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BPT14 - Neuro Rehab > SCI Review > Flashcards

SCI Review Flashcards

1
Q

What is SCI?

A

SCI stands for Spinal Cord Injury, which is a catastrophic condition that may cause drastic changes in a person’s life.

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2
Q

What are the risks associated with SCI?

A

Loss of independence and risk of developing secondary conditions.

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3
Q

What is required for successful rehabilitation and readaptation after SCI?

A

A team of healthcare professionals working in collaboration is necessary to regain independence and prevent complications.

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4
Q

What is the most common cause of SCI?

A

Trauma, such as car accidents or firearms.

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5
Q

What is the ASIA Scale used for?

A

The ASIA Scale is used to classify the severity of SCI based on motor and sensory function

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6
Q

What are the different categories in the ASIA Scale

A

A: No motor or sensory function preserved
B: Minor sensory deficit, but no motor function preserved below nli ,including lowest segments.
C: Sensory deficit. Motor function present below the injury, but strengths of more than half of the key muscles are graded < 3 on 5
D: Sensory deficit. Motor function present below the injury, but strengths of more than half of the key muscles are graded ≥ 3 on 5
E: Motor and sensory functions in key mucles & dermatomes are present

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7
Q

ASIA A

A

A: No motor or sensory function preserved.

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8
Q

ASIA B

A

B: Minor sensory deficit (incomplete), no motor function preserved below nli(complete), including the lowest segments

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9
Q

ASIA C

A

C: Sensory deficit, Motor function present below the injury, but strengths of more than half of the key muscles are graded < 3 on 5

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10
Q

ASIA D

A

D: Sensory deficit. Motor function present below the injury, but strengths of more than half of the key muscles are graded ≥ 3 on 5.

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11
Q

What are the different types of SCI?

A

Contusion, Laceration, and Solid (Myelopathy).

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12
Q

What is a Laceration?

A

Type of SCI (25%)
= Severing or tearing, usually from fire weapons & knife

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13
Q

What is a contusion?

A

Type of SCI ( 25-40%)
= bruising, usually from trauma (=> compression of SC)

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14
Q

What is a Solid injury?

A

Type of SCI (17%) also called Myelopathy
= axonal damage, through injury or demyelination

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15
Q

What is the etiology of SCI?

A

SCI is caused by a complete or incomplete lesion leading to paraplegia or tetraplegia. The manifestation, symptoms, and impairments vary according to the etiology of the lesion. About 20% of cases are related to infectious disease, tumors, or degenerative disease.Other common cause : trauma

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16
Q

What is tetraplegia?

A

Impairment or loss of motor and/or sensory functions due to damage to the cervical segments, affecting upper, lower extremities, and trunk. Also known as quadriplegia.

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17
Q

What is paraplegia?

A

Impairment or loss of motor and/or sensory function due to damage to the thoracic, lumbar, or sacral segments, affecting lower extremities and/or trunk. Can also refer to cauda equina and conus medullaris syndrome.

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18
Q

What is the difference between tetraplegia and paraplegia?

A

Tetraplegia affects upper, lower extremities, and trunk due to damage to cervical segments, while paraplegia affects lower extremities and/or trunk due to damage to thoracic, lumbar, or sacral segments.

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19
Q

What is the level of motor functions in C1-C4 complete injury (tetraplegia)?

A
  • Paralysis of arms and hands, legs, and trunk ❌
  • Face ✅
  • Cervival head flexion , rotation & side bending ✅
  • Shoulder elevation (shrugging) ✅
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20
Q

What are the activity limitations/capacities in C1-C4 injury (Tetraplegia)?

A

Without support/assistance, can’t :
- Breath ❌
- Speech ❌
- Cough ❌
- Swallowing ❌
- No bladder/bowel control ❌
=> Complete dependence for ADLs & 24/7 supervision/care

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21
Q

What are the mobility/locomotion capacities for C1-C4 tetraplegia?

A

-Transfer dependency.
- Powered or electrical wheelchair (with special control) or manual wheelchair pushed.

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22
Q

What is the level of motor functions in C5 injury (tetraplegia)?

A
  • C1 to C4 functions ✅
  • Shoulder ABD (=raise arm) & Ext rotation ✅
  • Diaphragm ✅
  • ELbow flexion ✅
  • Forearm supination ✅
  • Still paralysis of arms(part of it) and hands, legs, and trunk ❌
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23
Q

What are the activity limitations/capacities in C5 tetraplegia?

