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93 Cards in this Set
- Front
- Back
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most common spinal cord segments that are injured |
c1-2, c5-7, t12-L2 |
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is your life expectancy the same with spinal cord injury |
no slightly lesshe |
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where does the eighth spinal nerve exist |
between c7 and T1 |
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where is cauda equina |
after L1 |
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how is damage described in spinal cord injury |
by the level of mechanism and the location |
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common ways you injure spinal cord |
hyperflexion hyperextension compression |
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below l1 the spinal injury is gonna effect what |
lower |
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what is secondary damage due to |
vascular and inflammatory response to the primary spinal cord injury |
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when does secondary damage occur |
over days and weeks following the initial injury |
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ways to limit secondary damage |
immobilization stabilize the spine antiinflammatories |
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ways to stabilize to prevent secondary damage |
HALO TLSO |
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what is spinal shock |
all activity ceases at, below, or slightly above the level of injury no functiojn below the level no sensory or motor impoulses or reflexes |
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what is post spinal shock coming out |
reflexes start coming back below the level of injury |
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how to determine extent/ level of injury? |
assess strength (motor level) sensation (sensory level) ABCDE is assigned related to wether the injury is complete or incomplete as well as the neurological level t |
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what is the lowest ASIA level of injury |
motor- muscle stregth of three; muscles above 5 sensory: where pin prick and light touch are normal |
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what is the asia level for complete |
A |
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describe complete SPI |
no voluntary anal contraction no s4-5 sensation and no deep anal sensation |
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what is an incomplete asia SPI letter |
B-E |
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describe an incomplete SPI |
sacral sparing present partial or complete preservation of motor and or sensory function of S4 and s5 |
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word meaning involvement of all four extremities |
tetriplegia |
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where t1 or below is the first level for paraplegia |
paraplegia |
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spinal cord injury syndromes |
brown-sequard anterior cord central cord cauda equine |
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what is brown sequard syndrome |
1/2 of the spinal cord ipsilateral motor loss and propriception/ vibration loss contralateral side: loss of pain and temperature |
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what is central cord syndrome |
hyperextension injury in the cervical spine upper extermities more affected |
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cauda equine syndrome |
injury to l1 or below lower motor neuron injury
flaccididty, areflexia, loss of bowel and bladder |
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clinical manifestations of SCI |
motor and sensory loss cardiopulmonary dysfunction impaired temp control spasticity bowel and bladder dysfunction sexual dysfunction |
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complication of SCI |
pressure sores autonomic dysreflexia posture hypotension pain contractures heterotrophic ossificans DVT osteoporosis and renal caliculi respiratory compromise bowel and bladder dysfunction spasticity |
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234 staying phrenic nerve to diaphragm |
alive |
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bony promininces more susceptible |
pressure ulcer |
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pressure relief for ulcers |
pressure relief every one minutes for ecery 15 change positions every 2 hours |
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in injuries above T6 sns and pns acticity impaired function of the autonomic ns |
autonomic dysreflexia |
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what causes autonomic dysrelfexia n |
bowel or bladder full disruption of catheter scrotal compression noxious cutaneous stimulu below the level of the lesion pressure sores kidney stones passive stretch to patients hip |
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signs of autonomic dysreflexia |
HTN, severe pounding headache, vasoconstriction below the level of the lesion, vaso above, sweating, constricted pupils, goosebumps blurred vision, bradycardia (fight or flight kicking on) sns issue below the level higher levels are trying to slow that down |
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treating autonomic dysreflexia |
keep in sitting they have an elevated BP that their body cant get down find the cause and remove it meds |
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signs and symptoms postural hypotension |
drop in BP with sititng or standing |
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treating postural hypotension |
abdominal binder TED hose slowly acclimate to upright |
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neuropathic pain |
at above or below the level of injury sharp stabbing burning hypersensitive response to non noxious stimuli hard to treat |
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nociceptive pain |
musculoskeletal usually involves the shoulders and wrist hands dull aching pain |
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contractures for sci trtm |
usually flexion treatments: maintain rom, prevent deformity, positioning splints |
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where does het oss occur |
below the level of injury |
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s/s of het os |
ROM limitations swelling warmth pain |
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what can prevent DVT |
early mobs anticoagulant TED hose compression devices |
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cause and trtm of osteoperosis and renal calculi |
demineralization due to lack of WB calcium from the bones is absorbed in the blood is deposited in the kidneys causing kidney stones early mobes standing physiological ambulation |
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cause and trmt for respiratory compromise |
