Neuro Quiz #2 - ASIA and Examination

What is a good indicator of whether someone has precautions or not?

they come into the clinic with some type of brace

What are some medical or orthopedic precautions?

WB status

physiological stability

internal organs

True or False: we want to test the hip with resistance if there is a lumbar fracture

FALSE

Spinal precautions may include limited testing of:

ROM

functional mobility

muscle testing

The patient needs to be a(n) ____ participant in history taking.

active

We want to measure a patient's PROM if they are _____.

functionally relevant

Some key joints/flexibility to measure for function are ____.

pec

biceps

finger flexors

hamstrings

rec fem

gastroc

Hamstring flexibility with a stable pelvis may impact the patient in which position?

long sitting

We want to look at PROM of long finger flexors because we want the patient to assume a _____ grip.

tenodesis

Which two muscles are going to be important to be flexible for standing in the future for someone with an SCI?

rec fem

gastroc

Precautions for an unstable lumbar spine are ____.

no hip flexion >90 degrees

SLR greater than 60 degrees

Some examples of functionally relevant muscles that should be tested are ____.

deltoids, serratus anterior, lattisimus dorsi, trunk, hip extensors, abductors, adductors, hamstrings

You test other functionally relevant muscles if _____.

there is some function in that limb

True or False: if someone has a 3/5 strength in their trunk but a 0/5 strength at their L2 level, we should continue to test the lower extremity functionally relevant musculature.

FALSE; no function in LE, so no need to additionally test functionally relevant musculature

The ____ sign measures if someone with SCI has abdominal function.

Beevor's Sign

The positive Beevor's sign is ____.

if the umbilicus moves up, there is some function above the umbilicus

A ____ Beevor's sign is when there is no contraction or no movement.

negative abnormal

A negative normal Beevor's sign is when ____.

the umbilicus hasn't moved but there is some contraction of the abdominal muscles

There is generally (hyper/hypo)tonia following injury.

hypotonia

True or False: an involuntary contraction counts as a strength grade.

FALSE; it is a false strength grade

How does one distinguish between voluntary and involuntary contraction?

ask the patient to contract them relax on demand

The _____ is the most comprehensive balance test for those in the SCI population.

MiniBEST

Other balance tests you can perform with those with SCI are ____.

FRT

Tinetti POMA

Berg

SBACSI

True or False: tasks need to be observed and not just take the patient's word for it.

TRUE

The equivalent of the FIM for a patient with SCI is the ___.

SCIM

Other functional outcome measures for an individual with SCI are ___.

WISCI and SCIFAI

Participation outcome measures are most important in which rehab setting?

outpatient

Standardized participation assessments for SCI include:

craig handicap assessment and reporting technique

craig hospital inventory of environmental factors

community integration questionnaire

assessment of life habits

impact on participation and autonomy questionnaire

Areas of ____ are more prone to breakdown.

scarring

True or False: Areas of scarring can return to full normal.

FALSE; never return to full normal

True or False: almost all SCI patients will have some impairments of breathing and coughing.

TRUE

____ complications increase mortality.

respiratory

What might be done to start respiratory management early?

breathing exercises, abdominal support, assisted cough

What are four things we want to ask about a patient with SCI's pain?

Onset

intermittent/constant

relieving/aggravating factors

past interventions if chronic (past medical history - do they have a rotator cuff tear or a previous ankle reconstruction?)

Which levels of SCI have no functional ambulation?

C1-C8

C1-C4 has ____ assistance with bed skills, transfers, and is ____ with a manual wheelchair with ____.

total; independent; head/chin/mouth/breath

Level C___ has some assist with bed skills, some assist to independent with even transfers, and some to total assist with uneven transfers.

6

Level C5 has ____ assist with bed skills, ____ assist with transfers, and is ____ with hand control and pressure reliefs.

some; total; independent

Level C___ has independent to some assistance for bed mobility, independent with even transfers and independent to some assistance with uneven transfers.

7-8

Level C7-8 are ____ with a manual wheelchair indoors and outdoors on level terrain, and are ____ with unlevel terrain/

independent; some assistance

Levels ____ to ____ are independent with bed skills, and independent with even and uneven transfers.

T1-S5

Levels T1-S5 are ____ using a manual wheelchair indoors and outdoors on level and unlevel terrain.

independent

Functional ambulation is ____ for those with T1-9 SCI.

not typical

Levels ___ to ___ typically need ___ assistance or is independent using KAFOs and AD for ambulation.

T10-L1; some

Levels L2-S5 typically uses ____ and needs ___ assistance or is independent for ambulation.

KAFOs and AFOs; some

When writing goals, we want to focus on ____ rather than ____.

functional outcomes; impairments