coordination of respiratory and postural control need for fxn facilitation of anticipatory and reactive postural control responses maximization of fxn in short and long sitting for dressing, mobility, and transfers
71
what will we often see w/o UE control in SCI?
unstable shaking of the trunk/head
72
what would lead you to want to work on postural control in a pt with SCI?
results from the FIST show imbalance in sitting
73
why is sitting balance important in SCI?
ms responsible for postural control are impaired in SCI sitting balance correlates to independence (esp transfers)
74
what is the progression of sitting balance?
Static sitting on firm surface--> static sitting on unstable surface--> dynamic balance on firm surface-->dynamic balance on unstable surface

DPT 621 (16 decks)

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