SCI Flashcards by jasmine mander

does bony spinal injury equal SCI

How well did you know this?

Not at all

Perfectly

primary injur

initial mechanical insult

How well did you know this?

Not at all

Perfectly

secondary injury

post injury process - shock, electrolyte disturbances, toxicity

How well did you know this?

Not at all

Perfectly

early management goals SCI

stabilise
limit deficit
promote recovery

How well did you know this?

Not at all

Perfectly

non surgical options

bedrest
cervical collar
thoraclumbar colar

How well did you know this?

Not at all

Perfectly

unstable spine goals

neutral spine, HOB at 0

prevent wounds and clear chest

How well did you know this?

Not at all

Perfectly

stable spine goals

progression of mobility to upright / functional postures

How well did you know this?

Not at all

Perfectly

T/f unstable spine is a 2-3 person turn at all times

true

How well did you know this?

Not at all

Perfectly

stable but requires protection goals

turn and be neutral independently

must be neutral at all times

How well did you know this?

Not at all

Perfectly

t/f patient may flex ext rotate within limits if no limts

yes

How well did you know this?

Not at all

Perfectly

can you teach patient role to maintain neutral spine if no restrictions

yes

How well did you know this?

Not at all

Perfectly

is sympathetic or parasympathetic chain longer

para - it starts higher - so initially after SCI people are para dominant

How well did you know this?

Not at all

Perfectly

acute management - patient may be unable to manage their

BP
HR
temp

How well did you know this?

Not at all

Perfectly

after SCI resting BP is __ than normal

lower

How well did you know this?

Not at all

Perfectly

SCI clients don’t get __ but they have __

true tacky (>100bpm)
relative tacky from baseline

How well did you know this?

Not at all

Perfectly

need to watch if patients have __ due to __

fever

infection/sepsis

How well did you know this?

Not at all

Perfectly

what can a change in reflexes indicate

no longer in spinal shock

How well did you know this?

Not at all

Perfectly

S234 keeps

the poo off the flow

How well did you know this?

Not at all

Perfectly

abomdinal function comes at

T6- LUMBAR

How well did you know this?

Not at all

Perfectly

diaphragms comes at

C345

How well did you know this?

Not at all

Perfectly

spinal shock

suppression of reflexes

may last weeks to months

How well did you know this?

Not at all

Perfectly

neurogenic shock

loss of sympathetic control

injuries above t6

How well did you know this?

Not at all

Perfectly

__ vasomotor tone causing __ in neurogenic shock

decreased
hypotension
hypotheremia

How well did you know this?

Not at all

Perfectly

unopposed vagal nerve stimulation leads to __

bradycardia

How well did you know this?

Not at all

Perfectly

untreated neurogenic shock can lead to __

metabolic acidosis

leading cause of death in acute SCI

respiration

__ of patients with C5 or higher require mechanical venticlation at some time , although most wean

95%

T/f respiratory failure is evident intially

no may develop over 3-5 days due to fatigue

External / internal intercostal

T1-11

SCM, scalene, traps, pecs, lats, erectors spinal, subalvis

CN X1, C1-8

``` C1-3 cough function C4 C5-T1 T2-4 T5-10 T11 and below ```

``` absent non functional non functional weak poor normal ```

``` C1-3 acute vital capacty C4 C5-T1 T2-4 T5-10 T11 and below ```

``` 0-5% 10-15 30-40 40-50 75 to normal normal ```

``` C1-3 long term vital capacty C4 C5-T1 T2-4 T5-10 T11 and below ```

``` ventilator 50% of normal 60-70 60-70 nearly normal normal ```

how breathing different in SCI

paradoxical breathing vital capacity and inspiratory volume greater in lying decrease in all lung volume except residual volume

T/f easier for some Sci to breath laying down

yes

treatment options for trouble breathing

``` ventilator CPAP/BIPAP MIE stacked breathing secretion clearnce binders phrenic pacing ```

monitoring __ is important during acute stages to see changes in respiratory status

vital capacity Peak expiratory flow FEV1

a pounding headache is __ and light headache is

autonomic dsy hypotension

ortho hypo

sudden 20 SBPdrop | 10 drop in DBP

What to do for ortho hypo

stocking binders slow meds

AD is cursed by __

sympathetic discharge

Ad is triggered by

noxious or non noxious stimulate below level of SCI

AD due to loss of __

supra spinal control

AD occurs in injury __

T6 and above

more commonly AD occurs in

chronic Sci, complete

symptoms of AD

``` increase in BP of 20-30 Brady poudnign headache cramps blurred vision paresthesia ```

signs of AD

``` dilated pupils goosebumps above injury pilorection sweating above dry cool below ```

common caused AD

``` full bladder wounds tight clothes sex painful stimuli ```

how to treat AD

upright check BP find triggers loosen clothes

sensory exam scoring

2 normal 1 impaired 0 absent

motor exam scorin

0-5

neurological level of injury

most caudal segment with sensory and Motor antigravity mm function - with a 5 above it across both sides of the body

sacral sparing test

anal sensation s4/5 deep anal pressure voluntary anal contraction 3 or more if ANY of above, its incomplete

can physio do sacral sparing test

if you have training for internal exams

sensory incompleye

sacral sparing of lowest sacral segments s45 | Asia B

motor incomplete

sacral spring of motor function OR motor function sparing more than 3 levels below with intact sensory sparing S45

key prognostic test

pin prick LE - 75% can walk a year later

Central cord syndrome

UE more effected than LE hyperextension injury low velocity injury

anterior cord syndrome

loss of motor function / pain below lesion

brown squared

ipsilaterally paralysis, proprioception, vibration contralterally pain and temperatue

corticopsinal and dorsal cross at

brain

spinthalmic tract cross over at

conus medularris you might get

mixed presentation ofUMN an LMN (flaccid and spastic)

cauda equina syndrome

injury below conus | LMN

c1-3 injury

qventilator dependent overuse neck mm dependent

c4 injury

may be able to breath without ventilate bed mobility/ADL dependent power w/c independent

c4 and above goals

inspirtaroy mm training

C5 injury

manual w/c possible | bed mobility / ADL some assist required

goals for c5

inspiratory mm training | ADL adaptive equipment

have anti gravity wrist extention | may need some assistance, but can be ADL and ind

highest SCi level with some ind with or without equipment

problem with c6

no triceps so to need to lock elbows for transfer | tendonesis grip