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726: Phys Dys > spinal cord injuries > Flashcards

spinal cord injuries Flashcards

(56 cards)

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1
Q

SCI causes trauma

A
  • MVA
  • falls
  • diving
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2
Q

SCI non-traumatic

A
  • cancer
  • infection
  • arthritis
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3
Q

tetraplegia

A

4 limbs
inability to voluntarily move the upper and lower parts of the body.
complete and incomplete

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4
Q

paraplegia

A

complete and incomplete

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5
Q

zone of partial

A

preservation

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6
Q

paraparesis and tertraparesis

A

previously described incomplete injuries- no longer used

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7
Q

neurological level diagnosed according to

A

motor and sensory level

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8
Q

functional level refers to

A

lowest segment at which strength of key muscles is graded 3+ out of 5 or greater and sensation is intact

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9
Q

C1 & C2

A

neck flex/ext

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10
Q

C3

A

neck lateral flx

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11
Q

C4

A

scapula elevation

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12
Q

C5

A

shoulder abd and elbow flx

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13
Q

C6

A

elbow flx and wrist ext

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14
Q

C7

A

elbow ext and wrist flx

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15
Q

C8

A

thumb ext

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16
Q

T1

A

finger abd

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17
Q

classification A (most severe)

A
  • complete lesion, no motor or sensory function preserved in sacral segments S4-S5
  • if a client does not have any motor or sensory function in anal and perianal area, as represented by S4-S5, then they would be classified as a complete lesion
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18
Q

classification B

A

incomplete lesion, sensory but not motor function preserved below neurological level and includes sacral segments S4-S5

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19
Q

classification C

A

incomplete lesion, motor function is preserved below neurological level and more than half of key muscles below neurological level have muscle grade less than 3

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20
Q

classification D

A

incomplete lesion, motor function preserved below neurological level and at least half of key muscles below neurological level have muscle grade of 3 or more

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21
Q

classification E

A

motor and sensory functions are normal

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22
Q

syndromes not part of international standards examination or ASIA classification

A

all are incomplete injuries

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23
Q

central cord syndrome

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A

damge to center of spinal cord

24
Q

brown-sequard syndrome (most common)

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A

damage to one side of cord

25
anterior cord syndrome
rare due to absent blood supply to anterior cord
26
cauda equina syndrome
lower motor neuron (LMN) injury to 2 or more of lumbosacral nerve roots within spinal canal
27
conus medullaris syndrome
like cauda equina, but with some cord involvment
28
SCI prognosis affect by
- level and severity of SCI - age - availability & timing of services - living environment
29
SCI respiratory complications (pneumonia)
leading cause of death in 1st year of life after SCI
30
lesions above C4, damage to phrenic nerve (breathing nerve)
- partial or complete paralysis of diaphragm | - require ventilatory support, tracheostomy
31
lower cervical and thoracic spine injuries can result in paralysis of other breathing muscles
difficulty coughing and deep breathe
32
Autonomic Dysreflexia
AD
33
hyperactive reflex of ANS below area of injury causess
- distended bladder - bladder irritation (overfull catheter bag) - fecal mass - pain stimuli - menstruation
34
hyperactive reflex of ANS below area of injury above
T4-T6 levels
35
hyperactive reflex of ANS below area of injury medical emergency and
can be life threatening
36
autonomic dysreflexia (AD) symptoms
- muscle spasiticy - flushed face - pounding headache - sweating - erection of body hair (goose bumps) - nasal congestion - bradycardia - emergency
37
autonomic dysreflexia treatment (tx)
- place individual in upright position or raise head to 90 deg - lower legs if able - loosen constictive clothing - bladder should be drained - monitor blood pressure every 5 minutes (>T6 normal systolic 90-110 mmHg range)
38
orthostatic hypotension, pooling of blood in
LE's and abdomen due to decreased muscle tone
39
orthostatic hypotension
- results in decreased BP (hyptension) - supine to upright position or positional changes quickly - symptoms dizziness, nausea and loss of consciousness - recline quickly or tip back and elevate feet - compression garments/ stockings, abdominal binders and medications also help reduce symptoms
40
other complications after SCI
- neurogenic bladder and bowel - decubitus ulcers - decreased vital capacity - spasticiy - heterotopic ossification
41
additional secondary issues SCI
- temperature regulation - pain - fatigue and sleep issues - changes in muscle tone - thromboembolism (DVT) - pyschosocial issues - sexual function
42
sexual function SCI males
- affects erections and ejaculation - psychogenic erection is unlikely - reflexogenic erection may be possible with manual stimulation - decrease sperm count
43
sexual function SCI females
- menstruation can come for weeks to months - fertility not affected - pregnancy discomfort may cause AD
44
initial OT evaluation
- occupational profile - evaluation of performance skills - evaluation of performance in areas of occupation
45
occupational profiles
COPM, OPHI-II
46
performance areas & skills
- functional independence measure (FIM) - spinal cord independence measure (SCIM) - The Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) - Jebsen Test of Hand Function - sollerman hand function test
47
Client factors
- MMT - ROM - Muscle tone - pinch - grip - sensation
48
general objectives for OT tx
- maintain/ increase ROM - increase strength - increase activity tolerance - maximize ind with self care and ADL's - explore leisure interests - aid with psychosocial adjustments - AE/DME training - potential home modifications - increase/ maintain communication skills - pt/ family/ caregiver training - prevent skin breakdown
49
tx methods acute phase/ immobilized phase
- traction or stabilization devices - AVOID flexion, extension and rotation of spine and neck - splinting (tenodesis)
50
tx methods tenodesis splint
- splint positions thumb under index and middle finger - wrist extension splint transfers force into thumb - help client grasp items
51
tx methods active phase
- mobilization phase - sitting in wheelchair - instruction on pressure relieving techniques
52
tx methods universal cuff for
feeding, brushing teeth, painting, etc
53
tx methods mobile arm supports
-alllow intact shoulder girdle muscles to move hands
54
adaptive equipment
- universal cuff - reacher - transfer bench - plate guard
55
tx methods ADLs
- bed ladders - self-catherization - environmental control units should be considered - adapted driving
56
OT intervention outpatient
- adaptive driving - home management - leisure activities - vocational and work skills - other IADLs

726: Phys Dys (7 decks)

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