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726: Phys Dys > spinal cord injuries > Flashcards

spinal cord injuries Flashcards

1
Q

SCI causes trauma

A
  • MVA
  • falls
  • diving
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2
Q

SCI non-traumatic

A
  • cancer
  • infection
  • arthritis
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3
Q

tetraplegia

A

4 limbs
inability to voluntarily move the upper and lower parts of the body.
complete and incomplete

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4
Q

paraplegia

A

complete and incomplete

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5
Q

zone of partial

A

preservation

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6
Q

paraparesis and tertraparesis

A

previously described incomplete injuries- no longer used

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7
Q

neurological level diagnosed according to

A

motor and sensory level

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8
Q

functional level refers to

A

lowest segment at which strength of key muscles is graded 3+ out of 5 or greater and sensation is intact

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9
Q

C1 & C2

A

neck flex/ext

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10
Q

C3

A

neck lateral flx

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11
Q

C4

A

scapula elevation

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12
Q

C5

A

shoulder abd and elbow flx

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13
Q

C6

A

elbow flx and wrist ext

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14
Q

C7

A

elbow ext and wrist flx

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15
Q

C8

A

thumb ext

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16
Q

T1

A

finger abd

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17
Q

classification A (most severe)

A
  • complete lesion, no motor or sensory function preserved in sacral segments S4-S5
  • if a client does not have any motor or sensory function in anal and perianal area, as represented by S4-S5, then they would be classified as a complete lesion
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18
Q

classification B

A

incomplete lesion, sensory but not motor function preserved below neurological level and includes sacral segments S4-S5

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19
Q

classification C

A

incomplete lesion, motor function is preserved below neurological level and more than half of key muscles below neurological level have muscle grade less than 3

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20
Q

classification D

A

incomplete lesion, motor function preserved below neurological level and at least half of key muscles below neurological level have muscle grade of 3 or more

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21
Q

classification E

A

motor and sensory functions are normal

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22
Q

syndromes not part of international standards examination or ASIA classification

A

all are incomplete injuries

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23
Q

central cord syndrome

A

damge to center of spinal cord

24
Q

brown-sequard syndrome (most common)

A

damage to one side of cord

25
Q

anterior cord syndrome

A

rare due to absent blood supply to anterior cord

26
Q

cauda equina syndrome

A

lower motor neuron (LMN) injury to 2 or more of lumbosacral nerve roots within spinal canal

27
Q

conus medullaris syndrome

A

like cauda equina, but with some cord involvment

28
Q

SCI prognosis affect by

A
  • level and severity of SCI
  • age
  • availability & timing of services
  • living environment
29
Q

SCI respiratory complications (pneumonia)

A

leading cause of death in 1st year of life after SCI

30
Q

lesions above C4, damage to phrenic nerve (breathing nerve)

A
  • partial or complete paralysis of diaphragm

- require ventilatory support, tracheostomy

31
Q

lower cervical and thoracic spine injuries can result in paralysis of other breathing muscles

A

difficulty coughing and deep breathe

32
Q

Autonomic Dysreflexia

A

AD

33
Q

hyperactive reflex of ANS below area of injury causess

A
  • distended bladder
  • bladder irritation (overfull catheter bag)
  • fecal mass
  • pain stimuli
  • menstruation
34
Q

hyperactive reflex of ANS below area of injury above

A

T4-T6 levels

35
Q

hyperactive reflex of ANS below area of injury medical emergency and

A

can be life threatening

36
Q

autonomic dysreflexia (AD) symptoms

A
  • muscle spasiticy
  • flushed face
  • pounding headache
  • sweating
  • erection of body hair (goose bumps)
  • nasal congestion
  • bradycardia
  • emergency
37
Q

autonomic dysreflexia treatment (tx)

A
  • place individual in upright position or raise head to 90 deg
  • lower legs if able
  • loosen constictive clothing
  • bladder should be drained
  • monitor blood pressure every 5 minutes (>T6 normal systolic 90-110 mmHg range)
38
Q

orthostatic hypotension, pooling of blood in

A

LE’s and abdomen due to decreased muscle tone

39
Q

orthostatic hypotension

A
  • results in decreased BP (hyptension)
  • supine to upright position or positional changes quickly
  • symptoms dizziness, nausea and loss of consciousness
  • recline quickly or tip back and elevate feet
  • compression garments/ stockings, abdominal binders and medications also help reduce symptoms
40
Q

other complications after SCI

A
  • neurogenic bladder and bowel
  • decubitus ulcers
  • decreased vital capacity
  • spasticiy
  • heterotopic ossification
41
Q

additional secondary issues SCI

A
  • temperature regulation
  • pain
  • fatigue and sleep issues
  • changes in muscle tone
  • thromboembolism (DVT)
  • pyschosocial issues
  • sexual function
42
Q

sexual function SCI males

A
  • affects erections and ejaculation
  • psychogenic erection is unlikely
  • reflexogenic erection may be possible with manual stimulation
  • decrease sperm count
43
Q

sexual function SCI females

A
  • menstruation can come for weeks to months
  • fertility not affected
  • pregnancy discomfort may cause AD
44
Q

initial OT evaluation

A
  • occupational profile
  • evaluation of performance skills
  • evaluation of performance in areas of occupation
45
Q

occupational profiles

A

COPM, OPHI-II

46
Q

performance areas & skills

A
  • functional independence measure (FIM)
  • spinal cord independence measure (SCIM)
  • The Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP)
  • Jebsen Test of Hand Function
  • sollerman hand function test
47
Q

Client factors

A
  • MMT
  • ROM
  • Muscle tone
  • pinch
  • grip
  • sensation
48
Q

general objectives for OT tx

A
  • maintain/ increase ROM
  • increase strength
  • increase activity tolerance
  • maximize ind with self care and ADL’s
  • explore leisure interests
  • aid with psychosocial adjustments
  • AE/DME training
  • potential home modifications
  • increase/ maintain communication skills
  • pt/ family/ caregiver training
  • prevent skin breakdown
49
Q

tx methods acute phase/ immobilized phase

A
  • traction or stabilization devices
  • AVOID flexion, extension and rotation of spine and neck
  • splinting (tenodesis)
50
Q

tx methods tenodesis splint

A
  • splint positions thumb under index and middle finger
  • wrist extension splint transfers force into thumb
  • help client grasp items
51
Q

tx methods active phase

A
  • mobilization phase
  • sitting in wheelchair
  • instruction on pressure relieving techniques
52
Q

tx methods universal cuff for

A

feeding, brushing teeth, painting, etc

53
Q

tx methods mobile arm supports

A

-alllow intact shoulder girdle muscles to move hands

54
Q

adaptive equipment

A
  • universal cuff
  • reacher
  • transfer bench
  • plate guard
55
Q

tx methods ADLs

A
  • bed ladders
  • self-catherization
  • environmental control units should be considered
  • adapted driving
56
Q

OT intervention outpatient

A
  • adaptive driving
  • home management
  • leisure activities
  • vocational and work skills
  • other IADLs

726: Phys Dys (7 decks)

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