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Neuro Specifics
SCI levels, standardized exam tools, etc
| Question | Answer |
|---|---|
| Describe the functional outcome of C1-C3 SCI | -Face and neck innervated -Ventilator to breathe -Power wheelchair with mouth control on most surfaces -Dependent for ADLs and transfers |
| Describe the functional outcome of C4 SCI | -Face, neck, diaphragm, trapezius innervated -Dependent for ADLs and transfers -Independent mobility with power chair with mouth/head controls |
| Describe the functional outcome of C5 SCI | -Biceps, deltoid innervated -Max assist for transfers and bed mobility, maybe sliding board (maxA) -Independent mobility with power wheelchair, joystick -Mod I mobility with manual chair in forward direction on smooth surface only -Min assist ADLs |
| Describe the functional outcome of C6 SCI | -ECRL, pecs, serratus, rotator cuff innervated -Independent with power chair, joystick -Can be mod I with manual wheelchair, transfers, bed mobility, ADLs -Can drive a car with hand controls |
| Describe the functional outcome of C7 SCI | -Finger extensors and triceps innervated -Mod I with manual wheelcahir, ADLs, transfers (even without slide board) -Independent with cough -Can drive car with hand controls |
| Describe the functional outcome of C8-T1 SCI | -Finger flexors innervated -Independent with manual wheelchair with STANDARD RIMS! -I with ADLs, transfers, skin, driving with hand controls |
| Describe the functional outcome of T4-T6 SCI | -Upper half of intercostals and spinal muscles innervated -Independent with manual chair, WHEELIES, wheelchair sports -I with transfers, ADLs -Stand with standing frame -May amb short distances with KAFOs |
| Describe the functional outcome of T9-T12 SCI | -All abdominals and intercostals innervated -Independent with ADLs, transfers, manual wheelchair sports -May amb household distances with KAFOs, high energy consumption |
| Describe the functional outcome of L2-L4 SCI | -Quads, quadratus lumborum, most ant thigh muscles innervated -Independent with manual wheelchair on most terrains -Independent with FLOOR TRANSFERS -Amb with KAFOs |
| Describe the functional outcome of L4-L5 SCI | -Tib ant/post, medial hamstrings innervated -Independent with almost everything -May NOT need manual wheelchair- amb with AFOs |
| Describe the functional outcome of Central Cord Syndrome SCI | -Normal LE, UE weakness with minimal spasticity -MinA to mod I with ADLs, transfers, and wheelchair -Ambulation SBA to Independent |
| Describe the functional outcome of Brown Sequard Syndrome SCI | -Paresis on side of lesion, sensation loss on other side -Independent with ADLs, wheelchair, transfers -Amb with minA to mod I |
| What is the highest level of SCI that could operate a power chair with hand controls (joystick)? | C5 |
| What is the highest level of SCI that could drive a car with hand controls? | C6 |
| What is the highest level of SCI that can cough independently? | C7 |
| What is the highest level of SCI that could use a manual wheelchair with standard hand rims? | C8 |
| What is the highest level of SCI that can potentially amb short distances with orthotics and would be able to perform wheelies (wheelchair sports, uneven terrain)? | T4 |
| What is the highest level of SCI that could amb household distances with KAFOs? | T9 (still high energy comsumption) |
| What is the highest level of SCI that ambulation as primary mode of mobility would be possible (with orthotics)? | L4 |
| Anterior Cord (anterior spinal artery) Syndrome | -Cortiocopinal tract affected (motor function) -Vestibulospinal and Lateral Spinothalamic Tracts most affected (light touch, proprioception, pain, temperature) |
| Central Cord Syndrome | -UE affected, LE not really -LST (pain and temp) most affected -Motor more affected than sensory tracts -Most can walk and have some bowel/bladder control |
| Brown-Sequard Syndrome | -Similar to stroke presentation! -Hemiparesis on side of lesion, also loss of vibration and joint position sense -Loss of pain and temp on opposite side (LST) -Usually recover pretty well |
| Posterior Cord Syndrome | -Rare -Motor fxn ok -Pain, proprioception, 2 pt discrim, and stereognosis deficits |
