Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UM - Neuro 2 > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

What is central cord syndrome?

A

Weakness in UE > LE + sacral sparing present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Brown-Sequard syndrome?

A

Motor and proprioceptive deficits are more severe IPSI and pinprick/temperature sensation more severe CL to the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is anterior cord syndrome?

A

Proprioception is preserved; there is variable loss of motor function and sensitivity to pinprick and temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is conus medullaris syndrome?

A

Flaccid paralysis of LE and areflexive bowel/bladder. Some cases sacral reflexes are retained
(UMN and LMN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is cauda equina syndrome?

A

Flaccid paralysis of the LE, areflexive bladder and bowel
(more LMN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List some cardiopulm impairments someone with an SCI may have

A
  • OH
  • AD (>T6)
  • DVT
  • impaired cough/breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the cababilities of UE Instrument measure?

A

UE functional limitations in individuals with tetraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the Spinal Cord Independence Measure (SCIM III) Measure?

A

Impact of SCI on self-care, respiration and mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the wheelchair skills test?

A

A comprehensive generic instrument to measure both safety and performance of an individuals WC skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the SCI Functional Ambulation Inventory?

A

A measure of functional walking ability in those able to ambulate that includes observation of 3 domains of walking function (gait parameters, AD, Temporal distance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the walking index for SCI II

A

Assess the amount of PA needed + devices required for those post SCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Craig Hospital Inventory of Environmental Factors (CHIEF)

A

A tool that assess the degree to which elements of the physical, social, and political environments act as barriers w/the frequency and magnitude of each barrier defined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the Craig Handicap Reporting and Assessment Technique (CHART)

A

Measures 6 domains of social participation in those with an SCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the movement system diagnoses of SCI?

A
  • Force Production Deficit
  • Fractionated Movement Deficit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are positive prognostic factors for SCI?

A
  • spared voluntary motor function below the lesion
  • Spared sensation below the lesion
  • Central Cord or Brown Sequard (vs anterior cord)
  • younger age at time of injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T or F: Incomplete Tetraplegia has better outcomes for ambulation than Incomplete Paraplegia

A

False- it is the opposite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the general goals of acute care?

A
  • prevention of secondary complications
  • preparing patient for full rehabilitation participation
  • initiate discharge planning and family training
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the treatment ideas for acute care?

A

Out of bed, increase tolerance to upright sitting, ROM, early strength training, skin management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the treatment ideas for IPR?

A

ADLs, transfers, mobility, community outings, family training, preparing for transition back home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the treatment ideas for OP?

A

Advanced transfer training, adv w/c training, locomotor training, upgraded ADL training, and upgraded HEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the general goals for IPR?

A

Maximize independence in ADLs, transfers, and mobility
Prep for DC back home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the general goals for OPR?

A

Maximize independence, support community reintegration and participation in life activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which comes first:
- prevention of secondary complications
- functional training

A

prevention of secondary complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the four main areas to target for SCI intervention?

A
  1. Pt/family education and training
  2. Functional and gait training
  3. Therapeutic Exercise
  4. Equipment recommendation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are important education topics to teach?

A
  • pressure relief
  • bowel/bladder program
  • healing time
  • exercise
  • S/S of AD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the WC pressure relief program?

A

For T1 and lower, its every 15 mins for 15 seconds, and all else is every 30 mins for 30 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How do you instruct an anterior weight shift pressure relief?

A

WC locked w/castors forward
Gaurd pt in the front
pt rests elbows on thighs to relieve pressure on sacrum
Pt continues to slide down to anterior tibias
Return upright with triceps or wrist extensors and momentum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do you instruct lateral weight shift pressure relief

A

WC locked and castors forward, patient pushes rim or chair handle for stability to lean to opp side of WC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do you instruct push-up weight shift?

A

WC locked and casters forward
Elbow ext and shoulder depression to lift buttocks
Start w/Hips slightly anterior in WC to avoid shearing the sacrum against the back of the chair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do you instruct a tilt back WS?

A

Its a dependent method where the WC is locked, caregiver sits in sturdy chair behind Pt, and leans patient back and then slowly returns them upright after the desired amount of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Without triceps, how do you get a patient to be able to sit and maintain elbow extension?

A

> than normal shoulder extension, ER and full elbow extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which is essential for locking out the elbows?
a. forearm supination
b. forearm pronation
c. wrist flexion
d. wrist extension

A

a and d: forearm supination and wrist extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When would you want a tenodesis grip?

A

At C7 or higher quadriplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How do you do ROM without losing a tenodesis grip?

A

Finger extension ROM in neutral or fully flexed wrist, full finger flexion with wrist fully extended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

T or F: You need loose back extensors to help with transfers

A

False - mild tightness is required so that head and shoulder motions can be transmitted to the lower body during transfers and other functional activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How much DF is needed for ambulatory patients?