A
  • Breathing is of low performance (fatigue) ❌
  • Impaired cough ❌
  • Bowel/bladder control ❌-> dependence
  • Sitting balance ❌ (low to none)
  • Normal speech ✅
  • Minimal assistance for ADLs
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24
Q

What are the mobility capacities for C5 paraplegia ?

A
  • Dependence on transfers (patient might help).
  • Electrical wheelchair w/ hand grip adapted
  • may use adapted manual WC
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25
Q

What is the level of motor functions in C6 injury?

A
  • Still paralysis of hands, legs, and trunk ❌
  • Shoulder function ✅
  • Wrist extension (tenodesis grip) ✅
  • forearm pronation ✅
  • elbow flexion ✅
26
Q

What are the activity limitations/capacities in C6 injury (tetraplegia)?

A
  • Low breathing performance => fatigue
  • Weak cough
  • Bowel/bladder care w/ special equipment
  • Tenodesis grip
  • Low sitting balance
  • Independent -> Min. to max. assisstance for ADLs depending on patient
27
Q

What are the mobility capacities for C6 injury (tetraplegia)?

A
  • Move in & out of WC
  • Transfers/bed mobility independance w/ minimal assistance
  • Powered WC w/ hand control
  • Manual adapted WC
  • Drive adapted car
28
Q

What is the level of motor functions in C7 injury? (tetraplegia)

A
  • normal mvt of shoulder ✅(from before)
  • Wrist extension ✅(from before)
  • elbow extension ✅
  • finger flexion/extension ✅
  • start of wrist flexion ✅
29
Q

What are the activity limitations/capacities in C7 injury? (tetraplegia)

A
  • Bowel/Bladder care w/ special equipment
  • Most activities independance or with assistance (ADL)
  • weak cough
  • Low breathing performance -> fatigue
  • low sitting balance
30
Q

What are the mobility capacities in C7 injury? (tetraplegia)

A
  • drive adapted cars
  • manual wheelchair for short distance
  • electric wheelchair for long distance
  • Independent for transfers, except floor -> chair
31
Q

What is the level of motor functions in C8 injury? (tetraplegia)

A
  • all wrist mvt ✅(wrist flexion complete)
  • Finger flexion ✅
  • Finger ABD/ADD ❌
32
Q

What are the activity limitations/capacities in C8 injury? (tetraplegia)

A
  • All activities of daily living (ADL) are independent.
  • sitting balance is +/-
33
Q

What are the mobility capacities for C8 injury? (tetraplegia)

A
  • Independent in transfers
  • Drive adapted car
  • Manual wheelchair
  • Can stand in frame
34
Q

What is the level of motor functions in T1-T4 injury? (thoracic paraplegia)

A
  • UL ✅
  • Accessory resp. muscle ✅
  • Top half of intercostals + long back muscles ✅
35
Q

What are the activity limitations/capacities in T1-T4 injury? (thoracic paraplegia)

A
  • Sitting balance incr. ✅
  • Incr. resp. capacity ✅
  • ADLs full independance ✅
  • Cough still difficult ❌
36
Q

What are the mobility capacities for T1-T4 injury? (thoracic paraplegia)

A
  • Independent in transfers
  • Drive adapted car
  • Manual wheelchair
  • Can stand in frame (// bars), use of KAF orthoses
37
Q

What are KAF orthoses? function?

A
  • Knee-ankle-foot orthoses
  • To control instabilities in the lower limb by maintaining alignment and controlling motion.
38
Q

What is the level of motor functions for a patient with mid thoracic paraplegia (T5-T9)?

A
  • Latissimus dorsi ✅ -> (usefull for transfers)
  • intercostals ✅
  • upper part of abdominals ✅(-> usefull for sitting balance)
39
Q

What is the activity limitation/capacity for a patient with mid thoracic paraplegia (T5-T9)?

A
  • sitting balance ✅ (due to upper abd)
  • coughing/breathing ✅
  • standing balance +/- ; still impaired ❌
40
Q

What are the mobility capacities for mid thoracis paraplegic patient (T5-T9) ?

A
  • Independent in transfers
  • Drive adapted car
  • Manual wheelchair
  • Can stand in frame (// bars), walking frame, w/ use of KAF orthoses
  • can take a few steps possible
41
Q

What are the motor functions possible for a T10-T12 injury (paraplegia)?

