Chapter 27 - SCI

Question 1

Quadriplegia

Answer 1

Paralysis of all four extremities (page 535)

Question 2

Paraplegia

Answer 2

Paralysis of lower extremities (page 535)

Question 3

Tetraplegia

Answer 3

Any degree of paralysis of the four limbs and trunk muscles (page 535)

Question 4

Complete SCI

Answer 4

Complete interruption of ascending and descending nerve tracks below the level of injury. Total paralysis and loss of sensation.

Question 5

Incomplete SCI

Answer 5

Some sensory and motor nerve pathways below the level of injury still intact.

Question 6

Level C1 - C3 Functional Outcomes

Answer 6

Possible neck flexion, rotation, and extension.
Unable to breath or move independently.

Total assist in all ADL and IADLs. May be independent in power wheelchair with AE.
(page 545)

Question 7

Level C4

Answer 7

Possible neck flexion, rotation, and extension. Scapular elevation; inspiration.

Total assist in most activities. May be independent with AE in pressure relief/positioning , communication, and power wheelchair.

May be able to breath without ventilator.

Question 8

Level C5

Answer 8

Possible neck flexion, rotation, and extension. Scapular elevation; inspiration, abduction and adduction. Shoulder flexion, extension, abduction, adduction. Elbow flexion, extension and supination.

Independent to mod assist in most activities with AE. Low endurance and vital capacity.

Question 9

Level C6

Answer 9

Possible neck flexion, rotation, and extension. Scapular elevation; inspiration, abduction, adduction and protraction. Shoulder flexion, extension, abduction, adduction. Elbow flexion, extension and supination. Wrist extension.

U/E activities independent with some mod assist and AE. L/E mod assist to total assist.

Question 10

Level C7 - C8

Answer 10

Possible neck flexion, rotation, and extension. Scapular elevation; inspiration, abduction, adduction and protraction. Shoulder flexion, extension, abduction, adduction. Elbow flexion, extension and supination. Wrist extension and flexion. Finger flexion and extension. Thumb movement.

Independent with AE in most ADL and IADLs.

Question 11

Level T1 - T9

Answer 11

Complete movement of U/E with lower trunk and extremity paralysis.

Independent with AE in most ADL and IADLs.

Question 12

Level T10 - L1

Answer 12

Complete movement of U/E with lower trunk weakness and lower extremity paralysis.

Question 13

Level L2 - S5

Answer 13

Complete movement of U/E and trunk. Partial to full movement of L/E.

Independent in all ADL and IADLs. May require some assist or AE for standing/ambulation.

Question 14

Orthostatic Hypotension (Postural Hypotension)

Answer 14

Form of low blood pressure that happens when you stand up from sitting or lying down.

Question 15

Causes of Orthostatic Hypotension in SCI

Answer 15

Orthostatic Hypotension in SCI can be caused by medications, system shock, or pooling of blood in paralyzed extremities.

Question 16

Treatment for Orthostatic Hypotension

Answer 16

Alter medications that my be causing Orthostatic Hypotension, use compression stockings to reduce blood pooling, and lifestyle changes. Always use caution when transferring.

Question 17

Autonomic Dysreflexia

Answer 17

An imbalanced reflex discharge, usually triggered by some strong sensory input, resulting in acute hypertension. Occurs with SCI that are T6 or higher.

Symptoms include flushed face, pounding headache, profuse sweating, stuffy nose and blurred vision. If untreated, autonomic dysreflexia can lead to death.

Question 18

Causes of Autonomic Dysreflexia

Answer 18

Any strong, sensory impulse below the level of injury. Most common causes are UTI and bowel/bladder movement.

Question 19

Treatment for Autonomic Dysreflexia

Answer 19

Immediate removal of the sensory input. Remove tight clothes or restrictions and have patient lie down to reduce blood pressure. Drug treatments may be used if autonomic dysreflexia becomes a frequent problem.

Question 20

SCI Precautions

Answer 20

Pressure sores/ulcers
Autonomic Dysreflexia
Orthostatic Hypotension
Decreased vital capacity 
Osteoporosis
Spasticity