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DPT 830 Neuromuscular Rehab > Neuromuscular II SCI Unit Exam > Flashcards

Neuromuscular II SCI Unit Exam Flashcards

(69 cards)

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1
Q

what is SCI?

A

damage to the spinal cord resulting in symptoms below the level of injury

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2
Q

SCIs are most common between what age range?

A

16-30

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3
Q

what age do most SCIs occur? why?

A

19, frontal lobe development and myelination

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4
Q

do SCIs occur more in males or females?

A

males (80%)

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5
Q

what are the most common traumatic mechanisms of injury with SCIs?

A

MVA
falls
violence
sports related injuries

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6
Q

what are some non-traumatic mechanisms of injury of SCIs?

A

AVM
thrombus, embolus, hemorrhage to arterial supply
infection
tumor
MS lesions
ALS
spinal stenosis

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7
Q

incomplete SCIs have a _______ life expectancy than complete

A

longer

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8
Q

paraplegia has a ______ life expectancy than tetraplegia

A

longer

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9
Q

higher cervical tetraplegia has a ________ life expectancy than lower cervical tetraplegia. why?

A

shorter (innervation to vital organs)

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10
Q

________ rate is highest in the first year after spinal cord injury

A

mortality

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11
Q

happens immediately after SCI

A

spinal shock

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12
Q

a period of _______ lasts around 24 hours after spinal cord injury where everything is flaccid

A

areflexia

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13
Q

how many days does it take for reflexes to gradually return after spinal shock?

A

1-3 days

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14
Q

__________ may be present for 1-4 weeks after reflexes return following injury

A

hyperreflexia (high tone)

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15
Q

when is the ideal timeframe to administer an asia exam?

A

1-3 days

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16
Q

looks at motor and sensory levels bilaterally as well as sacral tone and sensation to determine SCI level, etc.

A

asia exam

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17
Q

asia exam determines what 5 naming categories of SCI

A

motor level of injury
sensory level of injury
neurologic level of injury
complete or incomplete
zone of partial preservation

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18
Q

asia C5 motor level

A

elbow flexors

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19
Q

asia C6 motor level

A

wrist extensors

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20
Q

asia C7 motor level

A

elbow extensors

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21
Q

asia C8 motor level

A

finger flexors

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22
Q

asia T1 motor level

A

finger abductors

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23
Q

asia L2 motor level

A

hip flexors

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24
Q

asia L3 motor level

A

knee extensors

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25
asia L4 motor level
ankle dorsiflexors
26
asia L5 motor level
long toe extensors
27
asia S1 motor level
ankle plantar flexors
28
no voluntary anal contraction or deep anal pressure
noon sign
29
what does the noon sign indicate?
complete SCI
30
no motor or sensory function is preserved in the sacral segments S4 to S5
asia A complete
31
sensory but not motor function is preserved below the neurological level and includes the sacral segments S4 to S5
asia B incomplete (motor complete)
32
more than half of the key muscles below the neurological level have a muscle grade less than 3 (all 1s and 2s)
asia C incomplete
33
at least half of the key muscles below the neurological level have a muscle grade of 3 or higher
asia D incomplete
34
asia level where motor and sensory function is normal
asia E
35
what is the motor level of injury?
lowest level that has a grade of 3 or higher if the level above it is a 5
36
what is the sensory level of injury?
lowest level of intact sensation (light touch and pink prick) (all 2s)
37
what is the neuralgic level of injury?
lowest level with normal motor and sensory function both on the right and left sides of the body (all 5s and 2s)
38
what is the zone of partial preservation?
levels below the motor or sensory level of injury that may be partially innervated
39
B loss of corticospinal and spinothalamic tracts
anterior cord syndrome
40
UEs more affected than LEs with varying degrees of sensory impairment, sacral sparing
central cord syndrome
41
ipsilateral DCML and corticospinal tract loss and contralateral spinothalamic tract loss
brown sequard syndrome
42
B loss of DCML
posterior cord syndrome
43
injury to this part of the spinal cord presents as mixed LMN and UMN signs
conus medullaris
44
injury to this part of the spinal cord presents with LMN signs, flaccid paresis, and saddle anesthesias
cauda equina
45
above conus medullaris
UMN
46
below conus medullaris
LMN
47
below which level generally presents as LMN?
T12
48
below T12 hyporeflexia flaccidity decreased tone
LMN
49
LMN bowel and bladder
flaccid
50
LMN sexual function
psychogenic responses
51
above T12 hyperreflexia spasticity increased tone
UMN
52
UMN bowel and bladder
spastic or hyperreflexive
53
UMN sexual function
reflexogenic arcs
54
ICU/floor setting that lasts for 1-3 weeks, working on upright tolerance and basic mobility
acute care
55
in this setting for 4-12 weeks learning ADLs, mobility, wheelchair training, and bracing
acute rehab
56
patients with higher level SCIs with complications, vents, or flap surgeries go to this setting
LTACH
57
setting that works on community integration, MSK injury prevention, and sports
outpatient
58
cardiopulmonary secondary complications
pneumonia (PNA) aspiration diaphragmatic muscle impairment PE/DVT BP management
59
what is autonomic dysreflexia?
sympathetic stimuli ascends to the brain but parasympathetic response cannot descend past the level of injury
60
autonomic dysreflexia can occur wits SCIs above what level? why?
T6 and above sympathetic chain
61
if BP is skyrocketing in a patient with autonomic dysreflexia, what should the PT do?
sit the patient up to induce orthostasis
62
autonomic secondary complications
autonomic dysreflexia BP management sweating response lack of higher center inhibition loss of descending control of ascending sympathetic reflexes
63
symptoms of autonomic dysreflexia
hypertension bradycardia headache (severe + pounding) profuse sweating increased spasticity vasodilation above LOI (flushing) constricted pupils nasal congestion pilorection blurred vision dry pale skin below LOI (vasoconstriction)
64
what is hypertension characterized by?
raise of 20-30mmHg systolic
65
autonomic dysreflexia typically occurs how many months after injury?
3-6 months may be chronic
66
neurologic secondary complications
tone/spasticity chances (UMN vs LMN) neuropathic pain sensory loss
67
musculoskeletal secondary complications
motor loss osteoporosis osteomyelitis secondary overuse injuries heterotropic ossification (HO)
68
why are patients with SCIs at an increased risk of developing osteoporosis?
not enough load through joints
69
why are standing frames so important for patients with SCI?

DPT 830 Neuromuscular Rehab (4 decks)

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