A
  • all Abd control ✅
  • Quadratus lumborus ✅ (->lifting hip)
  • erector spinae ✅
42
Q

What are the activity limitations/capacities for T10-T12

A
  • Sitting balance incr. ✅
  • Standing balance incr. ✅
  • Bowel/Bladder care w/ special equipment
43
Q

What is the level of mobility for T10-T12 paraplegic patient?

A
  • Can stand ✅
  • Walk from 1m to 10m in // bars or walking frame ✅
44
Q

What are the motor functions for a patient with spinal cord injury at the level of L1-L5?

A
  • all trunk muscles ✅
  • Hip flexion ✅
  • knee extension ✅
  • some knee flexion
  • some dorsiflexion
  • some eversion
45
Q

What are the activity limitation/capacities for L1-L5 paraplegic patient?

A
  • Incr. standing Balance ✅
  • Bowel/Bladder care w/ special equipment
46
Q

What are the mobility capacities for L1-L5 paraplegia?

A
  • Can walk with AFO (ankle foot orthosis)
  • Can walk w/ walking aids
  • Manual WC drive adapted car
47
Q

What are the possible/or not motor function for S1-S5 paraplegia?

A
  • Dorsiflexion ✅
  • Plantarflexion ✅
  • Knee flexion ✅
  • Hip extension✅
  • Eversion/inversion ✅
  • Weak LL
48
Q

What are the activity limitation/capacities in S1-S5 paraplegia?

A
  • Balance ✅
  • Possible bladder & bowel function ✅
  • Return to sport possible ✅
49
Q

What is the mobility/locomotion for S1-S5 paraplegic patient?

A
  • Walk ✅ (may be with aids)
  • Normal car ✅
50
Q

What is the clinical presentation of central cord syndrome?

A

Motor weakness and sensory loss in the upper limbs.

51
Q

What is the aetiology of CCS?

A

Damage to the central portion os the spinal cord.

52
Q

What is the aetiology of BSS?

A

Damage to one side of the spinal cord.

53
Q

What is the clinical presentation of Brown Sequard Syndrome?

A
  • Ipsilateral motor weakness and loss of proprioception and vibration
  • Contralateral loss of pain and temperature sensation.
54
Q

What is the aetiology of CES?

A

Compression or trauma to the cauda equina.

55
Q

What is the clinical presentation of Cauda equina syndrome?

A

Bilateral leg pain, weakness, and numbness, and saddle anesthesia.

56
Q

What are the red flags or special considerations for positioning in patients with spinal cord injury?

A

-⚠️ Lack of variation can lead to musculoskeletal, dermatologic, or respiratory complications.
- ⚠️ The patient should be in a position that permits environmental interaction.

57
Q

What are the red flags or special considerations for transfers and mobility in patients with spinal cord injury?

A

⚠️ Stabilization with correct key point of control is important to prevent loss of balance.
⚠️ Postural control with appropriate use of KPC is important to prevent loss of postural control.
⚠️ Incorrect management of head control in patients with poor or no head control can lead to complications.
⚠️ Insufficient management and care of hospital equipment for treatment or monitoring,
⚠️ Negligence of safety considerations on the use of assistive equipment can also lead to complications.
🚩In case of spinal fracture in acute, avoid rotation and torsion.

58
Q

What are the red flags or special consideration in therapy associated with therapy?

A
  • 🚩Fractures and dislocations due to loss of muscle tone and sensitivity, most common during stretching.
  • 🚩Injuries to the upper limbs can be very impairing, bcause UL are used to move around. Careful not to overuse
59
Q

What are the red flags or special considerations for behavior & awareness deficit?

A
  • 🚩Dépression
  • 🚩 Agression
  • 🚩 Anxiety
  • 🚩 Impaired cognitive function due to CSF reduction, leading to loss of consciousness (acute only)
  • ⚠️ Side effect of medications, often the ones used for neurological pain & spasticity management
  • ⚠️ Knowledge deficit about condition & prognosis
60
Q

Other red flags or specials considerations?

A
  • 🚩Respiratory (can lead to infection)
  • 🚩 Deep vein thrombosis (due to reduced use of limbs)
  • 🚩 Deep tissue damage & pressure injuries (due to cicatrisation)
  • ⚠️ Contractures (due to immobilizations)

BPT14 - Neuro Rehab (14 decks)

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