Midterm Greatest Hits

Question 1

How often should a wheelchair user be performing weight shifts for pressure relief?

Answer 1

2 mins every 30 mins

Question 2

how can a C4 SCI unweight

Answer 2

dependent unless power tilt in space WC

Question 3

how can a C5 SCI unweight

Answer 3

hook at elbow or forearm and lean forward or to side

Question 4

how can a C6 SCI unweight

Answer 4

hook at wrist and lean forward or to side

Question 5

how can a C7 SCI unweight

Answer 5

hook at wrist and lean forward or to side
OR WC push up (if strong enough)

Question 6

when does d/c planning start?

Answer 6

at initial chart review

Question 7

for many people, a ____ inch doorway is sufficient for WC

Answer 7

30”

Question 8

how often will Medicare pay for new WC?

Answer 8

every 5 years (unless change in function or diagnosis)

Question 9

WC rentals for Medicare vs. Medicaid

Answer 9

care - 13 months
caid - 6 months

Question 10

what population is the Comprehensive Rehabilitation Services (CRS) for?

Answer 10

pt with TRAUMATIC BI or SCI

Question 11

qualifications for Comprehensive Rehabilitation Services (CRS)

Answer 11

at least 15 yo
US citizen
participation in rehab

Question 12

what must be presents for a diagnosis of post-polio syndrome?

Answer 12

new weakness
(+ cluster of other symptoms)

Question 13

what is the hallmark of polio-related weakness?

Answer 13

no pattern

Question 14

will PPS have motor, sensory or both deficits?

Answer 14

MOTOR ONLY (anterior horn cells affected)

Question 15

4 main factors for dx of polio & PPS

Answer 15

spinal tap acutely
giant motor units
weakness w/o pattern
only motor deficits

Question 16

for a dx of PPS, there must be a period of neurological recovery followed by a period of stability lasting at least ___

Answer 16

15 years

Question 17

% of residual motor cells left w/ PPS dx?
5/5
4/5
3/5
2/5
1/5
0/5

Answer 17

5: 40%
4: 10-40%
3: 8-10%
2: 3-5%
1: 2-3%
0: 0%

Question 18

what are the signs of muscle overuse in PPS?

Answer 18

muscle cramping AT REST or during activity
muscle twitching
progressive weakness
progressive atrophy

Question 19

exercising general rule for PPS for muscle that are 3/5 or below

Answer 19

gentle stretching only
protect these muscles during exercise

Question 20

exercising general rule for PPS for muscle that are 3+/5 or 4/5

Answer 20

exercise cautiously

Question 21

exercising general rule for PPS for muscle that are 4+/5 or 5/5

Answer 21

exercise moderate to vigorously if no signs of overuse

Question 22

start PPS pt at ____% intensity of a nonpolio survivor with ____ rest

Answer 22

50%
twice as much rest

Question 23

golden rule of rehab for PPS

Answer 23

if anything causes fatigue, weakness, or pain, don’t do it! (or do much less of it)

Question 24

most common type of MS

Answer 24

relapsing-remitting MS

Question 25

type of MS? steady decline since onset with super-imposed attacks

Answer 25

progressive-relapsing MS

Question 26

type of MS? initial relapsing-remitting MS then suddenly begins to have decline w/o periods of remission

Answer 26

secondary progressive MS

Question 27

type of MS? steady increase in disability w/o attacks

Answer 27

primary progressive MS

Question 28

type of MS? unpredictable attacks that may or may not leave permanent deficits followed by periods of remission

Answer 28

relapsing-remitting MS

Question 29

unique signs and symptoms of MS

Answer 29

Lhemitte's sign Uhthoff's phenomenon Charcot's Triad (scanning speech, intension tremor, nystagmus) visual dysfunction

Question 30

what signals the end of spinal shock?

Answer 30

return of anal and bladder reflexes

Question 31

what is spinal shock?

Answer 31

transient, flaccid period no reflexes below lesion level SC ceases to function immediately after injury

Question 32

what is a huge factor for vertical tolerance training for orthostatic hypotension?

Answer 32

cannot start vertical tolerance training by dangling legs at the edge of the bed

Question 33

when will you perform a WC eval/order for a pt in acute care (post SCI)?

Answer 33

when pt can tolerate upright

Question 34

key muscles for UE ASIA

Answer 34

C5 elbow flexion C6 wrist extensors C7 elbow extensors C8 finger flexors T1 finger abductors

Question 35

key muscles for LE ASIA

Answer 35

L2 hip flexors L3 knee extensors L4 ankle DFs L5 long toe extensors S1 ankle PFs

Question 36

special rule for scoring C5 & L1 motor for ASIA testing

Answer 36

if they are the 1st weak key muscles --> sensation at C4 & L2 can be used as substitute for motor function

Question 37

ASIA A

Answer 37

complete no sensory or motor function at S4-5 NOON sign

Question 38

ASIA B

Answer 38

sensory incomplete sensory but no motor function at S4-5

Question 39

ASIA C

Answer 39

motor incomplete more than 1/2 of key muscles below the neurological level have a grade LESS than 3

Question 40

ASIA D

Answer 40

motor incomplete more than 1/2 of key muscles below the neurological level have a grade GREATER than 3

Question 41

ASIA B have a ____% chance to ambulate

Answer 41

33%

Question 42

ASIA C have a ____% chance to ambulate

Answer 42

75%

Question 43

____% of pts remain an ASIA A

Answer 43

80%

Question 44

CPR for classification and prognosis post SCI

Answer 44

age 65+ motor score L3 motor score S1 light touch score L3 light touch score of S1

Question 45

in order to use a universal cuff UE orthotic device, pts must have what muscle function?

Answer 45

wrist extensors

Question 46

for SCI, which hand/finger position should be focused on for UE orthotics?

Answer 46

thumb opposition

Question 47

what UE orthotic would most likely be used for C4-C6 SCI?

Answer 47

resting hand splint

Question 48

what UE orthotic would most likely be used for complete C6 SCI?

Answer 48

short opponens splint (work on tenodesis grasp)

Question 49

what UE orthotic would most likely be used for C5-C6 SCI?

Answer 49

wrist/hand orthotic with utensil insert (no wrist extensors but can use wrist flexion and shoulders)

Question 50

which UE orthotics keep the wrist in a neutral position?

Answer 50

wrist stabilization brace wrist cock-up splint