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Neuro Specifics

SCI levels, standardized exam tools, etc

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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