NDT Final
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| show | Neurological Level of Injury
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| up to 3 neurological segments at the point of damage to the SC where there is frequently some preservation of motor &/or sensory function is what? | show 🗑
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| show | Complete Injury
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| If patient has no contraction or sensation or anal sphincter muscle when finger inserted, are they complete or incomplete? | show 🗑
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| Preservation of any motor &/or sensory function below the zone of injury, which includes sacral sensory sparing is what kind of SC injury? | show 🗑
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| Impairment or loss of motor &/or sensory function in the cervical neuro segments 2ndary to damage of neural elements within SC is? | show 🗑
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| Impairment or loss of motor ∨ sensory function in the thoracic, lumbar, or spinal canal. Includes cauda equina & conus medullaris injuries, but not root abulsion/peripheral n injury outside neural canal. | show 🗑
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| If a person receives a SC injury at level T1 or below, they are termed what? | show 🗑
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| ASIA- No sensory or motor function in sacral segment S4-5. May have sensation up to S4-5 | show 🗑
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| Preservation of sensation below the level, extending through S4-5. No mvmt beyond zone of injury. | show 🗑
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| Preservation of motor function, with majority of key mm below leve of injury having MMT <3. | show 🗑
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| show | D= incomplete (Motor useful)
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| Recovery of normal motor & sensory function | show 🗑
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| What syndrome includes an injury through sacral cord & lumbar n roots traversing the neural canal with areflexic bladder, bowels & LEs? | show 🗑
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| What syndrome includes an injury below the conus to lumbosacral n roots within the neural canal with areflexic bladder, bowels & LEs? | show 🗑
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| What syndrome includes a dissociation in degree of motor weakness with lower limbs stronger than upper limbs & sacral sensory sparing? (Usually arms more involved than legs) It is often from a blunt force. | show 🗑
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| show | Brown-Seguard Syndrome
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| What occurs when nerve signals try to go up & can't, so they go down, then back up, leading to peripheral artery constriction, & thus escalation of BP? | show 🗑
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| Symptoms of Autonomic Dysreflexia | show 🗑
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| show | Sit them up (lower BP)!; Check catheter (unkink if necessary); Loosen clothing, remove abdominal binder/ted hose; Ask about bowel/check for increased distention; If still unresolved, call EMS!
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| Respiratory Issues of SCI pts | show 🗑
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| show | Decreased BP; Use of ted hose, abdominal binder, medication, lay pt down with legs elevated; slowly elevated patient over time
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| What occurs when there is growth of bone in a muscle near a joint? | show 🗑
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| show | No, once it occurs, it can't be taken out!
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| S/sx of Heterotrophic Ossification | show 🗑
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| S/sx of pulmonary embolism (EMERGENCY) | show 🗑
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| show | Swelling to extremity; Pain; Low-grade fever; Warmth
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| show | Finger flexers; Thumb webspace; Low back extensors
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| show | Muscles need to be tight to have a functional "quad body"
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| How many hours of therapy does a patient have to tolerate in in-patient rehab? | show 🗑
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| show | Pneumonia/respiratory conditions
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| Nerve roots/muscles for inspiration | show 🗑
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| Why are abdominal binders utilized? | show 🗑
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| show | Passive- Normal breathing; Active- cough, speak, sing, exercise
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| How can a patient's airway be cleared after an SCI? | show 🗑
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| Abdominal Thrust (assisted cough) | show 🗑
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| Lateral/costophrenic assist (assisted cough) | show 🗑
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| Which muscles are needed to roll over in bed? | show 🗑
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| Turning in bed should be done how often? | show 🗑
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| How often should pt shift weight while sitting in a w/c? | show 🗑
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| Bladder: T12 & above; small capacity with occasional spasms; spastic sphincter; indwelling/suprapubic options; intermittent cath (every 4-6 hrs) | show 🗑
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| Bladder: T12 & below/spinal shock; Flaccid sphincter; Large capacity; Incontinent with valsalva/increased intra-abdominal pressure; Catheter (every 4-6 hrs) | show 🗑
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| Bowel: 1-2 days; meds-softeneres; suppositories; diet- high fiber & fluid | show 🗑
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| Bowel: 1-2 days; Flaccid sphincter (DO NOT stretch with dig stim); Meds- avoid softeners; Suppositories; Diet- high fiber & fluids | show 🗑
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| show | Dig stim; Position with knees higher than hips; Side to side lean; Assist with ant/post weight shifts, depression lifts, credea massage, hot drinks/timing after meals
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| show | Manual evacuation; Valsalva; Positioning- knees higher than hips, side to side lean; Assist with ant/post weight shifts, depression lifts, Cerdea massage, hot drinks/timing after meals
