DFO Set Five

Question 1

Following a complete C6 spinal cord injury, a person’s ability to function on a day to day level will be significantly altered. Using the ICF briefly describe 3 areas of self cares and the person’s ability to participate in these activities following a complete C6 spinal cord injury.

Answer 1

Sleep hygiene - ability to independently move in/out of bed affected, adaptive equipment e.g. bedpole may be used
Showering - may not be able to move in/out of shower independently, but equipment such as shower stool/wet area shower may be used
Toileting - limited control of bowel/bladder, but with use of urinal or bedpan this may be managed

Question 2

Spinal cord damage causing some impairment to all 4 limbs is called _____

Answer 2

Tetraplegia

Question 3

A lowering of blood pressure when changing position is called ______

Answer 3

Postural hypotension

Question 4

Hyperactive autonomic reflexes in response to stimuli below the spinal cord lesion which can lead to increased blood pressure, headaches, seizures, and intra cerebral bleeding is known as ______

Answer 4

Autonomic dysreflexia

Question 5

When a person following a spinal cord injury still experiences a degree of voluntary movement and/or sensation below the injury it is said to be an _____ injury

Answer 5

Incomplete

Question 6

_____ are the leading cause of spinal injuries in New Zealand

Answer 6

Motor vehicle accidents

Question 7

How many cervical vertebrae are there?

Answer 7

Seven

Question 8

The cervical nerves innervate muscles of the:

Answer 8

Neck, diaphragm, arms, and hands

Question 9

List two ways a spinal injury is classified

Answer 9

Complete vs. incomplete injury

Location of the injury, e.g. between C5/6

Question 10

Give two possible causes of autonomic dysreflexia in spinal cord injury

Answer 10

Overfull bladder or bowel
Decubitus ulcers
Urinary tract infection

Question 11

Describe the differences between complete and incomplete spinal cord injuries

Answer 11

Incomplete - spinal cord not completely severed, incomplete transaction. Some sensory and motor output remains.
Complete - Complete severe/transaction of spine, no motor output or sensation remains.

Question 12

An individual who sustained a complete C6 spinal cord injury could be affected by which of the following?

a) Require adaptive aids to brush their teeth
b) Require urinary and bowel products
c) Dress their lower limb with assistance/aids
d) All of the above

Answer 12

d) All of the above

Question 13

Tim broke his neck during a rugby match which resulted in a C5/6 incomplete tetraplegia. Will Tim need a respirator to assist with breathing?

Answer 13

No

Question 14

Is Tim likely to be independent with his bowel and bladder care?

Answer 14

No, but there is potential with use of equipment

Question 15

Will Tim have increased or decreased muscle tone below the level of his injury once spinal shock has resolved?

Answer 15

Increased.

Question 16

Whilst on fieldwork placement you are introduced to two patients both with spinal cord lesions following car accidents, explain what a spinal cord lesion is.

Answer 16

An abnormal change (e.g. severance or partial severance) which occurs to the tissue of the spine, which can be caused by a spinal cord injury, accidents, or serious infection

Question 17

On assessment you find that they have quite different levels of motor and sensory abilities, explain why this could be.

Answer 17

Location of injury - e.g. C2/3 injury will have much greater impact than a S3/4 injury
Completeness of injury, e.g. incomplete transaction won’t result in complete loss of motor output and sensation while a complete injury would

Question 18

Briefly describe the complications associated with the skin which may affect the course and prognosis for a person with a spinal cord injury

Answer 18

Decubitus ulcers (pressure injuries/sores) - due to not being able to move independently, these may develop due to high pressure over long periods of time
Frostbite or burns, due to not being able to feel temperature

Question 19

Explain why a spinal cord injury is currently a non-recoverable state

Answer 19

The spinal cord is unable to repair itself/regenerate

Question 20

What is the function of the spinal cord?

Answer 20

To carry sensory information towards the brain, and motor information from the brain to the body

Question 21

What information is carried by the spinal nerves (give a specific example)

Answer 21

Temperature sensations, e.g. touching a hot stove will deliver sensory information regarding burning your hand

Question 22

Describe what is meant by a reflex arc

Answer 22

An impulse enters the spinal cord through the
dorsal nerve root, synapses, and exits by the
ventral nerve root which results in certain
muscle function. An example of this is if the
knee is tapped by a reflex hammer, the knee
will extend without any influence from the
brain.

Question 23

Describe how CNS pathways have been affected by a spinal cord injury. Comparing complete vs incomplete injuries

Answer 23

A complete SCI occurs with a complete
transaction of the cord. No motor or sensory information is transmitted.
An incomplete SCI occurs when the injury
doesn’t cause a total transaction, there will be some
degree of voluntary movement or sensation below
the level of injury.