A

Full DF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the goal of postural drainiage?

A

Use passive positioning to use gravity to mobilize secretions in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does L side lying do for postural drainiage?

A

It increases perfusion on the LEFT and ventilation on the RIGHT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When would you use glossopharyngeal breathing?

A

Pts C1-3 to use accessory mm of ventilation to improve VC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the four stages of a cough?

A

I: Inspiration
II: Hold (for gas distribution)
III: Compression (glottis closes and increases intrathoracic pressure)
IV: Expulsion (glottis opens and pushes air out)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

To improve breathing, you should do cervical thoracic ___ with exhalation and ___ with inhalation

A

flexion with exhalation and extension with inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How do you do the Heimlich-assisted cough?

A

Manual contact placed over the epigastric area w/a quick in and upward force as the pt attempts to cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How do you do the costophrenic assist cough?

A

Manual contacts on lateral aspects of lower ribs to then move down and in towards the navel

44
Q

What is a short-sit self-assist cough?

A

Pt takes deep breath during extension of upper body as balance allows followed by cough w/flexion forward at the trunk with Heimlich contact on self

45
Q

What is a long-sit self-assist cough?

A

Pt in long sit and takes deep breath in w/cues to extend trunk and retract scapula, on cough, pt throws trunk and arms forward to enhance forced exhalation

46
Q

What are the 3 basic concepts of functional mobility in those w/SCI?

A

Muscle substitution
Head-hips relationship
angular momentum

47
Q

What motions do you want to train with SCI?

A

elbow extension, shoulder flexion and horizontal adduction, scapular protraction and depression

48
Q

What should therapists do for gait training w/SCI?

A

Walk at high aerobic intensities (up to 85% HR max or RPE of 17-18) and use VR

49
Q

What may therapists do for gait training w/SCI?

A

Strengthening at 70% of 1RM
Circuit training, cycling at 85%, and balance w/VR

50
Q

What should therapists not do for gait training wSCI?

A

Static/dynamic balance
BWSTT w/emphasis on kinematics
Robot assisted walking training

51
Q

What is the starting level aerobic and strength activity recommendations for SCI

A

20 minutes 2x a week at moderate to vigorous intensity with 3 sets of 10 reps 2x a week for each major muscle group

52
Q

What is the advanced level aerobic and strength activity recommendations for SCI

A

30 minutes 3x a week of mod to vigorous intensity with 3 sets of 1- reps 2x a week for each mm group

53
Q

When does SCI treatment focus on:
a. compensation
b. recovery

A

a. AIS A or B
b. AIS C or D

54
Q

What do you do if OH occurs in your patient?

A

move to recumbent position + elevate LE

55
Q

When does OH commonly occur in SCI patients?

A

Acute recovery phase

56
Q

How do you get your patient to tolerate upright postures if they have OH?

A
  • gradual positioning
  • abdominal binder
  • thigh-high anti-embolism compression stockings
57
Q

What is the main sign of autonomic dysreflexia?

A

a pounding headache

58
Q

What should you do if Pt has AD?

A

Move them into upright short sitting position and assess their BP - if high, loosen restricted clothing

59
Q

Where do you want patient hypermobility w/SCI?

A

Shoulder and HS

60
Q

On the capabilites of UE instrument, do you want a higher or lower score?

A

Higher = greater function
Scale of 32 - 224

61
Q

Which test rank orders the ability of a person to walk 10m after a SCI from most to least severe impairment?

A

The walking index for SCI II

62
Q

On the CHART, do you want a higher or lower score?

A

Higher = less handicap

63
Q

SCI Disrupts which systems?

A
  • respiratory
  • CV
  • gastrointestinal (neurogenic vowel)
  • genitourniary (neurogenic bladder)
  • endocrine (osteoporosis)
64
Q

What should integumentary education consist of?

A
  • pressure relief
  • avoid prolonged immobilization
  • daily skin checks
  • evaluate support surface
65
Q

Ability to walk as AIS A

A
  • usually non-functional
  • potential increases as LOI is more caudal
  • Below T11 greatest potential to walk
66
Q

Ability to walk as AIS C or D

A
  • incomplete greater than complete
  • Brown-Sequard or Central Cord highest potential to return to walk
  • more accurate sensation is better chance of walking
67
Q

What are guidance/assist as need techniques for propulsion?

A
  • stabilizing straps w/anterior forces
  • slow speeds
  • weight support
  • hand hold
68
Q

What are guidance/assist as need techniques for stance control?

A
  • BW support (up to 40%) reduced as tolerated w/o knee buckling
  • hand hold
69
Q

What are guidance/assist as need techniques for limb advancement?

A
  • manual assistance
  • elastic assistance
  • mechanical facilitation
70
Q

What are guidance/assist as need techniques for stability and balance?

