WEEK 4 Weakness In Critically ill Flashcards
What are the 4 parts of a motor unit that can be affected by neuromuscular disorders?
Muscle, neuromuscular junction, peripheral nerve, anterior horn cell
What are some consequences of bedrest?
Deconditioning & NOT recovery, muscle weakness, loss of functional independence, body fluids go from extremities to thorax, decreased total blood volume, decreased hemoglobin concentration, increased resting heart rate, decreased VO2max, decreased ventilation, kidney stones & infection, increased calcium excretion, musculoskeletal, emotional, and behavioral changes
What are some pre-existing neuromuscular disorders that contribute to motor weakness in ICU?
Guillian-Barre, myasthenia gravis, ALS
What are some new onset neuromuscular disorders that contribute to motor weakness in ICU?
Undiagnosed neuromuscular disorders, spinal cord infarct after aortic surgery, epidural abscess
What are some complications of non-neuromuscular critical illness?
Critical illness polyneuropathy, critical illness myopathy
True or False: The true incidence of CIP is unknown but only sensory is impacted.
False (sensory & motor nerves)
What are some treatment options for CIP?
Treatment of sepsis & MODS, management of difficulty in weaning from ventilator, attempts at direct treatment of CIP, physical therapy
True or False: The true incidence of CIM is unknown & it has proximal & distal weakness.
True
What is the diagnostic method of choice for CIM?
Muscle biopsy
(CIP/CIM) has a major feature of diffuse flaccid weakness in all limbs.
CIM
Which phase is when the patient is acutely critically ill & restricted to bed rest since they’re profoundly weak & unable to bear weight?
Phase 1
Which phase is when the patient is able to stand but unable to ambulate?
Phase 2
Which phase is when the patient is able to ambulate & the focus is on improving orthostatic tolerance & endurance?
Phase 3
Which phase is when the patient can do higher levels of physical activities & is preparing for discharge?
Phase 4
Which phase is it most important for PT to see them?
Phase 2 because we don’t want them to lose the ability to stand
(CIP/CIM) is the main contributor to persistent disability, sepsis, & multi-system organ failure.
CIP
True or False: There is no specific pharmacological treatment for CIP or CIM.
True
(CIP/CIM) is associated with complete recovery.
CIM
