SCI

Question 1

No motor or sensory function is preserved in sacral segments S4-S5, what level of SCI injury is this on the ASIA scale

Answer 1

A (complete)

Question 2

Sensory function is preserved but not motor function below the neurological level and includes the sacral segments of S4-S5, what level of SCI injury is this on the ASIA scale

Answer 2

B (incomplete)

Question 3

Motor function is preserved below the neurological level and more than half the key muscles below the neurological level have a muscle grade of less than 3 what level of SCI injury is this on the ASIA scale

Answer 3

C (incomplete)

Question 4

Motor function is preserved below the neurological level and at-least half the key muscles below the neurological level have a muscle grade of 3 or more what level of SCI injury is this on the ASIA scale

Answer 4

D (incomplete)

Question 5

Motor and sensory functions are normal what level of SCI injury is this on the ASIA scale

Answer 5

E (normal)

Question 6

What is the mechanism of injury in brown sequard syndrome

Answer 6

Hemisection of the spinal cord (damage to one side)»_space; penetration wound, gunshot, stab

Question 7

Clinical features of brown sequard syndrome

Answer 7

• Ipsilateral flaccid paralysis & loss of proprioception, light touch, and vibration sense at lesion level
• Ipsilateral spastic paralysis and loss of vibration and position sense below the lesion level
• contra. Loss of pain & temp sense below lesion level
• asymmetrical

Question 8

Anterior cord syndrome mechanism of injury

Answer 8

Anterior portion of the spinal cord»_space; flexion injuries of the cervical region (compression to the anterior cord from fracture, dislocation, or disk protrusion)

Question 9

Clinical features of anterior cord syndrome

Answer 9

-Loss of motor function below lesion
- loss of pain & temp below lesion
- proprioception, light touch, vibration are preserved

Question 10

Central cord syndrome mechanism of injury

Answer 10

Central aspects of the spinal cord, hyperextension injuries of the cervical region (typically results in hemorrhage and edema leading to compressive forces on the central portion of cord)

• can also be due to congenital and degenerative narrowing of spinal canal

Question 11

Clinical features of central cord syndrome

Answer 11

• neurological involvement of UE > LE
• sensory impairment happens on varying degrees but less serves than motor deficits (distal > proximal)
• sacral sensation and motor function preserved

Question 12

Posterior cord syndrome mechanism of injury

Answer 12

Posterior portion of spinal cord > tumor or abscess compressing spinal cord

Question 13

Posterior cord syndrome clinical features

Answer 13

Loss of proprioception, pressure, and vibration but no motor affection (preserved)

Question 14

Cauda Equina syndrome clinical features

Answer 14

• damage to spinal nerve roots below L1
• reflexive bowel, bladder, saddle anesthesia
• LE paralysis is variable depending on extent of injury to the cauda equina

Question 15

Autonomic dysfunction is common following a spinal cord injury particularly at ____ level and above. Presenting more commonly in the chronic phase of spinal cord injury around _______ months

Answer 15

T6 and above / 3-6 months

Question 16

Signs & symptoms of autonomic dysreflexia above the level of the injury

Answer 16

• vasodilation
• systolic BP increase
• Bradycardia
• sweating
• flushed face
• headache

Question 17

Signs & symptoms of autonomic dysreflexia below the level of the injury

Answer 17

• vasoconstriction
• pale cool skin
• no sweating

Question 18

Glossopharyngeal breathing may be appropriate for patients with a high level cervical lesion who are dependent on mechanical ventilation or for patients with mid to high cervical lesions who are not dependent on mechanical ventilation. True or False

Answer 18

True

Question 19

Individuals with injuries below ____ are likely to have near normal ventilators and respiratory function

Answer 19

T10

Question 20

Injuries above ___ will decrease heart rate

Answer 20

T4

Question 21

• the patient may not breath on their own, cough, nor control bladder and bowel movements
• ventilator + ADL dependent
• independent use of power wheelchair with sip and puff
• 24 hours a day personal care

Which level of SCI injury is this

Answer 21

C1-C4

Question 22

• breath independently (abdominal binder)
• raise their arms and bend elbow
• independently using manual wheelchair with propulsion rims, power wheelchair can move from place to place independently
• need assistance in ADL

Which level of SCI injury is this

Answer 22

C5

Question 23

• wrist extension affected
• limited hand activity and grip
• may drive adapted vehicle
• avoid stretching finger flexors (maintain functional tenodesis grip)
• can transfer with sliding board

Which level of SCI injury is this

Answer 23

C6

Question 24

• elbow extension & finger extension
• can do most ADL alone but need assistance with complex tasks

Which level of SCI injury is this

Answer 24

C7

Question 25

- hand movement, grasp & release - can do ADL but need assistance with complex tasks Which level of SCI injury is this

Answer 25

C8

Question 26

- can use manual wheelchair - stand with standing frame, walk with HKAF orthosis - mainly affects trunk and LE Which level of SCI injury is this

Answer 26

T1-T5

Question 27

- fair to good ability in controlling and balancing trunk in seated pos. - can cough productively (if abs intact) - manual wheelchair use - standing frame and walking with KAF orthosis Which level of SCI injury is this

Answer 27

T6-T12

Question 28

- loss of function in hip & legs - little to no voluntary control of bowel and bladder (but can manage independently with equipment) - depending on strength may need a wheelchair or may walk with braces - if L3 & lower may use AFO What level of SCI injury is this ?

Answer 28

L1-L5

Question 29

- loss of function in hips and legs - little to no control of bowel and bladder but can manage with special equipment - most likely will be able to walk What level of SCI injury is this ?

Answer 29

S1-S5

Question 30

- loss of function in hips and legs - little to no voluntary control of bowel or bladder but can manage with special equipment - depending on strength of legs may need a wheelchair or maybe all with braces - L3 & lower may use AFO orthoses What level of SCI injury is this

Answer 30

L1-L5

Question 31

- loss of function in hips and legs - little to no voluntary control of bowel or bladder but can manage with special equipment - most likely able to walk What level of SCI injury is this

Answer 31

S1-S5