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BPT14 - Neuro Rehab > SCI Review > Flashcards

SCI Review Flashcards

(60 cards)

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1
Q

What is SCI?

A

SCI stands for Spinal Cord Injury, which is a catastrophic condition that may cause drastic changes in a person’s life.

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2
Q

What are the risks associated with SCI?

A

Loss of independence and risk of developing secondary conditions.

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3
Q

What is required for successful rehabilitation and readaptation after SCI?

A

A team of healthcare professionals working in collaboration is necessary to regain independence and prevent complications.

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4
Q

What is the most common cause of SCI?

A

Trauma, such as car accidents or firearms.

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5
Q

What is the ASIA Scale used for?

A

The ASIA Scale is used to classify the severity of SCI based on motor and sensory function

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6
Q

What are the different categories in the ASIA Scale

A

A: No motor or sensory function preserved
B: Minor sensory deficit, but no motor function preserved below nli ,including lowest segments.
C: Sensory deficit. Motor function present below the injury, but strengths of more than half of the key muscles are graded < 3 on 5
D: Sensory deficit. Motor function present below the injury, but strengths of more than half of the key muscles are graded ≥ 3 on 5
E: Motor and sensory functions in key mucles & dermatomes are present

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7
Q

ASIA A

A

A: No motor or sensory function preserved.

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8
Q

ASIA B

A

B: Minor sensory deficit (incomplete), no motor function preserved below nli(complete), including the lowest segments

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9
Q

ASIA C

A

C: Sensory deficit, Motor function present below the injury, but strengths of more than half of the key muscles are graded < 3 on 5

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10
Q

ASIA D

A

D: Sensory deficit. Motor function present below the injury, but strengths of more than half of the key muscles are graded ≥ 3 on 5.

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11
Q

What are the different types of SCI?

A

Contusion, Laceration, and Solid (Myelopathy).

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12
Q

What is a Laceration?

A

Type of SCI (25%)
= Severing or tearing, usually from fire weapons & knife

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13
Q

What is a contusion?

A

Type of SCI ( 25-40%)
= bruising, usually from trauma (=> compression of SC)

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14
Q

What is a Solid injury?

A

Type of SCI (17%) also called Myelopathy
= axonal damage, through injury or demyelination

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15
Q

What is the etiology of SCI?

A

SCI is caused by a complete or incomplete lesion leading to paraplegia or tetraplegia. The manifestation, symptoms, and impairments vary according to the etiology of the lesion. About 20% of cases are related to infectious disease, tumors, or degenerative disease.Other common cause : trauma

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16
Q

What is tetraplegia?

A

Impairment or loss of motor and/or sensory functions due to damage to the cervical segments, affecting upper, lower extremities, and trunk. Also known as quadriplegia.

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17
Q

What is paraplegia?

A

Impairment or loss of motor and/or sensory function due to damage to the thoracic, lumbar, or sacral segments, affecting lower extremities and/or trunk. Can also refer to cauda equina and conus medullaris syndrome.

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18
Q

What is the difference between tetraplegia and paraplegia?

A

Tetraplegia affects upper, lower extremities, and trunk due to damage to cervical segments, while paraplegia affects lower extremities and/or trunk due to damage to thoracic, lumbar, or sacral segments.

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19
Q

What is the level of motor functions in C1-C4 complete injury (tetraplegia)?

A
  • Paralysis of arms and hands, legs, and trunk ❌
  • Face ✅
  • Cervival head flexion , rotation & side bending ✅
  • Shoulder elevation (shrugging) ✅
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20
Q

What are the activity limitations/capacities in C1-C4 injury (Tetraplegia)?

A

Without support/assistance, can’t :
- Breath ❌
- Speech ❌
- Cough ❌
- Swallowing ❌
- No bladder/bowel control ❌
=> Complete dependence for ADLs & 24/7 supervision/care

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21
Q

What are the mobility/locomotion capacities for C1-C4 tetraplegia?

A

-Transfer dependency.
- Powered or electrical wheelchair (with special control) or manual wheelchair pushed.

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22
Q

What is the level of motor functions in C5 injury (tetraplegia)?

