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34 notecards = 9 pages (4 cards per page)

Viewing:

otd 570: pain + spinal injuries

front 1

A client with a C8 spinal cord injury is working on independence with their bowel and bladder routine. Which of the following is the MOST appropriate recommendation?

back 1

Likely independent with digital stimulation and intermittent catheterization

front 2

A client with an incomplete SCI has intact sensation at S4-5 but no motor function below the injury. What ASIA classification is this?

back 2

B

front 3

Which spinal cord syndrome is characterized by loss of motor function, pain, and temperature sensation below the level of injury while preserving proprioception?

back 3

Anterior cord syndrome

front 4

What is the most common cause of death in individuals with a spinal cord injury?

back 4

Pneumonia

front 5

Which of the following describes a compensatory strategy for a client with reduced sensation in their hands?

back 5

Visual scanning and use of unaffected hand for temperature checks

front 6

A therapist is using silicone sheets and massage to manage a client’s scar formation after surgery. Which phase of healing is this most appropriate for?

back 6

Maturation

front 7

A client with a hand injury is unable to feel light touch but can detect deep pressure. How should this be documented?

back 7

Loss of protective sensation

front 8

Which phase of wound healing involves fibroplasia and new blood vessel growth?

back 8

Proliferative

front 9

What is the best way to document a client’s sensory function after testing with
Semmes-Weinstein Monofilaments?

back 9

The smallest monofilament size detected

front 10

A client who describes pain as "a burning sensation that spreads down the arm" is most likely experiencing:

back 10

Neuropathic pain

front 11

Which of the following is NOT a typical sensory assessment used in occupational
therapy?

back 11

Berg Balance Scale

front 12

At what level is bowel and bladder function affected?

back 12

Below S2 - S4

front 13

Hypotension: _/_ mmHG

back 13

90/60 mmHG

front 14

Normal: _/_ mmHG

back 14

120/80 mmHG

front 15

Hypertension: _/_ mmHG

back 15

130/80 mmHG

front 16

Semmes Weinstein Monofilaments

Green (1.65-2.83):

back 16

Normal; recognition of touch and deep pressure

front 17

Semmes Weinstein Monofilaments

Purple (3.84-4.31):

back 17

Diminished light touch; fair use of hand, intact temp/stereognosis

front 18

Semmes Weinstein Monofilaments

Red (4.56 & up):

back 18

Diminished protective sensation; difficult manipulating objects, drops
objects, has temp and pain awareness

front 19

Semmes Weinstein Monofilaments

Red (no response to 6.65):

back 19

Loss of protective sensation; little hand use, reduced temperature
appreciation, intact pressure, high risk of injury

front 20

Semmes Weinstein Monofilaments

back 20

Loss of all sensation

front 21

Moberg Pick-Up Test (Stereognosis)

back 21

Assesses hand dexterity and functional sensibility
Tested with vision and with vision occluded

front 22

Vibration

back 22

Inability to sense may indicate nerve compression or inadequate
sensory re-innervation

front 23

Desensitization

back 23

Start early- so long as no open wounds and there are complaints of
hypersensitivity

  • ◦Grade stimulus materials: fine ⇒ coarse
  • Grade type of contact, gentle to strong:
    • passive touch -> moving rub ->tap
  • Gradually increase force, duration, frequency of stimulus
  • Immersive exploration in graded background

front 24

Specific Reeducation Protocols: Wynn-Parry & Dellon

back 24

  • Mostly for PNI
  • Stroke fingertips with static/moving deep touch (pencil eraser)
    • Alternating with/without vision
  • When 256 cps vibration perceived
    • Stimulate with varying textures/manipulate objects of differing
      sizes/textures

front 25

Hyperalgesia

back 25

  • Increased pain in response to a stimulus because of sensitized peripheral afferents
  • bumping your shin on a coffee table at thelocation of a bruise (likely from the sametable)

front 26

Allodynia

back 26

  • Perceiving innocuous stimuli as painful
  • Putting on a shirt over a sunburn

front 27

Spontaneous pain

back 27

  • Temporally distinct from an external stimulus; often appears to be unprovoked
  • Often described as burning pain, shootingsensations, or electrical sensations

front 28

Temporal summation

back 28

  • Perception of increased pain in response to a repeated or continued presence of a stimulus
  • Increasing pain with each repetition of a therapeutic exercise

front 29

Secondary hyperalgesia

back 29

  • “spread” of pain to adjacent, uninjured areas
  • Entire finger is painful even though the paper cut is localized

front 30

CHRONIC PRIMARY PAIN

back 30

  • Pain matrix dysfunction (central sensitization)
    • Fibromyalgia
  • Pain syndromes
    • Complex regional pain syndrome
      (CRPS)
    • Chronic non-specific low back pain

front 31

CHRONIC SECONDARY PAIN

back 31

  • Nociceptive
    • Osteoarthritis
    • Cancer pain
  • Neuropathic
    • Phantom pain

front 32

Chronic Secondary Pain Syndromes

back 32

  • Arthritis
  • Cancer
  • Myofascial
  • Traumatic injury

front 33

Neuropathic Pain Examples

back 33

PNI
Small fiber neuropathy
Amputation
Phantom pain

front 34

Mechanisms of Wound Healing

back 34

  • Tissue regeneration
    ◦Regeneration of identical cells without loss of function
  • Tissue repair
    ◦Damaged tissue is replaced, but new tissue lacks the structure and function of the original tissue
  • Primary closure (skin)
    ◦Wound edges are in close proximity with little or not tissue loss
    ◦Think sutures
  • Secondary closure
    ◦Wounds heal through contraction & re-epithelialization