SCI intro Flashcards

(50 cards)

1
Q

What is the most common distribution of SCI

A

Incomplete tetraplegia (partial paralysis of arms and legs)

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2
Q

What is the highest level of SCI where the UE is fully innervated

A

T1 (the level of injury refers to the last working level)

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3
Q

Why might spinal cord injury patients have cognitive deficits

A

Due to associated injuries (TBI and LOC)

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4
Q

Most SCI deaths are due to what

A

respiratory disease

Note: but the rates of cardiovascular disease, infection, and suicide are also higher than normal population

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5
Q

What is the most common kind of SCI in the cervical spine

A

hyperext

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6
Q

What is the most common cause of SCI in the thoracic spine

A

flexion-rotation injury

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7
Q

FRT vs mFRT

A

The modified functional reach test allows sitting

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8
Q

Why might the FES and ABC scale not be helpful to SCI patients

A

Because they may not walk and those scales ask about how worried you are about falls while walking

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9
Q

What is the instrument that assesses safety of transfers and risk of overuse injuries

A

Transfer assessment instrument

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10
Q

What signals the end of spinal shock’

when does it typically resolve

A

return of anal and bladder reflexes

begins to resolve in 24 hours, lasts a few weeks

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11
Q

Why might SCI patients have a hard time regulating temp

A

Unable to sweat, shiver, or have goosebumps below level of injury

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12
Q

A SCI patient who has a lesion above or at ___________ might have bowel and bladder affected

A

S2 S3 S4

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13
Q

UMN injury leads to what kind of B&B problems

A

Reflexive/neurogenic

they need a supossitory program and need to use digital stimulation to empty

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14
Q

LMN injury leads to what kind of B&B problems

A

flaccid

must manage fluids, diet, may need to manually evacuate

(make sure these patients are not constipated)

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15
Q

Which gender has fertility impacted by SCI

UMN vs LMN

A

male

UMN: arousal cant occur but can be manually stimulated

LMN: won’t become erect no matter what

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16
Q

How often to reposition SCI patients in bed in the hospital?

A

every 2-4 hours (Even at night they need to have an alarm to wakeup and turn)

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17
Q

how often to reposition patients in WC

A

every 30 minutes for 2 minutes

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18
Q

What are the most common areas of pressure injuries in supine patients

A

heel and sacrum

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19
Q

What are the most common areas of pressure injuries in WC patients

A

sacrum, trochanter, ischium

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20
Q

Where can contractures form in a SCI patient?

A

below level of lesion

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21
Q

What do you need in a SCI patient to prevent osteoporosis

A

Weightbearing and muscles pulling on bone

22
Q

What has to happen on a cardiopulm basis before we can assess if a patient will need a power chair

A

They must be able to sit up without passing out

23
Q

What is the first thing we do with a SCI patients when we see them and want to improve their upright tolerance

A

tilt the head of their bed upwards

do not get them up or have them seated EOB

24
Q

what can we do to assist patients with venous return for up right tolerance

A

compression for LE, abdominal binder

25
autonomic dysreflexia can occur in SCI patients above what level?
T5/T6
26
What do patients who have autonomic dysreflexia need to carry on them
a card behind their wallet explaining their condition for EMS
27
What do we need to do for patients with autonomic dysreflexia
check for irritants create orthostatic hypotension call 911
28
T or F: Higher level spinal cord injuries have more difficulty adjusting than lower level injuries
F, age is the primary factor of ability to adjust older people have harder time adjusting
29
When will we see a patient with Gardner-wells tongs
When theyre awaiting surgery provides traction and decompresses cervical spine
30
Can you make a minor adjustment for a patient with a halo vest?
No! also side note: these allow for early out of bed activities, eliminates all motion of cervical spine
31
What kind of cervical braces can be removed briefly for hygiene
Sternal Occipital mandibular immobilizer Philidelphia collar
32
What kind of neck stabilizing brace is least restrictive
Philadelphia collar
33
What kind of brace is made to minimize thoraco-lumbar movement
body jacket
34
what is a less restrictive thoracolumbar brace?
Taylor-knight brace
35
what is the LEAST restrictive thoracolumbar brace
Jewett mainly restricts flexion
36
What do we need to teach our patients who might have a chest-tube
Glossopharyngeal breathing to be able to breathe and stay calm incase chest tube comes out
37
What movements do we want to avoid for SCI patients who complain of neck pain with cervical injuries
Avoid shoulder flexion and abduction
38
What movements do we want to avoid for patients with SCI at the lumbar who complain of back pain
SLR no hip flexion over 90 degrees for lumbar injuries
39
What technique do we want to use to turn SCI patient in bed
log roll
40
Can SCI patients do long sitting initially?
No, avoid longsitting until atleast 90 degrees of passive unilateral SLR attained on both sides
41
Whats the most important thing to emphasize for SCI patients early
The patient's responsibility for their own care
42
General program progression for SCI in PT
Bedside treatment Upright tolerance Mat activity Transfer WC skills Power building and conditioning Advanced WC skills Gait Pain management
43
What was the main difference of people who have a SCI and have shoulder pain vs those without shoulder pain
The time they've lived with their injury more time= more chance of shoulder pain
44
What levels are considered a high tetraplegic?
C1-C4
45
What is the main goal for instructions of care for patients with high level tetra
Instruction needs to be good enough that someone who's never done the task before can safely assist
46
A patient on greater than _______ of oxygen on a vent can't leave the room
2L
47
What outcome measure for SCI is more responsive than the FIM and includes respiratory/bowel management
SCIM
48
What outcome measure is more effective for SCI rather than the Falls Efficacy Scale (FES) or the Activity Specific Balance Confidence Scale (ABC)
SCI-FCS SCI fall concern scale
49
A pt has passed out from orthostatic hypotension, what do!
Raise feet and lower head ASAP
50
T or F: a patient with 1 episode of autonomic dysreflexia is likely to have another
T