Physical Disabilities (Still Need To Watch Lectures) Flashcards
(9 cards)
List some common physical disabilities seen in the adult Australian population (incl ones from the lectures)
- Spinal cord injury
- Stroke
- Amputation
- MSK (back pain)
- Hearing loss
- Neuro (migraine, epilepsy, MS)
- Ischaemic heart disease
- Gastro (inflammatory bowel disease)
Common comorbidities with physical disability
- Mental health issues (depression/anxiety/distress)
- Chronic disease clustering (metabolic syndrome, obesity, diabetes, CVD)
- Polypharmacy/medication side effects
- Socioeconomic distress (harder to integrate/pay bills)
Communication strategies for someone with a disability
- Talk to the person, never carer/anyone else
- Plain language/simple words for clarity
- Aids/diagrams where possible
- Allow additional time if needed
- Check understanding (e.g. teachback)
- Ensure patient-centered, needs-first care
Typical demographics/aetiologies of spinal cord injury
- Demographics: young males most common
- Aetiology: commonly trauma - can also be from chronic conditions like cancer
Recall the neurology of micturition during voiding vs storage
Filling
- Afferent (pelvic) → sacral cord → PAG (inhibited) → cortex (sense)
- Efferent: ↑ sympathetic (hypogastric) + ↑ somatic (pudendal) → hold urine
Voiding
- Cortex disinhibits PMC → PMC active
- Efferent: ↑ parasympathetic (pelvic) to detrusor + ↓ sympathetic (hypogastric) + ↓ somatic (pudendal) → void
Pharm vs non pharm management of neurogenic bladder
- Non-pharm: indwelling catheter, self-catheterisation
- Pharm: amitryptiline, botox
UMN vs LMN Bowel
- UMN: Hyperreflexia, increased tone, may have accidnets
- LMN: hyporeflexia, flaccidity, may be constipated
Lifelong management considerations in SCI patients
- Fertility
- Osteoporosis
- Autonomic dysreflexia (WIT?; hint: ingrown toenail)
- Spasticity
Commonest causes for UL vs LL amputation
- UL: cancer, trauma
- LL: diabetes, smoking
