Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro > SCI > Flashcards

SCI Flashcards

1
Q

Upper Motor Neuron Lesion

A

lesion above anterior horn cells
typically cortical
increased spasticity with hyerreflexia
loss of motor &/or sensory function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lower motor neuron lesion

A

at or below the level of anterior horn cells
flaccidity with hyporeflexia
*spasticity can be present-just not as common
loss of motor and/or sensory funciton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tetrapelgia

A

complete paralysis of all four extremities and trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

paraplegia

A

complete paraylsis of all or part of the trunk and lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

neurological level

A

most caudal level with normal sensory and motor function

*what most injuries are named after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

motor level

A

most caudal level with normal motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

c1-c3 motor level

A

talking
mastication
sipping
blowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

c4 motor level

A

respiration and scap elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

c5 motor level

A 
shoulder ER 
abduction to 90
limited flexion
elbow flexion
forearm supination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

c6 motor level

A 
shoulder flex/ext
abduction/adduction
elbow flex
forearm pro/sup
wrist ext-tenodesis***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

C7 motor level

A 
elbow extensors
all of the shoulder
elbow flex
forearm sup/pron
wrist flex/ext
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

C8 motor level

A

full innervation of UE muscles

finger flexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T1 motor level

A

full innervation of UE muscles

finger abductors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T2-T6 motor level

A

improved trunk control

increased respiratory capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T7-12 motor control

A

additional improved trunk control

increased endurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

L1-L4

A

hip flexion
hip abduction
knee ext

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

L2 specifically

A

hip flexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

L3

A

knee extensors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

L4

A

ankle dorsiflexors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

L5

A

big toe extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

L4-L5

A

strong hip flexion and knee extension
weak knee flex
improved trunk control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

S1

A

ankle plantar flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sensory Level

A 
-most caudal level with normal sensory function
sharp/dull
light touch
deep pressure
proprioception
t4-nipple line
t10-umbilicus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

skeletal level

A

level where there is the most bony damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

complete injury

A

absence of sensory and motor function below the neuro level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

incomplete injury

A

partial preservation of sensory and motor function below the neuro level
more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

American Spinal Injury Association Impairment Scale-ASIA classifications

A
  1. A- complete injury-no motor or sensory function
  2. B- incomplete-sensory function present but not motor function below neuro level
  3. C-incomplete-motor function preserved w/ more than 1/2 the key muscles below neuro level
    * muscle grade less than three
    * *no sensory
  4. D- Incomplete: motor function preserved with more than 1/2 key muscles below neuro level
    * muscle grade 3 or higher
    * no sensory
  5. E- Normal: motor and sensory function is normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

5 types of incomplete SCI

A 
Central cord Syndrome
brown-sequard syndrome
anterior cord syndrome
posterior cord syndrome
cauda equina syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Central cord syndrome

A

UE weakness is greater than lower extremity

almost always a cervical level lesion
Damage to all three tracts: spinothalamic, corticospinal and sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Brown-sequard syndrome

A

loss of voluntary motor control and loss of sensation in the dermatome segment corresponding to the level of the lesion on the ipsilateral side as the cord damage

loss of pain and temperature sensation on controlateral side

common with penetration wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Anterior Cord Syndrome

A

loss of motor function

loss of pain and temperature sensation

intact proprioception, knesthesia and vibration sensation

all voluntary motor control is lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Posterior Cord Syndrome

A

Very Rare
damage to posteriour spinal artery from tumor or vascular infarct

pt. with lose ability to perceive proprioception and vibration

Loss of epicritic sensations-two point discrimination, graphesthesia, sterognosis

intact motor function, pain and light touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Cauda Equina Syndrome

A 
injury to L-S nerve roots
*lower motor neuron injury
Areflexic bladder
flaccidity 
loss of bowel/bladder
LE weakness 
regeneration of involved peripheral nerve root possible but depends on extent of damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ROM factors

A

1 range of motion: extreme ranges will compensate for strength deficit

2 decrease ROM can influence level of functional independence -decrease ability to ambulate

3 selective tightness:

  • lumbar ext-lift transfer and trunk stability
  • long finger flex, wrist ext=tenodesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Functional Strength

A

C6-T1: pectoralis major-rolling
C5: biceps-feeding, bed mobility, hooking over WC, transfers
C6: wrist ext-tenodesis
C7: triceps- improved ADL and transfer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Balance

A

need one UE for stability and the other UE for function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Spasticity/Tone

A

Mild:
resistance to passive stretch but tone doesnt interfere with ROM or functional movement

Moderate:
more resistance to stretch, full ROM, tone starts to interfer with functional movement

Severe:
ROM compromised, some functional movement skills are not available or possible due to tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Quality Characteristics of Tone

A

constant vs. intermittent
influenced by position
symmetrical vs. asymmetrical
time of day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

factors that influence independence

A 
ROM
Strength
Balance
Spasticity/Tone
Respiratory 
Orthopedic problems
Alterations in bowel/bladder
Other:
-skin 
-age
-body size in relation to trunk
-cognition
-premorbid personality
-family/SO support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Pressure Sores

A

common sites:
scapula, elbow, sacrum, AIS, trochanters, ischium, knees, heels, malleoli

Prevention:
Lying: turn every 2 hours
Sitting: 10-15 seconds of wt. shift or pressure relief every 10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Autonomic Dysreflexia-Hyperreflexia

A

Occurs in lesions above T6

-exaggerated autonomic response to stimulus that normally would be considered normal

42
Q

AD: initiating Stimuli

A 
bladder/bowel distention
bladder infection
urinary stones
kidney malfunction
urethral or bladder irritation
excessie PROM, stretch-especially at hip
noxious cutaneous stimuli
pressure sore
environment temp change
43
Q

AD: symptoms

A 
hypertension-life threatening
bradycardia-life threatening
headache 
profuse sweatingincreased spasticity
restlessness
vasoconstriction below level of lesion
vasodilation above level of lesion
constricted pupils
nasal congestion
piloerection
blurred vision
44
Q

AD: interventions

A

considered medical emergency
find the source of stimulus and remove it
unable to find stimulus-contact MD ASAP
treat symptoms

45
Q

Postural Hypotension

A

loss of sympathetic vasoconstriction control and further enhanced by decrease muscle tone
Intervention:
-gradually progress to vertical position while monitoring vital signs=tilt table, anti-gravity system
-LE compression garment, abdominal pressure garment
-Medication to increase BP

46
Q

Heterotropic Ossification

A

extra-articular and extra-capsular abnormal bone growth

typically occurs adjacent to large joints: shoulder, elbow, spine and hip/ knee

47
Q

Symptoms of Ossification

A

swelling
decreased ROM
Erythemia
local warmth near joint

48
Q

Intervention for HO

A

medication to inhibit calcium phosphate
ROM exercise to prevent LOM
surgery to remove bone if LOM occurs

49
Q

Contracture

A

decreased ROM

prevention: positioning, orthotics, ROM

50
Q

Deep Venous Thrombosis

A

loss of normal pumping mechanism in LE muscle contraction

Prevention:
medications-anticoagulants
PROM,AAROM
repositioning
LE compression garments
Elevate LE
51
Q

4 types of pain

A

traumatic
nerve root
spinal cord dysesthesia
musculoskeletal

52
Q

traumatic pain

A 
initial injury to soft tissues
interventions:
immobilize 
medications
TENS
53
Q

Nerve Root

A

irritation to nerve roots
invervention:
medications
TENS

54
Q

Spinal Cord Dysesthesia

A

Uknown etiology

Symptoms:
diffuse, below level of lesion and similar to amputee “phantom” pain

Intervention:
gentle positioning
medication

55
Q

musculoskeletal pain

A

typically at shoulder and due to overuse
prevention:
ROM
positioning

56
Q

bladder dysfunction

A

T12 or below, increase intra-abdominal pressure using Valsalva maneuver or Crede maneuver

