Spinal Cord Injury

Question 1

Describe effects of an acute SCI on cardiorespiratory function (Cx and Tx)

Answer 1

Cx - SNS disrupted, PNS intact = increased resting airway tone and hypersecretion

Tx - T4 and below will breathe like a tetraplegic patient

Question 2

Describe the effects of a chronic SCI on cardiorespiratory function (Cx and Tx)

Answer 2

Cx - postural hypotension (loss of mm pump), autonomic dysreflexia above T6 (increased BP PNS)
Tx - postural hypertension (loss of mm pump), autonomic dysreflexia above T6 (increased BP PNS)

Question 3

Describe effects of medical Mx for SCI on cardiorespiratory function

Answer 3

Bed rest - hypovolemia
Traction - Tx and Lx patients are lying flat
Surgery - anaesthetic = decreased FVC due to MV
Collar - decreased ROM, atrophy of mm
Mechanical ventilation -

Question 4

List innervations of respiratory muscles

Answer 4

C3/4/5 keeps you alive (diaphragm)
T1-11 intercostals
T5-12 abdominals

C1-2 SCM
accessory nerve SCM, upper traps
C5/6 pec major
C3-8 scalenes

Question 5

Describe pros and cons of physio Rx for SCI patients

Answer 5

Prevent complications

Sitting up pulls diaphragm flat and increases WOB
Positive pressure to increase volume comes with risks
Assisted coughing removes secretions
Suctioning via Geudel’s airway traumatic, bradycardia

Question 6

Describe modifications to physio Rx for patients with SCI

Answer 6

Start patient in supine or side lying to unload diaphragm