ASIA Classification Flashcards
ASIA A
Complete
-NOON sign
No:
Sacral sensation S4-S5
Deep Anal Pressure
Voluntary Anal Contraction
ASIA B
Sensory Incomplete
Have:
Sacral SENSATION, DAP and VAC
No:
Sacral MOTOR in VAC
MOTOR return of 3 levels below MOTOR level
VAC
Voluntary Anal contraction
DAP
Deep Anal Pressure
Sacral Sensation/Motor
S4-S5
ASIA C
Motor Imcompete
Have:
Sacral SENSATION, DAP and VAC
Sacral MOTOR in VAC
MOTOR return of >3, below MOTOR level
No:
>3 muscle grade 50% or more muscles beflow NEURO level
ASIA D
Motor Imcomplete
Have:
Sacral SENSATION, DAP and VAC
Sacral MOTOR in VAC
MOTOR return of >3, below MOTOR level
>3 50% or more muscles beflow NEURO level
No:
Normal Sensory and motor
ASIA E
Normal
-normal sensory and motor after SCI
Anterior Cord Syndrome
-A. Spinal Artery stroke
-Paralysis, analgesia, loss of discriminative sensation, loss of temp below lesion
-Keep proprioception and light touch (DCML)
Central Cord Syndrome
-trauma induced
-tumors
-Nueromyelitis optica
-hyperextension
-syringomyelia
Small Lesion: pain and nociception impaired at level of lesion
Large Lesion: pain and nociception impaired at level of lesion AND UE motor issues
S/s: UMNL
Brown-Sequard (Hemicord) Syndrome
Ipsilateral segment:
-pareplegia and analgesia of everything
Ipsilateral Below:
-Paralysis and loss of proprioception and light touch
-maintain nociception and temp
-ipaired sweating and nerve root pain
Contralateral Below:
-nociceptive and temp impaired (1-2 levels below)
-maintain motor and light touch/proprioception
Cause:
-penetrating trauma
-MS
-epidural abscess
Cauda Equina Syndrome
-sensation impaired, pain, LE paralysis, bowel/bladder
-no hyperreflexia (LMNL)
Causes:
-disc herniation
-vascular
-infections
-radiation
-neoplastic
-inflammatory
Posterior Column Syndrome
-cause of nuerosyphilis
-early cervical spondylotic myelopathy
-radiation induced myelopathy
S/s:
-inpaired vibration and proprioception
-sensory ataxia
-gait imbalance
Psychometric Properities
->4 yrs
-72 hours post injury
Steps in Classification
- Determine sensory levels
- Determine Motor Levels
- Determine Neurologic Level of Injury
- Complete vs. Incomplete
- ASIA Scale
- Determine Zone of Partial Preservation (ZPP)
Muscle Function Grading
-muscles must have functional sig and innervated from 2 segments
-C5-S1
-T2-L1 intact for sensory assume motor is too
-Scarecrow and Balet
-Look for 3/4/5 with a 5 above
Grade:
0= Total Paralysis
1=Palable/visible contraction
2= Full ROM gravity eliminated
3= full ROM against gravity
4= full ROM against gravity and mild resistance
5= full ROM against full resistance
NT= not testable
NT*= other condition inhibited testing or results
Sensory Grading
1) Light touch: DCML
2) Sharp/Dull: ST, 8/10 is normal
-supine
-28 points testing 3x C2-S4/5
-Most caudal 2/2
Grade:
0= absent
1= altered or hyper
2= Normal; 8/10
NT= not testable
NT*= other condition inhibited testing or results
C5
Elbow Flexors
-Biceps/Brachialis
C6
Wrist Extensors
-ECRL/B
C7
Elbow Extensors
Triceps
C8
Finger flexoors to middle finger
-FDP to 3rd digit
T1
Small digit abd
Abd digiti minimi
L2
Hip flexors
Iliopsoas
L3
Knee extensors
-Quads
