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Kcep 210 final > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

What is a SCI?

A

Quadraplegia and Paraplegia acquired through some kind of trauma

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2
Q

Causes and % (5)

A
  • 48% Motor vehicles
  • 21% Falls
  • 14% Violence
  • 14% Sport injuries
  • 3% other
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3
Q

Number 1 cause of SCI

A

Diving (pool, lake)

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4
Q

Incidence - new cases and number of Canadians

A
  • 1100 new cases per year

- 44 000 Canadians live with SCI

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5
Q

Incidence - annual health care cost

A

3.6 billion

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6
Q

Incidence - lifetime health care cost/ person

A

between 1.6 and 3 million depending on the severity and the age.

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7
Q

Incidence - gender, age and why

A
  • 80% male
  • between 16 and 30 years
  • takes more risks
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8
Q

Lesions - types and %

A
  • Complete (50%)

- Incomplete (50%)

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9
Q

Lesions - most common type in the past

A
  • more complete lesions vs incomplete
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10
Q

Lesions - why decrease in complete lessions (3)

A
  • Meds
  • Car safety belt + airbag
  • Paramedics (spinal immobilization)
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11
Q

Organization of the nervous system - sensory information

A

somatosensory system (cutaneous & proprioceptive info) -> Ascending pathways (dorsal tracts)

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12
Q

Organization of the nervous system - motor commands

A

motor commands -> descending pathways (ventral tracts)

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13
Q

Severity of condition - depends on

A
  • Level of lesion

- Whether it is complete or incomplete

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14
Q

Severity of condition - Quadriplegia

A
  • also known as Tetraplegia
  • involve all 4 limbs and trunk
  • Cause : cervical segment
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15
Q

Quadriplegia - most common vertebrae and why

A

C5-C6 because of car accident

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16
Q

Quadriplegia - Vertebrae important for wheelchair users

A

C7 because it innervates the tricep = elbow extension

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17
Q

Severity of condition - Paraplegia

A
  • involve lower limbs and trunk (if higher than lumbar)

- Cause damage to thoracic or lumbar spine

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18
Q

Paraplegia - complete lesions (3 types)

A
  • T1 to T6 = no sitting balance
  • T7 to L1 = some useful sitting
  • L2 and lower = normal trunk control
  • important for wheelchair sports
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19
Q

Health concerns in SCI (6)

A
  • Sensation loss
  • Contractures and injury prevention (Spasticity)
  • Lower limb atrophy
  • Osteoporosis
  • Weight management
  • ANS dysfunction
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20
Q

Sensation loss - complete lesion

A

total loss below lesion

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21
Q

Sensation loss - incomplete lesion

A
  • partial loss below lesion
  • Lose some sensations
  • Vulnerable to injury
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22
Q

Contractures - spasticity

A
  • Shortening and tightening of muscles
  • Flexor in upper limbs
  • Extensor in lower limbs
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23
Q

Injury prevention - spasticity

A

Stretching 2x / day (full ROM)

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24
Q

Lower limb atrophy, osteoporosis and weight management - why common (not in exam)

A
  • decreased in muscles contraction (paralysis)
  • decreased in mechanical loading
  • decreased in energy expenditure
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25
Q

Weight management

A

more prone to hypokinetic diseases

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26
Q

What does ANS stands for?

A

Autonomic Nervous System

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27
Q

ANS - regulation

A
  • Regulates involuntary function
28
Q

ANS - sympathetic system during exercise

A
  • Increase heart rate
  • Increase blood pressure
  • Constrict blood vessels
29
Q

ANS - origin of cardiac sympathetic fibers

A

T1-T4 (partly T5)

30
Q

ANS dysfunction- sympathetic system during exercise

A
  • Decrease heart rate
  • Decrease blood pressure
  • Impairment of vasoconstrictor function = decrease blood to heart = decrease oxygen = early fatigue
  • Sweating impairments
31
Q

ANS dysfunction- In which condition can it be present

A
  • Quadriplegics

- High paraplegics (T5 and above)

32
Q

ANS signal origine

A

Brainstem

33
Q

High intensity training in SCI, causes and symptoms

A
  • May not be tolerated for quadriplegics and high paraplegics because of hypotensions
  • Cause: sympathetic nervous system (ANS dysfunction)
  • Symptoms : dizziness or nausea
34
Q

Recommendations for Exercise programming (3)

A
  • Decreased cardiovascular capacity
  • Decreased endurance
  • Decreased active muscle mass during exercise
35
Q

Decreased % cardiovascular capacity and endurance - paraplegics

A
  • decreased 50 %
36
Q

Decreased % cardiovascular capacity and endurance - quadriplegics

A
  • decreased 75%
37
Q

Recommendations for Exercise programming - decreased muscle mass

A
  • Lower limb muscle = 2/3 of muscle mass

- Quadriplegics = greater loss of cardiovascular capacity = greater loss than paraplegics