| Cauda Equina Sydnrome | -Below L1, usually incomplete -Lower motor neuron injury= flaccid paralysis -Full recovery not typical |
| CVA Standard Tests | NIH Stroke Scale (assessment of impairment) FIM (level of assist with mobility and ADLs) Stroke Impact Scale (level of physical and social disability) Fugl-Meyer (motor, sensory, balance, pain, ROM) |
| Bobath theory | -NDT, key points of control -Postural control -Facilitation and inhibition -Reflex inhibiting postures (inhibit abnormal tone/movement) |
| Brunnstrom theory | -Hemiplegia -Synkinesis and phenomenons -Seven stages of recovery |
| Kabatt, Knott, and Voss theory | -PNF -Mass movement, overflow |
| Rood theory | -Use sensory system to facilitate/inhibit motor -Goal of homeostasis -Heavy vs light work -Ex: brushing, icing, approximation |
| At what age do infants start rolling? | 4-5 months supine<->sidelying 6-7 months supine<->prone |
| At what age do infants st independently? | 6-7 months |
| At what age do infants start to crawl and cruise? | 8-9 months |
| At what age do infants start to walk without support? | 12-15 months |
| RLA Level I | No response Appears to be in deep sleep, no response to any stimuli |
| RLA Level II | Generalized response Inconsistent, non-purposeful reaction to stimuli |
| RLA Level III | Localized response Inconsistent, but specific reaction to stimuli |
| RLA Level IV | Confused-Agitated Bizarre, non-purposeful behavior. Unable to cooperate directly with treatment efforts. |
| RLA Level V | Confused-Inappropriate Can respond to simple commands ONLY, most of the time. Severe memory impairment, unable to learn new info. |
| RLA Level VI | Confused-Appropriate Follows simple commands consistently. Shows carryover of relearned tasks. Memory still impaired. |
| RLA Level VII | Automatic-Appropriate Automatic daily routine, robotic. Slow carryover for new learning. Impaired judgement. |
| RLA Level VIII | Purposeful-Appropriate Aware and appropriately responsive to normal environment. Independent with re-learned activities. May still have deficits relative to PLOF (reasoning, judgement, stress response) |
| Glasgow Coma Scale- Eye Opening | Spontaneous 4 To speech 3 To pain 2 Nil 1 |
| Glasgow Coma Scale- Best Motor Response | Obeys commands 6 Localizes pain 5 Withdraws 4 Abnormal flexion 3 Extensor response 2 Nil 1 |
| Glasgow Coma Scale- Verbal Response | Oriented 5 Confused conversation 4 Inappropriate words 3 Incomprehensible sounds 2 Nil 1 |
| Glasgow Coma Scale- What do the scores mean? | 8 or less= severe brain injury 9-12= moderate brain injury 13-15= mild brain injury |
| Brunnstrom Stage 1 | No volitional movement |
| Brunnstrom Stage 2 | Limb synergies appear. Spasticity begins. |
| Brunnstrom Stage 3 | Synergies performed voluntarily. Spasticity increases. |
| Brunnstrom Stage 4 | Movement patterns begin outside of synergies. Spasticity decreases. |
| Brunnstrom Stage 5 | Independence from synergies. Spasticity continues to decrease. |
| Brunnstrom Stage 6 | Isolated joint movements with coordination |
| Brunnstrom Stage 7 | Normal movement is restored |
| What are the superficial sensations? | Pain, temp, touch, pressure |
| What are the deep sensations? | kinesthesia, proprioception, vibration |
| What are the cortical sensations? | stereognosis, 2 pt discrim, grapthesthesia, barognosis |
| MMSE scoring | 27-30= normal cognition. 19-27= mild 10-18= moderate 9 or less= severe impairment |
| Barthel Index- describe | Performance of ADLs (how independent) including continence Score 0-20 with lower scores indicating more disability, need for assist. |
| Modified Rankin Scale | Post-CVA general level of disability, scored 0-6 0= No symptoms 3= Moderate disability 6=Dead |
| Does cerebellar pathology cause hypo or hypertonia? | HYPO |
| Which NDT techniques are used for strengthening? | Repeated contractions Alternating Isometrics Resisted Progression Timing for emphasis |
| What is the timeframe for the Landau reflex? | 3 mo-2 years |
| What is pusher syndrome? | More common in R CVA Lateral deviation TOWARD hemiplegic side |
Created by:
smit4163
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