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| What are specifications for an at-home ramp? | show 🗑
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| show | Straight entry- 32"
Turn entry- 36"
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| show | No reflexes; Flaccidity; Loss of sensation/mvmt below LOL; Lasts several hours-several weeks; Early resolution=good
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| Bulbocavernosus Reflex | show 🗑
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| Another name for autonomic dysreflexia is... | show 🗑
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| Why does autonomic dysreflexia happen? | show 🗑
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| Why does postural hypotension happen? | show 🗑
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| Postural hypotension more common in which areas of lesion? | show 🗑
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| show | Below LOL can't shiver; No vasodilation/constriction in response to heat/cold; no sweating-excessive compensatory diaphoresis above LOL; INcomplete lesions- spotty areas of localized sweating BLOL
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| show | C1-C2/3; must use ventilator or phrenic n simulator
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| show | Bronchopneumonia & Pulmonary Embolism
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| show | Flattening of upper chest wall, decreased chest wall expansion, dominant epigastric rise during inspiration
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| show | Expiration; Negative intrathoracic pressure moves air into lungs
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| show | BLOL after spinal shock; increases during first 6 mos
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| What will increase spasticity? | show 🗑
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| show | Slight weight-bearing; Assisting with xfers
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| show | UTI
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| Bladder is what during spinal shock? | show 🗑
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| Bladder with a lesion within cord above conus medullaris? | show 🗑
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| show | Contracts & reflexively empties in response to certain filling pressures
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| Spastic (reflexive) bladder is aka what? | show 🗑
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| show | Flaccid (Areflesive/Non-reflex) bladder
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| Flaccid Bladder | show 🗑
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| show | LMN Bladder
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| show | Intermittent catheterization & restriction of fluid intake
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| show | Timed voiding; establish intake & voiding schedule
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| Use what with a reflexive bowel? | show 🗑
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| Use what with a non-reflexive bowel? | show 🗑
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| Male erectile capacity | show 🗑
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| show | External stimulation of genitals/perineum. Needs intact reflex arc.
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| Psychogenic Erection (Male) | show 🗑
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| show | Higher incidence with LMN, esp with low LOL; better with INcomplete lesion
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| show | Males; female fertility is unaffected
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| Female sexual response with UMN | show 🗑
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| show | Psychogenic responses but no reflexogenic responses
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| show | 1-3 mos post-injury, regardless of LOL or complete/incomplete
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| show | can get pregnant but not perceive labor pains; this could trigger autonomic dysreflexia
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| 2 most influential factors in developing pressure sores | show 🗑
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| Loss of vasomotor control causes pressure sores why? | show 🗑
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| Spasticity causes pressure sores why? | show 🗑
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| Pressure sores from skin maceration occurs why? | show 🗑
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| Nutritional deficiencies can lead to pressure sores how? | show 🗑
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| DVTs according to Barb | show 🗑
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| show | first 2 months
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| Prolonged pressure on body parts leads to? | show 🗑
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| Loss of vasomotor tone & immobility? | show 🗑
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| show | Paralysis + spasticity, faulty positioning, HO, edema
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| Contractures commonly seen in what positions? | show 🗑
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| HO is what, in relation to joint & capsule? | show 🗑
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| show | swelling; decreased ROM; erythema; local warmth near joint; (-) X-ray initially
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| Does surgery prevent recurrence of HO? | show 🗑
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| show | As body heals, subsides. May need to be immobilized for injuries other than just SCI; +/- analgesics, TENS
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| show | May arise from damage or/near site of cord damge= sharp, stabbing, burning, shooting. Follows dermatomes. Most common in cauda equina injuries. Drugs; +/- TENS; Possible surgery.
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| Spinal Cord dysesthesia | show 🗑
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| show | Shoulder, occurs above LOL
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| show | Faulty positioning ∨ inadequate ROM
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| show | Changes in Ca2+ metabolism--osteoporosis BLOL & development of renal calculi. Following SCI, net loss of bone mass b/c rate of resorption>rate of new bone formation. Increased fractures first 6 mos.
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| Treat osteoporosis & renal calculi with what? | show 🗑
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