Bladder retraining-intermitten catheterization, timed voiding program

57
Q

bowel dysfunction

A

location of cord lesion

  • above conus medullaris: spastic or reflex bowel-UMN
  • cord lesion in conus: flaccid or non-reflex bowel-LMN
Bowel Programs:
-spastic or reflex management
use suppositories
digital stimulation
-flaccid or non-reflex
straining with available musculature
mannual evacuation techniques
58
Q

Respiratory Management

A

patients injured above T12 are lacking proper bronchial hygiene and adequate inspiratory volume are at risk:

  • pulmonary infection
  • activity limitations
  • increased frequency of hospital admissions
  • increased mortality
59
Q

C1-2 respiration

A

loss of phrenic nerve-no diaphragm movement
mechanical ventilation
if reflex arc not damaged, may be able to get a nerve stimulator

60
Q

C3 respiration

A

LMN damaged and prohibits use of phrenic nerve stimulator
mechanical ventilation
tracheostomy required for bronchial hygienee due to cough impaired

61
Q

C4-C5 respiration

A

unilateral or bilateral damage to a portion of the phrenic nerve

decrease in vital capacity

pt. requires a tracheostomy but may be removed after vital capacity and ability to mobilize secretions has improved
pt. usually does not require mechanical ventilation after acute period

cough assistance usually necessary

risk of complications due to poor cough ability

62
Q

C6-T6 respiration

A

interference with ability to deep breath and produce adequate cough

cough assitance and incentive spirometry needed

individual may be independent with self-assit cough

pt. can easily develop problems due to illness

63
Q

T6-T12 respiration

A

major muscles for ventilation are usually intact

pt. may have weak, ineffective cough due to loss of abdominal and intercostal muscles

cough assitance and incentive spirometry needed

64
Q

Respiratory Evaluation

A 
function of muscles
vital capacity
respiratory rate
chest expansion
cough fucntion/effectiveness
breathing pattern
65
Q

Respiration Treatments General

A

done by whole team

diaphragmatic re-education
muscle strengthening
breathing exercises
chest mobility
pulmonary hygiene
home instructions
66
Q

PT and OT treatments for respiratory

A

inspiratory and expiratory force and endurance developed by using sip and puff tasks and control tasks

glosspharyngeal breathing

airshift maneuver

strengthening exercises

assisted coughing

abdominal support

stretching

67
Q

Incentive spirometry

A

helps with diaphragmatic breathing

68
Q

Selective strengthening

A

during first few weeks following injury
application of resistance during exercise to these areas may be contraindicated due to lack of spinal stability

  1. Tetraplegia: scap and shoulder
  2. Paraplegia: pelvis and trunk
69
Q

Pts. with tetraplegia emphasis on:

A

anterior deltoid
shoulder extensors
biceps
lower trap

If present:
radial wrist extension
triceps
pectoralis

70
Q

Pts. with paraplegia emphasis on

A 
all UE musculature 
especially:
shoulder depressors
triceps
latissimus dorsi
71
Q

Skin inspection

A

must be regular and a lifelong component of daily routine

all patients can direct skin inspection

72
Q

Manual Wheel Chair

A

intact triceps-C7

73
Q

Power WC

A

C6 or C5 and higher

**Especially C4

74
Q

Push Rim: PAPAW

A

manual with power assist wheels
requires less energy and lower stroke frequency
less shoulder ROM needed
beneficial for mid to lower cervical C5-C6

75
Q

In order to ambulate after SCI a patient must have what?

A

adequate muscle strength
adequate postural alignment
adequate ROM
sufficient cardiovascular endurance

76
Q

If pt. does not become functional ambulator, standing will still help benefit what?

