quiz #1 – spinal cord treatment

  1. what does ASIA stand for
    American Spinal Injury Association
  2. what is the main focus of treatment in the first 2 – 4 weeks
    • medical stability
    • treatment of other injuries
    • stability of surgery – fusions are common to stabilize fracture, patients refer to this as rods or cages
  3. what is the main focus of treatment during 4 –6 weeks
    • seating and adaptive equipment
    • transfer training
    • Tolerance to sitting/standing
    • Weight-bearing if appropriate – ASAP
    • Patient and family education
    • Planning for next phase of rehab, home modifications
  4. what is the main focus during outpatient therapy
    • neuromuscular recovery
    • Ambulation
    • Tolerance to sitting/weight-bearing
    • Balance
    • Posture
    • Strength
  5. true or false – outpatient therapy is on-again and off-again because patients can hit plateaus in performance
  6. what is compensation
    treatment focused on teaching patient to use what strength they have to accommodate for motor loss as a result of spinal cord injury
  7. what is recovery
    more recent treatments focus on stimulating the neuromuscular system to promote recovery or regrowth of neurons
  8. what are some types of treatments for compensation
    • early-onset of bracing in splinting
    • limited weight-bearing
    • bed mobility, transfers
  9. what are some treatments for recovery
    • locomotor training
    • Estim (FES) – FES bikes, Bioness
    • Early initiation of weight-bearing
    • Facilitation to achieve appropriate kinematics with all activities
  10. what is Locomotor training
    complex treatment that focuses on specific motor neurons to get muscles working
  11. what is the goal of locomotor training
    goal is to stimulate and retrain the nervous system for recovery of function – sensory, motor, decreased muscle spasm, improve B&B control
  12. true or false – this is an example of locomotor training
    Image Upload 2
    • true
    • goal is to retrain the nervous system
  13. true or false – the best treatment is a combination of compensation and recovery
  14. what are some complications of spinal cord injuries
    • autonomic dysreflexia
    • pressure ulcers
    • posture/scoliosis
    • pulmonary embolism, deep vein thrombosis
    • orthostatic hypotension
    • urinary tract infection, bowel complication
    • tone, spasm
    • contractures
    • decreased bone density
  15. autonomic dysreflexia is an issue for injuries above _____
  16. what is the cause of autonomic dysreflexia
    triggered by noxious stimulus, is an imbalance between parasympathetic and sympathetic activity
  17. true or false – autonomic dysreflexia can be a medical emergency, the cause must be found and removed immediately
  18. true or false– autonomic dysreflexia can be a lifelong problem
  19. true or false – research shows 10 min. out of every hour is minimal requirement to allow re-vascularization of superficial blood vessels
    • true
    • this is especially important in spinal cord injuries because the patient's are at an increased risk of developing pressure ulcers
  20. what is pressure mapping
    is a special device that shows area of increased pressure that are at increased risk of ulceration. This helps the therapist to choose appropriate cushion
  21. what are some important things to remember when addressing postural collapse/scoliosis
    • impaired mobility may cause gravity to increase scoliosis and pelvic obliquities
    • adjustments should be made to seating surface and seat back to assist patient with upright posture
    • once a scoliosis curve develops gravity will generally assist with development of obliquity and progression of both
  22. true or false – patients who suffer from a spinal cord injury have an increased risk of pulmonary embolism's and deep vein thrombosis
  23. orthostatic hypotension is also known as?
    postural hypotension
  24. what causes orthostatic hypotension
    • decrease in blood pressure as a result of change in position
    • supine to sit
    • sit to stand
    • result in dizziness, fainting
  25. what is the treatment for orthostatic hypotension
    slow progression of position changes
  26. UTI stands for?
    urinary tract infection
  27. what increases the risk of urinary tract infection
    catheter use
  28. what are some of the signs and symptoms of urinary tract infection
    changing color, consistency or smell of urine, pain with urination, change of frequency
  29. how can a physical therapist help the patient who suffers from a urinary tract infection
    patient should be educated in clean technique with catheters and how to monitor for complete emptying
  30. true or false – patients that suffer from joint contractures are at an increased risk of ulceration
  31. what are some of the psychosocial issues for a patient that suffers from a spinal cord injury
    • depression
    • grieving
    • anxiety
    • changes in personality
    • changes in family and other relationships

    Probably not going to be excited about therapy
  32. what are some issues a physical therapist should educate a patient with a spinal cord injury
    • pressure relief
    • signs and symptoms of urinary tract infection
    • signs and symptoms of autonomic dysreflexia
    • proper proportion techniques
    • home exercise program to maximize recovery – because our time is very limited
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quiz #1 – spinal cord treatment
spinal cord treatment