OT MIDTERM: SCI

Question 1

• C1-3

Answer 1

neck muscles

Question 2

C4

Answer 2

Diaphragm, upper traps

Question 3

C5

Answer 3

deltoids, biceps

Question 4

C6

Answer 4

wrist extensors

Question 5

• C7

Answer 5

triceps, extensor digitorum

Question 6

C8

Answer 6

Flexor digitorum

Question 7

• T1

Answer 7

hand intrinsics

Question 8

• T2-T12

Answer 8

intercostals

Question 9

• T7-L1

Answer 9

abdominal

Question 10

Quadriplegia:

Answer 10

spinal cord injury above the first thoracic vertebra
* Can often use arms/wrists
* Never has full use of hands

Question 11

• Paraplegia:

Answer 11

the level of injury occurs below the first thoracic vertebra.
* Small muscles in their hands
* Finger abduction

Question 12

C8-T1- what is this now considered

Answer 12

paraplegia

Question 13

OT tx goals motor:

Answer 13

• strengthen remaining mm groups
• Teach compensatory/substitute motions
• Splints to maintain functional position of hand+ to assist w substitute motions
• Teach energy conservation
• Teach w/c mobility skills

Question 14

OT tx goals sensory:

Answer 14

¨ Educate to compensate for decreased sensation
¨ Teach visual skin inspection

Question 15

OT tx goals self-care

Answer 15

¨ Teach alternative strategies for ADLs
¨ Train in use of assistive devices, home/environmental adaptations.

Question 16

OT tx goals productivity

Answer 16

¨ Determine vocational goals

Question 17

OT tx goals leisure

Answer 17

¨ Expand and develop leisure interests.

Question 18

Autonomic Dysreflexia

Answer 18

irritation below level of injury, message cannot get to the brain, reflex

Question 19

Symptoms of Autonomic Dysreflexia

Answer 19

Headache, profuse sweating, anxiety, flushed

Question 20

What could be an irritant that leads to Autonomic Dysreflexia

Answer 20

overfull bladder, ingrown toenail, clothing too tight, infection

Question 21

What should you do for a client with Autonomic Dysreflexia symptoms?

Answer 21

Sit upright, call for help, loosen clothing, check urinary drainage

Question 22

Orthostatic hypotension

Answer 22

Drop in BP caused by going from lying to sitting or standing

Question 23

Signs of Orthostatic hypotension

Answer 23

Lightheaded, dizzy, loss of vision, seeing dots

Question 24

Tx for orthostatic hypotension

Answer 24

Lie down until symptoms ease
Binder or compression socks

Question 25

Temp regulation

Answer 25

• Most people w SCI do not sweat below level of injury
• The body can become hyperthermic
• Nausea headache, tired,
• Can also become hypothermic

Question 26

Philadelphia collars

Answer 26

• May or may not have a trach opening
• Must be fitted properly

Question 27

Halo traction

Answer 27

• More effective at preventing cervical motion than collar
• metal ring around the head which is affixed to the skull with screws
• Sheepskin lining
• Allows client to initiate early mobility
• Particularly used for non-displaced fractures

Question 28

Resting hand splints

Answer 28

• Are often used in the acute stages to maintain functional hand position
• May be used at night beyond the acute stage.

Question 29

Tenodesis:

Answer 29

• A tenodesis grasp can be used by people with C6/C7 quad
• The wrist extensors extend the wrist
• This causes tension on the long finger flexors causing the fingers to flex

Question 30

Why is tenodesis important?

Answer 30

Preserving mild tightness for the long finger flexors is actually desirable to maximize the function of the grasp

Question 31

Tenodesis: static split

Answer 31

A static splint may be used to maintain the thumb in a position of opposition to improve the effectiveness of the tenodesis grasp