Week 2

Question 1

• based on the musculoskeletal system - muscles, tendons, bones, nerves
• looks at posture and alignment
• helps them develop better habits and prevents injuries
• skin breakdown can occur if parts of the body are pushing on others

Answer 1

biomechanical FOR

Question 2

the best biomechanical alignment gives a patient the best what?

Answer 2

the best chance of doing the activity the best they can - sets pt. up for best performance

Question 3

• looks at the interaction between person, activity, and environment
• if something is affected in one of those areas, it can affect the other areas and the person’s ability to perform the task

Answer 3

occupational adaptation FOR

Question 4

• always some aspect of learning involved

- how does one acquire and apply knowledge

Answer 4

acquisition FOR

Question 5

• try to make people better - is it a temporary thing or is it permanent
• if it’s permanent, we use compensation

Answer 5

rehab FOR

Question 6

if someone has a permanent disability, based on the rehab FOR, what should you do?

Answer 6

compensation - change the task, change the tools/equipment, using assistive technology or adaptive equipment

Question 7

describe a screening.

Answer 7

-general, through an interview, less formal, brief

Question 8

describe an evaluation.

Answer 8

more in depth than a screening

Question 9

describe a formal eval.

Answer 9

• planned, standardized test

- goniometric measures

Question 10

describe an informal eval.

Answer 10

• conversation, observation, interview

- ex: ROM - raise your hands, reach behind your back, etc.

Question 11

describe a standardized eval.

Answer 11

there are absolute instructions that you need to follow in order to use the norms that come with it.

Question 12

describe a non-standardized eval.

Answer 12

• can still be formal, but not enough people haven’t been tested using it - no norms
• don’t have to follow exact instructions
• can use a standardized eval. in this way if you don’t use the norms.

Question 13

what does C5 innervate?

Answer 13

diaphragm, elbow flexors

Question 14

name the 4 areas that we assess in rehab?

Answer 14

• sensory
• motor
• psychosocial
• cognition & behavior

Question 15

what is the ultimate plan for rehab?

Answer 15

discharge

Question 16

when does discharge planning begin?

Answer 16

at admission

Question 17

describe respiratory considerations initially after injury.

Answer 17

often requires intubation

Question 18

describe respiratory considerations if the lesion is below C5.

Answer 18

there is a good chance that the person will eventually be able to breathe on his/her own

Question 19

describe respiratory considerations if the lesion is between C3 and C5.

Answer 19

may or may not need mechanical ventilation

Question 20

describe respiratory considerations if it is a high injury (C3 or higher).

Answer 20

need ventilator

Question 21

describe respiratory considerations if it is an incomplete injury.

Answer 21

difficult to predict outcome of respiratory abilities.

Question 22

suctioning is __ __ on presence of trach tube.

Answer 22

NOT dependent

Question 23

suctioning is not dependent on presence of __ __.

Answer 23

trach tube

Question 24

name 6 signs of need for suctioning/distress.

Answer 24

1. frightened look
2. flared nostrils
3. restlessness
4. paleness or bluishness around mouth
5. clammy skin
6. sinking in of the chest (retractions)

Question 25

goes directly into the trachea and points incoming air into the lungs.

Answer 25

trach tube

Question 26

the trach tube prevents what?

Answer 26

aspiration pneumonia

Question 27

when the cuff is inflated and trach is in place, what happens?

Answer 27

the person can't talk - air isn't going past vocal folds

Question 28

if the cuff is deflated or ventilator is disconnected, what happens?

Answer 28

air passes the vocal folds to allow the person to talk

Question 29

allows some air to go out mouth and nose if open.

Answer 29

fenestration hole

Question 30

inside trach tube, blocks fenestration window if person isn't ready to breath out mouth and nose

Answer 30

inner canula

Question 31

describe a hollow inner canula.

Answer 31

no fenestration - so air is not escaping if paired with an outer canula with fenestration

Question 32

describe a solid inner canula.

Answer 32

closes hole in trachea so 100% of breathing has to be through nose and mouth - can be used for 15 mins or however long during weaning process

Question 33

used for someone who needs less support breathing or is able to breath on their own.

Answer 33

fenestration canula

Question 34

forces the air in and sucks the air out

Answer 34

mechanical ventilation

Question 35

external way to assist air in expelling if a person is choking while on a trach.

Answer 35

assisted cough

Question 36

when someone is coughing you should make sure of what?

Answer 36

that they are disconnected from ventilator tube - have to do it quick since they are disconnected from tube.

Question 37

when someone with a trach is coughing where will body fluids exit?

Answer 37

their neck (not mouth or nose)

Question 38

when should suctioning occur?

Answer 38

always after meals

Question 39

with a cervical injury, the placement of a halo is usually restricted to how many degrees of which movement?

Answer 39

usually restricted to 90 degrees flexion/abduction at shoulders

Question 40

name 3 orthopedic considerations with SCI.

Answer 40

- usually restricted to 90 degrees flexion/abduction at shoulders - prevent overstretching low back - UE external rotation

Question 41

name 4 common medical complications and interventions of SCI.

Answer 41

- autonomic dysreflexia - orthostatic hypotension - deep vein thrombosis - heterotopic ossification

Question 42

the impairment is complete; there is no motor or sensory function left below the level of injury.

Answer 42

Grade A SCI (ASIA scale)

Question 43

the impairment is incomplete; sensory function but not motor function is preserved below the neurologic level (the first normal level above the level of injury) and some sensation is preserved in the sacral segments S4 and S5.

Answer 43

Grade B SCI (ASIA scale)

Question 44

the impairment is incomplete; motor function is preserved below the neurologic level, but more than half of the key muscles below the neurologic level have a muscle grade less than 3 (they are not strong enough to move against gravity)

Answer 44

Grade C SCI (ASIA scale)

Question 45

the impairment is incomplete; motor function is preserved below the neurologic level, and at least half of the key muscles below the neurologic level have a muscle grade of 3 or more (the joints can be moved against gravity)

Answer 45

Grade D SCI (ASIA scale)

Question 46

the patient's functions are normal; all motor and sensory functions are unhindered.

Answer 46

Grade E SCI (ASIA scale)

Question 47

- lesion at the level of sacral micturition reflexes or peripheral innervation of the bladder - accompanying detrusor muscle dysfunction - external sphincter tone and perineal mm tone are diminished - voluntary urination does not occur but can be achieved through supra pubic pressure

Answer 47

flaccid bladder

Question 48

what is a flaccid bladder also known as?

Answer 48

areflexia or areflexive bladder

Question 49

occurs with lesion above the level of sacral control of micturition (S2-S4)

Answer 49

spastic bladder

Question 50

what is spastic bladder also known as?

Answer 50

reflex neurogenic bladder or spastic neurogenic bladder