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SCI
| Question | Answer |
|---|---|
| Zone of partial perservation | complete injuries that have some innervation of dermatomes below level of injury |
| Spinal shock | initial stage, lasting between 24 hours and 6 weeks, reflex activity ceases resulting in spasticity |
| C1-C4 | respiratory assist dep for ADL limited head and neck movement sympathetic system compromised, autonomic dysreflexia, no bowel or bladder control electric wheelchair with sip and puff |
| C5 | breathing with diaphragm dep for ADL full head and neck movement, raise arms and flex elbows, no extension sympathetic compromised, autonomic dysreflexia, no bowel or bladder control electric wheelchair with hand controls |
| C6 | mod assist for personal care full head and neck movement ability to raise arms and flex elbows, no extension some wrist extension little bowel or bladder control electric w/c w/ hand controls manual chair for short distances drive with hand contr |
| C7 | limited assist for personal care extend elbows wrist flexion and extension partial finger movement little bowel/bladder control independent transfer |
| C8 | independent with personal care |
| T1-5 | normal UE ROM and strength little bowel or bladder manual wheelchair |
| T6-T12 | stand in standing frame or walk with braces |
| L1-L5 | normal respiratory partial paralysis in hips and legs |
| s1-s5 | some loss of function in hips and legs able to walk with assist or aids though slowly with difficulty can load wheelchair into car independently |
| orthostatic hypotension | position in supine, elevate legs above heart move slowly for supine to sit |
| autonomic dysreflexia | stand person loosen restrictive clothing check catheter for obstruction |
| heterotopic ossification | maintain ROM |
| DVT | check color, size, temperature |
| Bowel and bladder | affected for all injuries above s2-s5 |
| Approach recommended | top-down approach |
| Acute recovery phase | education, environmental control, UE ROM |
| UE ROM emphasis in acute recovery | scapular rotation, shoulder scaption, shoulder external rotation, elbow extension, forearm pronation |
| Positioning in acute recovery | 80 deg shoulder abduction external rotation with scapular depression full elbow extension forearm pronation |
| Tenodesis splint | dorsal, wrist in extension, thumb in opposition wrist drive wrist-hand orthosis |
| C5 tetraplegia physical intervention | mobile arm support grasp and hold require wrist stabilization and use of an assistive device such as u-cuff or c-clamp |
| C6/7 tetraplegia physical intervention | greater innervation of shoulder girdles greater force for rolling in bed and crossing midline tenodesis grasp wrist-drive wrist-hand orthosis (tenodesis splint) maximize pinch strength |
| C8 tetraplegia physical intervention | grasping with MCP extension and DIP/PIP flexion |
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10212468994420890
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