cause: decreased muscle innervation of respiration trtmt: early upright position abdominal corset cough techniques |
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how do we handle bladder and bowel issues with SCI |
drugs to pee schedule for bowel excavation |
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important thing about sexual dysfunction |
women can still get pregnant |
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important stuff about spasticity |
can maintain muscle bulk even though it is not intentional manage it with stretch |
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key muscles for c1-c3 |
SCM scalenes partial upper trap |
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key muscles c4 |
upper middle lower trap diaphragm muscles partially |
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key muscles c4 |
upper middle lower trap diaphragm muscles partially |
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c1-3 muscles require what |
ventilator dependent ADL dependent power wc |
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c4 issues |
ventillator inititally may be able to wean has all the c1-3 too |
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c4 issues |
ventillator inititally may be able to wean has all the c1-3 too |
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c5 muscles |
full diaphragm partial delts biceps brachialis brachioradialis |
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c5 muscles |
scap stab/mob rhomboids partial scalenes partial pec major may be able to assist with adls han dto mouth |
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C6 muscles |
wrist extensors scap stab mob partial lat partial serratus partial pec major tendonesis grasp |
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c7 muscles |
get their triceps back wrist flexors, finger and wrist extensors, partial lat |
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c8 muscles |
finger flexors full wrist and finger extensors full lat |
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c7-8 muscles function |
first level where there is potential to live independent |
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T1 |
finger abductors |
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t1- t12 |
in/external intercostals, erector spinae, abdominals transfers independently without a slide board independent adls |
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muscles L2 |
hip flexors quadratus lumborum manual wheelchair |
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L3 function |
may be able to ambulate with afos and crutches or a walker |
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l4 and l5 muscles |
anterior tib, long toe extensors hip abd hams |
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s1 muscles |
gastroc-soleus hip extensors |
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l4 -5 and s1 function |
ambulate with afos may not need assistive device may need wc for longer disgtances s1 can ambulate without ad |
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how many degrees do they need for lower extremity rom for hip flex and hip er |
flex 110 er 45 |
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PT interventions |
prevent deformity + maintain ROM strengthen weak muscles endurance and mat activities |
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how do we utilize motor learning for SCI |
early in the development of the skill utilize extrinsic and more frequent feedback then decrease feedback break into parts early on |
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what are these: avoiding stress at the fracture site skin integriy blood pressure fall risk overstretching overuse |
common precautions with SCI |
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what is head hip training |
move head in one direction to move hips in opposite direction |
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what are the 4 compensatory trainings |
head hip control momentum substitution task modification |
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things not to do with upper extremity ROM |
stretch or position fingers in extension for c6 and above (stretching/rom, function) overstretch the thumb web space or cervical extensors |
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amount of shoulder extension needed for supine to long sit |
60 |
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amount of elbow extension needed for locking elbows in sitting transfer |
90 |
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rom needed with tendinesis need how much wrist extension |
90 |
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things not to do for lower extremity ROM |
overstretching the lower back make sure the pelvis is stabilized with hamstring stretching |
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how much hamstring flexibility and hip external rotation is needed for dressing in long sitting |
110 and 45 |
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what do we do with the muscles that still are there |
strengthen them |
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key muscles to strengthen for tetriplegia |
anterior delt shoulder extension biceps scapula stabilizers |
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key muscles to strengthen with paraplegia and c7-8 tetriplegia |
triceps, lats, shoulders scap depressors |
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how to develop endurance in SCI |
20-60 minutes per day high reps low weight wc training gait etc |
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describe the respiratory program |
teaching frog breathing diaphragm strength ribcage expansion assistive cough |
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exercises in prone on elbows |
approximations weight shifting alternating isos rythmic stabil scap strength |
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what are the benefits of lying prone on elbows for sci |
fascilitates head and neck control stability of glenohumeral joint and scap stab |
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what can you work on in supine |
ham stretching bed mobility preparing for long sit weight shifting |
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why is long sitting functional |
dressing skin inspection, self stretching. |
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What is the fate for T2 to T11? |
Therapeutic standing or ambulation only |
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What is the fate for T2 to T11? |
Therapeutic standing or ambulation only |
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What is the feet for T 12 to L2 |
Potential for household ambulation |
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What is the fate for T2 to T11? |
Therapeutic standing or ambulation only |
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What is the feet for T 12 to L2 |
Potential for household ambulation |
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Fate for L3, and below |
Potential for community ambulation |
