20. SCI

Question 1

where does the spinal cord end

Answer 1

L1

Question 2

what is the DCML tract do

Answer 2

sensory
(Poor Val got GBS 2x keep fighting)
proprioception
vibration
graphesthesia (draw)
barognosic (pressure/wt)
stergonosis - (eyes closed guess object)
2pt discrimination
kinesthesia,
fine touch

Question 3

what is ALS

Answer 3

anterolateral system

has
anterior spinothalamic tract
lateral spinothalamic tract

Question 4

what is anterior spinothalamic tract responsible for

Answer 4

crude touch - feel it yes or no

Question 5

what is lateral spinothalamic tract responsible for

Answer 5

pain and temp

Licensed PT

Question 6

what is DCML

Answer 6

dorsal column medial leminscus

Question 7

corticospinal tract

Answer 7

motor tract - descending tract

Question 8

which tracts are ascending

Answer 8

sensory

Question 9

posterior cord syndrome

Answer 9

DCML tract

rare usually caused by iatrogenic (medical error)

Question 10

anterior cord syndrome

Answer 10

hyper flexion injury

tract: STT and corticospinal
function: pain/temp and motor

loss of movement pain and temp, still able to feel position vibration and touch

Question 11

brown squared syndrome

Answer 11

hemicord syndrome
all tracts on 1 side

caused by stab wound or gunshot

pain and temperature affected on opposite side (brown POT)

Question 12

central cord syndrome large lesion

Answer 12

MUD-E
motor
UE more affected
Distal more affected
extension injury is typical cause

B/L DCML, CST, ALS

Question 12

central cord syndrome small lesion

Answer 12

pain and temp bilaterally affected

Question 13

conus medullaris

Answer 13

bilateral and symmetrical in perineum and thighs

sensory - saddle distribution, bilateral, symmetric

motor - symmetric

type - UMN and LMN

Question 14

cauda equina

Answer 14

unilateral and asymmetrical in perineum, thighs, leg, back

sensory - saddle distribution, unilateral, asymmetric

LMN type

Question 15

complete injury

Answer 15

no sensory or motor function in the lowest sacral segments (S4 and S5)

Question 16

incomplete injury

Answer 16

motor and/or sensory function below the neurological level including sensory ad/or motor at S4 and S5

Question 17

incomplete syndromes

Answer 17

anterior cord
posterior cord
brown squared
central cord

Question 18

key muscles associated with C5

Answer 18

elbow flexors

Question 19

key muscles associated with C6

Answer 19

wrist extensors

Question 20

muscles associated with C7

Answer 20

elbow extensors

Question 21

muscles associated with C8

Answer 21

finger flexors

Question 22

muscles associated with T1

Answer 22

5th finger abductors

Question 23

Muscles associated with L2

Answer 23

hip flexors

Question 24

muscles associated with L3

Answer 24

knee extensors

Question 25

muscles associated with L4

Answer 25

ankle DFs

Question 26

muscles associated with L5

Answer 26

long toe extensors

Question 27

muscles associated with S1

Answer 27

ankle PFs

Question 28

sensory level injury level

Answer 28

the most caudal segment of the spinal cord with normal sensory function on BOTH sides of the body lowest level where sensation is 2/2 and all above levels are 2s

Question 29

motor level of spinal cord injury

Answer 29

lowest level at which strength is 3/5 and all levels above is 5/5

Question 30

neurological / functional level of SCI

Answer 30

the most caudal segment od the spinal cord with normal sensory and motor function on BOTH sides of the body find the motor and sensory level and pick the higher one (superior)

Question 31

ASIA A

Answer 31

complete - no motor or sensory function at S4/S5

Question 32

ASIA B

Answer 32

sensory incomplete - sensory intact but no motor function present below NLI and S4/S5 no motor function more than 3 levels below injury

Question 33

ASIA E

Answer 33

normal

Question 34

ASIA C

Answer 34

motor incomplete majority below NLI are /= 3/5

Question 35

ASIA D

Answer 35

motor incomplete majority of muscles below NLI >3/5 at least HALF of key muscles below NLI having a muscle grade >/=3/5

Question 36

autonomic dysreflexia/hyperreflexia

Answer 36

cardiac complication at or above T6 pt has noxious stimuli below level of lesion rise in systolic BP of 20 to 30 mmHg is diagnostic of episode more common in chronic stage (3-6m after injury); can be in acute too more common with complete SCI call 911

Question 36

complications with SCI and PT interventions

Answer 36

orthostatic HTN autonomic dysreflexia respiratory dysfunction urinary and bowel pressure ulcers contracture, weakness, tone

Question 37

causes of autonomic dysreflexia

Answer 37

fracture below level of lesion labor sexual activity GI irritation painful stimulus below level bladder/bowel irritation

Question 38

signs and symptoms of autonomic dysrexia

Answer 38

increase BP - systolic 20-30 decrease HR severe headache, anxiety constricted pupils, blurred vision flushing, piloerection above level dry, pale skin below lesion increased spasticity

Question 39

intervention for AD

Answer 39

SIT UP and LOWER LEGS remove painful stimuli - loosen clothing, abdominal binder CHECK BLADDER distension - unclamp catheter and drain it monitor vitals throughout

Question 40

walking SCI

Answer 40

central cord large lesion C5 can walk B/L DCML, ALS , CST (UE>LE), pain and temp can walk to the door but can't open it

Question 41

functional level C1-C4

Answer 41

transfers: mechanical lift wheel chair: power wc - head/chin/mouth control

Question 42

functional level c5

Answer 42

Transfers: dependent using slide board WC: manual WC - plastic coated hand rims

Question 43

functional level c6

Answer 43

transfers - independent with sliding board WC: manual WC - plastic coated hand rims

Question 44

functional level c7/c8

Answer 44

Transfers: even: independent without sliding board, uneven - dependent on sliding board C8 - may be able to do floor to WC WC: manual wc - plastic coated hand rims C7 - independent on even surface, not with ramps/curbs C8 - independent with ramps/ccurbs

Question 45

functional level t1

Answer 45

transfers: floor to WC WC: independentu

Question 46

functional level t4

Answer 46

transfer: sitting pivot WC: independent

Question 47

functional level L3

Answer 47

transfers: L3 WC: indepdent