A 
improved circulation
skin integrity
bowel and bladder function
sleep
feeling of well being
77
Q

factors that restrict ambulation

A 
energy consumption
severe spasticity
loss of proprioception: esp. hips&knees
pain
presence of secondary complication
decubitus ulcer
heterotropic bone formation at hips
deformity 
financial cost 
frustration and motivation
78
Q

Levels of ambulation

A

Community: L2 or below

Household: T9-T12
* only within house on level surfaces

Emergency T6-T8:

  • 2-3 steps with orthotics and AD to bedroom or through narrow areas WC cannot access
  • *not wheel chair bound
79
Q

Gait Training for individuals with complete SCI

A

orthotic Rx:
Thoracic lesion: KAFO’s
Reciprocating Gait Orthosis RGO: KAFO joined

80
Q

Gait training strategies

A

Donning and Doffing orthosis in bed or on a mat table
need special equipment to put it on and off
**prevent jack-knifing=releasing Y ligament

81
Q

Types of ambulation for complete SCI

A

standing from WC with crutches
UE push up from crutches
Crutch balancing
Falling safely

82
Q

Locomotor training for incomplete SCI

A

distinct and specific task of walking with aim of tapping into the intrinsic neural pathways responsible for generating steps

  • partial body weight support
  • treadmill
  • manual assistance by trainers
83
Q

Train LIke you walk locomotor training

A

LE maximally loaded for weight-bearing-minimize or eliminate loading of arms

posture trunk, pelvis and limb kinamatics coordinated and specific to the task of walking

compensatory strategies for movement

84
Q

Self LE ROM for C5, C6, C7-C8

A

C5:
Ind. direct ROM
depended with ROM

C6:
Ind Direct ROM
assist or perform parts of self LE ROM

C7-C8
Ind direct ROM
independent with self LE ROM

85
Q

Sitting C5 C6 C7-C8

A

C5:
direct sitting method
assist w. head, scap and some shoulder movement
dependent with everything else

C6:
direct sitting method
ind. with sitting with AD
ind with POE or supine on elbows

C7-C8:
direct sitting method
independent w/ sitting via UE push-up

86
Q

Bed mobility C5 C6 C7-C8

A

C5:
Direct bed method
assit with head, scap and some shoulder movement

C6:
direct bed method
independent with bed mobility with adaptive equipment

C7-C8:
independent with bed mobility w/ or w/o equipment

87
Q

Pressure Relief C5, C6, C7-C8

A

C5:
Direct method
ind. with motorized recline WC w/ head control

C6:
DM
Ind. w/ self-pressure relief skills

C7-C8:
DM
Ind. w/ all self-pressure relief skills including WC push-up

88
Q

Transfers C5, C6, C7-C8

A

C5:
DT
assit w/ head, scap and shoulder mvmt
POE transfer

C6:
DT
assit with head, scap, shoulder mvmt and biceo
Ind. or assist w/ transfer with slide board

C7-C8:
DT
Assist with head, scap, shoulder mvmt, bicep and wrist ext.
ind. w/ all trasnfers w/ or w/o slide board

89
Q

WC mobility C5, C6, C7-C8

A

C5:
DWCM
ind. maneuver elec. WC w/ adaptive controls
ind. maneuver manual with oblique protection

C6:
ind. maneuver w/ vertical projections or plastic coated hand ribs w/ WC mitts

C7-8:
ind. maneuver of WC w/ or w/o plastic hand rims w/ mitts on smooth or slight uneven terrain

90
Q

Ambulation T6-8

A

independent in // bars ambulation with bilateral KAFOs and bilateral swing to pattern via abdominal control

supervision w/ ambulation w/ walker and bil. KAFOs

91
Q

Ambulation T9-12

A

ind. household ambulation w/ bil. KAFO and walker or crutches on level surface
sing to or swing through pattern
supervision on elevations and rough surfaces

92
Q

Ambulation L2-3

A

ind. functional ambulation with bil. KAFOs w/ forearm crutches on level surface

Elevations w/ swing to, swing through or 4pt. pattern

93
Q

Ambulation L4-5

A

ind. functional ambulation w. bil. AFOs w/ bil. forearm crutches or canes on level surface

2 or 4 pt. pattern

94
Q

L1-L4

A

Hip Flexors

95
Q

L4-S1

A

hip abductors

96
Q

L2-L4

A

Hip adductors

97
Q

L5-S2

A

Hip Extensors

Knee Flexors

98
Q

L3-L4

A

knee extensors

99
Q

L4-L5

A

Ankle Dorsiflexors

100
Q

S1-S2

A

ankle plantarflexors

Neuro (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions