Watch the video version of this Q&A episode on YouTube - https://youtu.be/KBHY0lDN4sY

A physical therapist utilizes a manual assisted cough technique on a patient who has a mid-thoracic spinal cord injury. When completing this technique with the patient in the supine position, which of the following locations is the MOST appropriate for placement of the therapist’s hands?

1. Xiphoid process
2. Epigastric area
3. Umbilical region
4. Suprapubic region

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist utilizes a manual assisted cough technique on a patient who has a mid-thoracic spinal cord injury. When completing this technique with the patient in the supine position, which of the following locations is the MOST appropriate for placement of the therapist’s hands?

1. Xiphoid process
2. Epigastric area
3. Umbilical region
4. Suprapubic region

The degree of respiratory impairment is related to the level of the spinal cord injury, residual muscle function, trauma at the time of injury, and premorbid respiratory status. 

Weakness or paralysis of the abdominal muscles compromises the patient’s ability to cough and expel secretions.

Manual Assisted Coughing
Manual assisted cough techniques can assist individuals with spinal cord injuries with a weak or absent cough to clear the airway of mucous. 

Inability to clear mucous from the throat or lungs can lead to significant respiratory impairments including pneumonia.

Let’s explore each of the options:

Option 1 - Xiphoid process 
The xiphoid process is a small cartilaginous extension to the lower part of the sternum that is usually ossified in the adult. Pressure over this region should be avoided.

Option 2 - Epigastric area 
The epigastric area is the upper central region of the abdomen, located between the costal margins and the subcostal plane. Applying manual hand pressure inwards and upwards over the epigastric area can assist the patient to cough and promote airway clearance.

Option 3 - Umbilical region 
The umbilical region is the area surrounding the umbilicus (i.e., belly button). This region is too low to provide effective pressure to assist with coughing efforts.

Option 4 - Suprapubic region 
The suprapubic region is the area below the umbilical region between the two ilia. This region is too low to provide effective pressure to assist with coughing efforts.

The correct answer is Option 2

Let’s explore the all student data:
26% of students selected Option 1, Xiphoid process
52% of students selected Option 2, Epigastric area, the correct response
20% of students selected Option 3, Umbilical region
2% of students selected Option 4, Suprapubic region

System Classification
This question is a Cardiovascular and Pulmonary Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is an Interventions question which represents approximately 29% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!