A
  • C1 to C4 functions ✅
  • Shoulder ABD (=raise arm) & Ext rotation ✅
  • Diaphragm ✅
  • ELbow flexion ✅
  • Forearm supination ✅
  • Still paralysis of arms(part of it) and hands, legs, and trunk ❌
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23
Q

What are the activity limitations/capacities in C5 tetraplegia?

A
  • Breathing is of low performance (fatigue) ❌
  • Impaired cough ❌
  • Bowel/bladder control ❌-> dependence
  • Sitting balance ❌ (low to none)
  • Normal speech ✅
  • Minimal assistance for ADLs
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24
Q

What are the mobility capacities for C5 paraplegia ?

A
  • Dependence on transfers (patient might help).
  • Electrical wheelchair w/ hand grip adapted
  • may use adapted manual WC
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25
What is the level of motor functions in C6 injury?
- Still paralysis of hands, legs, and trunk ❌ - Shoulder function ✅ - Wrist extension (tenodesis grip) ✅ - forearm pronation ✅ - elbow flexion ✅
26
What are the activity limitations/capacities in C6 injury (tetraplegia)?
- Low breathing performance => fatigue - Weak cough - Bowel/bladder care w/ special equipment - Tenodesis grip - Low sitting balance - Independent -> Min. to max. assisstance for ADLs depending on patient
27
What are the mobility capacities for C6 injury (tetraplegia)?
- Move in & out of WC - Transfers/bed mobility independance w/ minimal assistance - Powered WC w/ hand control - Manual adapted WC - Drive adapted car
28
What is the level of motor functions in C7 injury? (tetraplegia)
- normal mvt of shoulder ✅(from before) - Wrist extension ✅(from before) - elbow extension ✅ - finger flexion/extension ✅ - start of wrist flexion ✅
29
What are the activity limitations/capacities in C7 injury? (tetraplegia)
- Bowel/Bladder care w/ special equipment - Most activities independance or with assistance (ADL) - weak cough - Low breathing performance -> fatigue - low sitting balance
30
What are the mobility capacities in C7 injury? (tetraplegia)
- drive adapted cars - manual wheelchair for short distance - electric wheelchair for long distance - Independent for transfers, except floor -> chair
31
What is the level of motor functions in C8 injury? (tetraplegia)
- all wrist mvt ✅(wrist flexion complete) - Finger flexion ✅ - Finger ABD/ADD ❌
32
What are the activity limitations/capacities in C8 injury? (tetraplegia)
- All activities of daily living (ADL) are independent. - sitting balance is +/-
33
What are the mobility capacities for C8 injury? (tetraplegia)
- Independent in transfers - Drive adapted car - Manual wheelchair - Can stand in frame
34
What is the level of motor functions in T1-T4 injury? (thoracic paraplegia)
- UL ✅ - Accessory resp. muscle ✅ - Top half of intercostals + long back muscles ✅
35
What are the activity limitations/capacities in T1-T4 injury? (thoracic paraplegia)
- Sitting balance incr. ✅ - Incr. resp. capacity ✅ - ADLs full independance ✅ - Cough still difficult ❌
36
What are the mobility capacities for T1-T4 injury? (thoracic paraplegia)
- Independent in transfers - Drive adapted car - Manual wheelchair - Can stand in frame (// bars), use of KAF orthoses
37
What are KAF orthoses? function?
- Knee-ankle-foot orthoses - To control instabilities in the lower limb by maintaining alignment and controlling motion.
38
What is the level of motor functions for a patient with mid thoracic paraplegia (T5-T9)?
- Latissimus dorsi ✅ -> (usefull for transfers) - intercostals ✅ - upper part of abdominals ✅(-> usefull for sitting balance)
39
What is the activity limitation/capacity for a patient with mid thoracic paraplegia (T5-T9)?
- sitting balance ✅ (due to upper abd) - coughing/breathing ✅ - standing balance +/- ; still impaired ❌
40
What are the mobility capacities for mid thoracis paraplegic patient (T5-T9) ?
- Independent in transfers - Drive adapted car - Manual wheelchair - Can stand in frame (// bars), walking frame, w/ use of KAF orthoses - can take a few steps possible
