Sci 4

Front 1

10 key muscles are evaluated

10 Right

10 Left

Total: 20

Back 1

Myotomes

Front 2

Elbow Flexion (Biceps)

Back 2

C5

Front 3

Wrist Extension (ECRL)

Back 3

C6

Front 4

Elbow Extension (Tricep)

Back 4

C7

Front 5

Finger Flexion (FDP)

Back 5

C8

Front 6

Finger Abduction (Abd. Digiti Minimi)

Back 6

T1

Front 7

Hip Flexion (lliopsoas)

Back 7

L2

Front 8

Knee Extension (Quads)

Back 8

L3

Front 9

Ankle Dorsiflexion (T.A)

Back 9

L4

Front 10

Big toe extension (EDL)

Back 10

L5

Front 11

Ankle plantar flexion (Gastrocnemius)

Back 11

S1

Front 12

0- Absent

1Trace

2 Poor

3 Fair

4- Good

5- Normal

Total Motor Index Score (TMIS)- 100

Back 12

Grading: (MMT)

Front 13

Compute the total motor index score of an SCI patient whose muscles at L2 level and above are graded good, muscles at L3 and L4 are graded poor and remaining muscles are graded zero

Back 13

72

Front 14

to preserve tendonesis effect in C6, avoid:

Back 14

wrist ext + finger ext

Front 15

L2 above good (B), L3-L4 poor:

Back 15

56

Front 16

biceps, triceps, wrist extensors normal bilaterally, finger flexion & abduction fair bilaterally, all LE poor=

Back 16

62

Front 17

4 stages of ambulation:

Back 17

standing only

therapeutic ambulation

household ambulation/ indoor ambulation

community ambulation/ outdoor ambulation

Front 18

walk between parallel bars with assist

Back 18

therapeutic ambulation

Front 19

T3-T11

Back 19

therapeutic ambulation

Front 20

T2 up

Back 20

standing only

Front 21

T12-L2

Back 21

household ambulation/ indoor ambulation

Front 22

L3 down

Back 22

community ambulation/ outdoor ambulation

Front 23

Period of areflexia immediately following SCI

Back 23

Spinal Shock

Front 24

Flaccidity and loss of sensation below the level of the lesion

Back 24

Spinal Shock

Front 25

Generally subsides within 24 hours

Back 25

Spinal Shock

Front 26

(+) BCR

Back 26

Spinal Shock

Front 27

1st reflex that returns first

Back 27

BCR

Front 28

S1-S2

Back 28

bulbocavernosus reflex

clitocavernosus reflex

Front 29

pinch the glans penis (+) contracts the anal sphincters

Back 29

bulbocavernosus reflex

Front 30

pinch the glans clitoris (+) contracts the anal sphincters

Back 30

clitocavernosus reflex

Front 31

Velocity dependent increase in muscle tone

Back 31

Spasticity

Front 32

Spasticity Management:

Back 32

1. Bacloren-Drug of Choice

2. Surgical- Myotomy, Tenotomy, Neurectomy, Rhizotomy, Myelotomy

3. PT/OT-Icing (Slow), NMES, PROME, Stretching

Front 33

Spasticity Drug of Choice

Back 33

Bacloren

Front 34

Level: T6 up

Back 34

Autonomic Dysreflexia (AD)

Front 35

S/Sx:

Increase BP

Decrease HR (Bradycardia).

Pounding

HA

Diaphoresis

Piloerection

Facial Flushing

Constricted Pupils

Nasal Congestion

Blurred Vision

Back 35

Autonomic Dysreflexia (AD)

Front 36

Acute Management:

Elevate Head (Sit patient up)

Back 36

Autonomic Dysreflexia (AD)

Front 37

Level: T6 up

Back 37

Postural Hypotension (PH)

Front 38

S/Sx:

Decrease BP

Increase HR (Tachycardia)

Lightheadedness

Dizziness

Faintness

Back 38

Postural Hypotension (PH)

Front 39

Acute Management: Elevate Legs

Back 39

Postural Hypotension (PH)

Front 40

most common cause of autonomic dysreflexia

Back 40

Bladder Distention

Front 41

Heterotopic Ossification (HO)

SCI

Back 41

Hip> Knee> SH> Elbow

Front 42

Heterotopic Ossification (HO)

TBI

Back 42

Shoulder

Front 43

Heterotopic Ossification (HO)

CVA-

Back 43

Shoulder

Front 44

Heterotopic Ossification (HO)

Burns

Back 44

Post Elbow

Front 45

Heterotopic Ossification (HO)

Lab

Back 45

Increase Serum Alkaline Phosphatase

Front 46

Heterotopic Ossification (HO)

Pharma

Back 46

Disodium Ethidronate

Front 47

surgical removal of the muscle

Back 47

myotomy

Front 48

surgical removal of the tndon

Back 48

tenotomy

Front 49

surgical removal of the peripheral nerve

Back 49

neurectomy

Front 50

surgical removal of the nerve roots

Back 50

rhizotomy

Front 51

surgical removal of the SC fibers

Back 51

myelotomy

Front 52

PT/OT management for spasticity:

Back 52

1. Slow Icing

2. NMES

3. PROMES

4. stretching

Front 53

decreases Gamma motor neuron firing (intrafusal fibers)

Back 53

slow icing

Front 54

autogenic inhibition principle= fatigue effect on the spastic ms.

Back 54

NMES (neuromuscular electrical stimulation)

Front 55

standard management for spasticity (slow, maintained and prolonged)

Back 55

stretching

Front 56

autonomic dysreflexia aka

Back 56

autonomic hyperreflexia

Front 57

medical emergency

Back 57

increase BP

Front 58

d/t vagal stimulation compensation

Back 58

decrease HR

Front 59

profuse sweating

Back 59

diaphresis

Front 60

postural hypotension aka

Back 60

orthostatic hypotension