38
Q

Recommendations for Exercise programming - When ANS dysfunction is present

A
  • Decreased drive from sympathetic nervous system

- Max heart rate 110-120 beats/min

39
Q

Cardiovascular training may include (3)

A
  • Arm Ergometer
  • Locomotor training with crutches or body weight support
  • Wheelchair propulsion using rollers
40
Q

Cardiovascular training - Arm Ergometer

A
  • Suitable for use at home or center
  • Workload can be adjust
  • Grips cuffs used for quadriplegics
41
Q

Cardiovascular training - Locomotor training with crutches or body weight support

A
  • Increase muscle strength and bone mineral density

- Prevent pressure sore by increasing blood circulation

42
Q

Cardiovascular training - Wheelchair propulsion using rollers

A

rollers are to wheelchair what treadmills are to ambulatory runners

43
Q

Prevention upper extremity overuse syndromes

A
  • Vary exercises from week to week
  • Strengthen muscles of upper back and posterior shoulder
  • Stretch muscles of ant. should and chest
44
Q

Prevention contractures and injury

A
  • Stretching exercises for both extremities
45
Q

Seated flexibility exercises (4)

A
  • Chest Stretch
  • Shoulder Retraction
  • Triceps Stretch
  • Seated Chest Stretch in doorway
46
Q

Why most spinal cord injured persons prefer wheelchair over crutches and braces ?

A

To save energy especially for long distance

47
Q

Sports wheelchair common characteristics

A
  • No push handle
  • Not foldable = more solid
  • Wheel camber
  • Anti-tipping support
48
Q

Which characteristics is common in all wheelchair except racing wheelchair?

A

Anti-tipping

49
Q

Characteristics - basketball wheelchair (5)

A
  • Fixed camber bars
  • Anti-tipping support
  • Quick release wheels
  • Rollerblade casters
  • Adjustable back and footplate height
50
Q

Characteristics - rugby wheelchair (5)

A
  • Fixed camber bars
  • Anti-tipping support
  • Cross spoked wheels + quick release
  • Rollerblade casters
  • Adjustable back and footplate height
51
Q

Racing Wheelchair - camber angle

A

11 to 15 degree

52
Q

Racing Wheelchair - cage

A

Build according to body dimensions

53
Q

Racing Wheelchair - frame

A

Made of aluminum

54
Q

Racing Wheelchair - Steering

A

Maneuver the front wheel during sharp turns

55
Q

Racing Wheelchair - Tires

A

Preferably tubular tires

56
Q

Racing Wheelchair - Hand ring

A

Used for propulsion (push from 12 to 9)

57
Q

Racing Wheelchair - Fenders

A

Protection for torso and arms

58
Q

Wheelchair propulsion - 2 types

A
  • Short propulsion thrust

- Long-duration circular-propulsion thrust

59
Q

Wheelchair propulsion - short propulsion

A
  • ADL, most sport except racing
  • Pushes forward and downward (noon to 3 o’clock) and trunk moves forward
  • Handrims release at 3 o’clock and trunk return upright
60
Q

Wheelchair propulsion - Long-duration circular-propulsion

A
  • track and marathon racing
  • Contact with handrims through 3/4 of the circle, applying force the entire time
  • Trunk in flexion
  • Final propulsion thrust is the shoulder extension
61
Q

Wheelchair basketball - characteristics (7)

A
  • 5 players / team
  • Net 10 feet
  • 3 sec in the key
  • Dribble, shoot or pass after 2 pushes
  • No double dribble rule
  • Can’t raise butt off chair
  • Open to able-bodied (no major comp)
62
Q

Wheelchair basketball - classification for International Wheelchair Basketball Federation

A
  • Have a permanent physical disability in lower limbs (can’t run, jump and pivot)
  • Classification based on observed trunk mvt and stability during basketball competitions (not based on medical diagnosis )
63
Q

Second most common condition after SCI in wheelchair basketball?

A

Amputation

64
Q

Adapted Tennis - characteristics (6)

A
  • Individuals or pairs
  • **Ball may bounce once or twice **
  • Scoring is the same
  • Played by people w/ paraplegia and quadriplegia
  • Created in 1976 (USA)
  • More than 6000 players
65
Q

Adapted Rugby - characteristics (7)

A
  • Score points by carrying the ball over opponents’ goal line
  • Very fast, contact team sport
  • Play w/ volleyball for easier manipulation
  • Played w/ hands or forearms
  • Must dribble or pass at least every 10 sec
  • Goal score when goal line touch with 2 wheels
  • Violation includes charging, interference, etc

Kcep 210 final (8 decks)

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