41
What are the motor functions possible for a T10-T12 injury (paraplegia)?
- all Abd control ✅ - Quadratus lumborus ✅ (->lifting hip) - erector spinae ✅
42
What are the activity limitations/capacities for T10-T12
- Sitting balance incr. ✅ - Standing balance incr. ✅ - Bowel/Bladder care w/ special equipment
43
What is the level of mobility for T10-T12 paraplegic patient?
- Can stand ✅ - Walk from 1m to 10m in // bars or walking frame ✅
44
What are the motor functions for a patient with spinal cord injury at the level of L1-L5?
- all trunk muscles ✅ - Hip flexion ✅ - knee extension ✅ - some knee flexion - some dorsiflexion - some eversion
45
What are the activity limitation/capacities for L1-L5 paraplegic patient?
- Incr. standing Balance ✅ - Bowel/Bladder care w/ special equipment
46
What are the mobility capacities for L1-L5 paraplegia?
- Can walk with AFO (ankle foot orthosis) - Can walk w/ walking aids - Manual WC drive adapted car
47
What are the possible/or not motor function for S1-S5 paraplegia?
- Dorsiflexion ✅ - Plantarflexion ✅ - Knee flexion ✅ - Hip extension✅ - Eversion/inversion ✅ - Weak LL
48
What are the activity limitation/capacities in S1-S5 paraplegia?
- Balance ✅ - Possible bladder & bowel function ✅ - Return to sport possible ✅
49
What is the mobility/locomotion for S1-S5 paraplegic patient?
- Walk ✅ (may be with aids) - Normal car ✅
50
What is the clinical presentation of central cord syndrome?
Motor weakness and sensory loss in the upper limbs.
51
What is the aetiology of CCS?
Damage to the central portion os the spinal cord.
52
What is the aetiology of BSS?
Damage to one side of the spinal cord.
53
What is the clinical presentation of Brown Sequard Syndrome?
- Ipsilateral motor weakness and loss of proprioception and vibration - Contralateral loss of pain and temperature sensation.
54
What is the aetiology of CES?
Compression or trauma to the cauda equina.
55
What is the clinical presentation of Cauda equina syndrome?
Bilateral leg pain, weakness, and numbness, and saddle anesthesia.
56
What are the red flags or special considerations for positioning in patients with spinal cord injury?
-⚠️ Lack of variation can lead to musculoskeletal, dermatologic, or respiratory complications. - ⚠️ The patient should be in a position that permits environmental interaction.
57
What are the red flags or special considerations for transfers and mobility in patients with spinal cord injury?
⚠️ Stabilization with correct key point of control is important to prevent loss of balance. ⚠️ Postural control with appropriate use of KPC is important to prevent loss of postural control. ⚠️ Incorrect management of head control in patients with poor or no head control can lead to complications. ⚠️ Insufficient management and care of hospital equipment for treatment or monitoring, ⚠️ Negligence of safety considerations on the use of assistive equipment can also lead to complications. 🚩In case of spinal fracture in acute, avoid rotation and torsion.
58
What are the red flags or special consideration in therapy associated with therapy?
- 🚩Fractures and dislocations due to loss of muscle tone and sensitivity, most common during stretching. - 🚩Injuries to the upper limbs can be very impairing, bcause UL are used to move around. Careful not to overuse
59
What are the red flags or special considerations for behavior & awareness deficit?
- 🚩Dépression - 🚩 Agression - 🚩 Anxiety - 🚩 Impaired cognitive function due to CSF reduction, leading to loss of consciousness (acute only) - ⚠️ Side effect of medications, often the ones used for neurological pain & spasticity management - ⚠️ Knowledge deficit about condition & prognosis
60
Other red flags or specials considerations?
- 🚩Respiratory (can lead to infection) - 🚩 Deep vein thrombosis (due to reduced use of limbs) - 🚩 Deep tissue damage & pressure injuries (due to cicatrisation) - ⚠️ Contractures (due to immobilizations)

BPT14 - Neuro Rehab (14 decks)

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