A
  • anterolateral straps to minimize pelvic translation
  • hand-held support
71
Q

What are error augmentation techniques for propulsion?

A
  • increase speed (on treadmill)
  • resisted walking
  • stair climbing
  • uphill walking
72
Q

What are error augmentation techniques for stance control?

A
  • weighted vest
73
Q

What are error augmentation techniques for limb advancement?

A
  • leg weights
  • elastic resistance
74
Q

What are error augmentation techniques for stability and balance?

A
  • balance beams
  • uneven surfaces
  • multidirectional walking
  • obstacle avoidance
  • stair climbing
75
Q

What are some key things to remember about strengthening for SCI?

A
  • UE as stabilizer w/trunk movement
  • better to do multi-joint movements
  • functional strengthening is important
76
Q

What modifications can you use for a patient without triceps when completing strengthening of the UE?

A
  • air cuffs
  • shoulder ER
  • machines
77
Q

What modifications can you use for a patient without grip?

A
  • wrist straps
  • ace wraps
  • gloves
78
Q

What modifications can you use for a patient in antigravity?

A

-powderboard
- active assist
- skate on table

79
Q

What % of people w/SCI have shoulder pain

A

30-70%

80
Q

According to the STOMPs protocol, where should you stretch your shoulder?

A
  • anterior shoulder joint
  • posterior shoulder joint
  • UT
81
Q

What should you do for a warm-up (STOMPS Shoulder HEP)

A
  • scaption
  • ER
  • scapular retraction
  • shoulder adduction
82
Q

What resistive training should you do (STOMPS HEP)

A
  • scaption, ER, cap retraction, shoulder adduction + resistance
  • hypertrophy: 8 rep max
  • endurance: 15 rep max
83
Q

What is the STOMPS movement optimization transfer and raise?

A
  • lead w/painful side
  • close surfaces, level whenever possible, use graded heights if necessary
  • use a forward or side to side lean
  • turn hands outward whenever possible
84
Q

What is the STOMPS movement optimization WC Propulsion?

A

Use long, smooth strokes w/natural drift downward at end
push off tires
avoid steep inclinces

85
Q

What types of exercises should those w/SCI do?

A

aerobic, strengthening, and flexibiility

86
Q

What are some negative effects of spasticity?

A

contractures
positioning
sleep
comfort
hygiene

87
Q

What are some positive effects of spasticity

A
  • assist w/mobility
  • preserve mm mass and contribute to circulation
  • bowel and bladder function
88
Q

What are some physical treatments of spasticity?

A
  • muscle stretching
  • serial casting
  • bracing
  • E-stim
89
Q

What are some pharmacological treatments of spasiticty

A
  • baclofen
  • diazepam
  • dantrium
  • zanaflex
  • botox
90
Q

When does the most bone loss occur in SCI?

A

The first 6 months

91
Q

When does the most bone loss occur in SCI?

A

The first 6 months

92
Q

What percent of bone is lost in the first two years?

A

40%

93
Q

Where do most fractures occur post-SCI?

A

In the distal femur and proximal tibia

94
Q

T or F: People with paraplegia have more fractures than those with tetraplegia?

A

True

95
Q

What are signs of a fx after a SCI?

A
  • pain
  • limb deformity
  • swelling
  • hematoma
  • increased difficulty w/functional mobility
  • increase in mm spasms
  • AD
  • sweating
96
Q

What are non-modifiable risk factors for a fx w/SCI?

A
  • inc. time since injury
  • more complete SCI
  • Female
  • peds
  • previous fragility fx
  • paraplegia
97
Q

What is Heterotopic Ossification?

A

The formation of pathological bone in muscle or soft tissue

98
Q

When is there the highest risk of HO?

A

First 2 months after SCI, below the level of paralysis

99
Q

Where is the most common location for HO?

A

In the hips, but could also be at elbows or knee

100
Q

What are early signs/symptoms of HO?

A

swelling, joint and muscle pain, decreased ROM, erythema, and local warmth near a joint

101
Q

When would you see a spastic/hyperreflexive bladder (UMN bladder)

A
  • pts w/lesions above conus medullaris & sacral segments
102
Q

When would you see a flaccid or areflexive bladder (LMN Bladder)

A

Conus medullaris or a lfesion of the sacral segment

103
Q

What occurs with sexual function in males at the cauda equina/conus medullaris level of injury?

A
  • no reflex erections
  • occasional ejaculation
104
Q

What occurs with sexual function in males at the thoracic/cervical level of injury?

A
  • short duration reflex erections
  • occasional ejaculation
105
Q

What occurs with sexual function in females at the cauda equina/conus medullaris level of injury?

A
  • absent vaginal secretions
  • fertility still usually intact
106
Q

What occurs with sexual function in females at the thoracic/cervical level of injury?

A
  • vaginal secretions are present
  • fertility intact
  • absent sensation of labor pain

UM - Neuro 2 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions