3.2 Other SCI issues 2

Question 1

What activity can cause autonomic dysreflexia and why?

Answer 1

• sex

- repeated stimulus your body picks up on

Question 2

pain considerations

Answer 2

• surgical pain over the site

- radicular pain

Question 3

SCI and DJD

Answer 3

• quadriplegic at risk for DJD

- happens in the spine because all upper body weight on the spine with no muscular support

Question 4

Who are UTIs a life-threatening issue for?

Answer 4

• elderly

- SCI pt

Question 5

Why are UTIs life-threatening?

Answer 5

• won’t feel the pain from a UTI

- by the time it’s really bad, they’ll have fever, achy, malaise. May also have foul odor

Question 6

What can be caused by a UTI for SCI pts?

Answer 6

• can create additional spasticity if systemic

- autonomic dysreflexia

Question 7

What increases the risk of getting a UTI?

Answer 7

If pt doesn’t have independent bladder control, have an 80% chance of having a UTI at some point

Question 8

heterotopic ossification in SCI pt

Answer 8

• happens at a higher rate in SCI patient
• lays down bone inside the joint
• get drastic, fast decreased in ROM, need to address (pt education)

Question 9

What is the endfeel for heterotopic ossification?

Answer 9

• bony endfeel

- warm (inflammatory response)

Question 10

Where would you want contracture in an SCI pt?

Answer 10

• low back

- finger flexors

Question 11

low back contractures in SCI

Answer 11

want tight thoracolumbar fascia

• over time, it will stretch out
• the tighter we can keep it, the better our head hip relationship is

Question 12

What is a major problem with pregnant SCI pts?

Answer 12

laxity (esp with thoracolumbar fascia)

Question 13

How much dorsiflexion does an SCI pt need?

Answer 13

10˚

Question 14

How much hip flexion does an SCI pt need?

Answer 14

110˚

Question 15

Why do we want finger flexors to get tight for an SCI pt?

Answer 15

tenodesis grip

- can do passive finger flexion with active wrist extension

Question 16

finger flexor nerve level

Answer 16

C8

Question 17

wrist extension level

Answer 17

C6

Question 18

Who gets educated on tenodesis grip?

Answer 18

anyone without hand control

Question 19

What can be done for osteoporosis in an SCI pt?

Answer 19

• not a lot we can do about it
• try standing just for upright, WB, digestion, etc
• could do some estim

Question 20

benefit to using FES

Answer 20

• may create upflow to cause neuroplasticity just by causing the motion in the body
• seeing if the spinal cord can heal that way

Question 21

What causes scoliosis in SCI pts?

Answer 21

• seated position
• muscle imbalances
• repetitive stress

Question 22

muscle imbalance effects

Answer 22

• affect respiratory status

- wound issues: bony prominences where there wouldn’t be before

Question 23

repetitive stress: what to consider for an SCI

Answer 23

think about poor spinal alignment and transfers

Question 24

GI issues for an SCI pt

Answer 24

• don’t have normal motility (higher risk of impaction)
• upper GI stress ulcers
• IBS

Question 25

metabolic/endocrine: initially

Answer 25

- typically lose some at the beginning because of decreased muscle mass - in therapy a lot, pushed

Question 26

metabolic/endocrine:What can happen when they get home?

Answer 26

- gets out of the house and does things | - stays at home: depression, may find comfort in food

Question 27

low level para calorie burn and strength

Answer 27

- lower level para will burn a LOT of calories | - can get very strong

Question 28

quad calorie burn

Answer 28

- quads don't have a lot to do to burn calories - typically have to cut down on what they eat - "quad belly"

Question 29

What does quad weight gain affect?

Answer 29

can affect balance and base of support

Question 30

Which types of SCI have decreased cardio function?

Answer 30

higher level injuries

Question 31

Why measure based on RPE instead of THR for SCI pts?

Answer 31

- difficult especially with quads | - don't have much to work with

Question 32

potential autonomic issues for SCI pts?

Answer 32

can their body regulate sympathetics and parasympathetics?