2.29 SCI 4

Question 1

some SCI respiratory characteristics

Answer 1

• ind in airway clearance
• weak functional cough
• nonfunctional cough

Question 2

independent in airway clearance

Answer 2

• forceful, loud, 2 or more coughs per exhalation

- get stuff out of the mouth

Question 3

weak functional cough

Answer 3

• soft, less functional
• 1 per exhalation
• ind for clearing throat
• assistance needed to clear secretions

Question 4

nonfunctional cough

Answer 4

• sigh
• trying, but don’t have negative pressure
• no true cough
• need assistance their entire life for airway clearance

Question 5

SCI pts and lung function

Answer 5

they lose a lot of lung function depending on level of injury

Question 6

treatment for respiratory issues

Answer 6

• incentive spirometry
• teach them how to use accessory muscles to breathe
• quad cough
• abdominal bracing may help so the diaphragm works against some resistance
• some percussion therapy or postural drainage etc

Question 7

teaching how to use accessory muscles to breathe

Answer 7

• act like a frog trying to suck up a big

- “sniff” and feel what happens to your neck

Question 8

quad cough causes

Answer 8

forceful expiration

Question 9

Why are SCI pts at risk for decubitus ulcers?

Answer 9

• sedentary
• lack of sensation
• poor circulation
• initial weight loss (lose muscle mass and cushioning over bony prominences)
• nutrition, etc

Question 10

Positioning with an SCi pt

Answer 10

• positioning is huge: need to offload all the time

- full weight shift off of the surface

Question 11

pressure ulcers put pts at risk for

Answer 11

infection

Question 12

PT treatment of SCI pts with ulcers

Answer 12

• positioning
• padding
• changing positions
• specialized beds
• watch skin

Question 13

s/s orthostatic hypotension

Answer 13

• dizzy
• lightheaded upon changing from supine to sitting
• happens a lot with SCI pts

Question 14

SCI pts at risk for passing out

- sequelae

Answer 14

• lose color top down
• may have blank stare
• may only make short answer
• steps become very slow, etc

Question 15

important things to prevent orthostatic hypotension

Answer 15

• TED hose

- hydration

Question 16

TED hose

Answer 16

keep everything without motor control with a little bit of pressure to facilitate blood flow

Question 17

hydration concerns with SCI pts

Answer 17

• elderly and SCI pts don’t want to hydrate a lot because it takes a lot of energy to go to the bathroom
• have to always do intermittent catheterization

Question 18

When does a DVT often occur with SCI pts?

Answer 18

typically occurs early on in their therapy as their body is trying to figure out the new norm

Question 19

Why is it important to monitor for DVT in an SCI pt?

Answer 19

they won’t be able to feel pain or warmth

Question 20

s/s of an active PE

Answer 20

• having trouble breathing

- tired and haven’t done anything

Question 21

What should you do if a pt is showing s/s of an active PE?

Answer 21

• need to check out their O2 stat

- sit them down and check them

Question 22

blood thinners

Answer 22

• coumadin

- lovenox

Question 23

DVT that becomes a stroke: What is FAST

Answer 23

• Face
• Arms
• Speech
• Time

Question 24

signs that a DVT may be becoming a stroke?

Answer 24

• drooling

- coughing with each swallow

Question 25

When do we do sensory on the ASIA scale?

Answer 25

between T1-L2: the one instance where we will defer to sensory to give them a level of injury - 2 intact - 1 impaired - 0 nothing

Question 26

Why don't we do MMT for trunk muscles in T1-L2 range?

Answer 26

- difficult to determine level | - shelf of strength at level and a drop off

Question 27

T1 vs. T10 injury and balance

Answer 27

- T1 will need more arms for balance | - T10 will have a good base of support

Question 28

Going from top down on level of the lesion, where do you draw the line?

Answer 28

- draw the level of the lesion at the highest point, even if there's 5's below the level - Only reason you'd go lower is that there's a documented reason for there to be a 4 or lower at that level

Question 29

C5

Answer 29

elbow flexors

Question 30

C6

Answer 30

wrist extensors

Question 31

C7

Answer 31

elbow extensors

Question 32

C8

Answer 32

finger flexors

Question 33

T1

Answer 33

finger abductor

Question 34

L2

Answer 34

hip flexors

Question 35

L3

Answer 35

knee extensors

Question 36

L4

Answer 36

ankle dorsiflexors

Question 37

L5

Answer 37

big toe extensors

Question 38

S1

Answer 38

plantarflexors