LECT 5 SCI

Question 1

If artery of adamkiewick is injured in renal surgery, what level of spine will be affected

Answer 1

T7

Question 2

SCI lesion clues in history/exam

Answer 2

-bilateral
-sensory level
-tight sensation around torso (MS hug)
-B&B DYSFUNCTION
-Lhermitte or Uhthoff
-stiff legs
-neck/back pain

Question 3

what should you do if someone might have SCI

Answer 3

-avoid hypotension
-immobilize head/neck
-need surgical decompression in 24 hrs
-airway protection
-plain films and CT*

Question 4

cervical spondylosis is most common at

Answer 4

C5, C6
bc of disc, bone spurs, thick ligaments, compromised cord/roots

Question 5

acute SCI is most common at

Answer 5

CERVICAL C5, C4

Question 6

muscle grading for ASIA 0

Answer 6

total paralysis

Question 7

muscle grading for ASIA 1

Answer 7

palpable/visible contraction

Question 8

muscle grading for ASIA 2

Answer 8

gravity eliminated full ROM

Question 9

muscle grading for ASIA 4

Answer 9

moderate resistance in full ROM against gravity

Question 10

muscle grading for ASIA 5

Answer 10

full ROM and full resistance, can also be enough resistance to be considered normal if identified factors (pain, disuse) were not present

Question 11

C6 and c8 mm groups for asia

Answer 11

C6: wrist extensors
C8: finger flexors

Question 12

ASIA sensory eval

Answer 12

0-absent
1-altered
2-normal
NT-not testable

Question 13

ASIA A

Answer 13

complete, no sensory or motor
-NO VOLUNTARY ANAL CONTRACTION
-SENSORY IS 0
DEEP ANAL PRESSURE IS 0

Question 14

ASIA B

Answer 14

sensory incomplete
sensory preserved, but not motor

Question 15

ASIA C

Answer 15

motor incomplete
motor preserved with more than half of mm with grade less than 3 (weak)

Question 16

ASIA D

Answer 16

motor complete
motor preserved and stronger (half or more mm have grade 3-5)

Question 17

ASIA E

Answer 17

NORMAL

Question 18

-min A with LE dressing in bed
-mod assist with undressing LE in bed

Answer 18

C6 level lesion

Question 19

independent with AD in bed dressing

Answer 19

C7

Question 20

independent with AD in WC dressing

Answer 20

C8

Question 21

min assist for upper body bathing and drying
mod A for lower body drying
AD (tub chair)

Answer 21

C6

Question 22

set up required for communication (independent verbal, AD for written)

Answer 22

C6

Question 23

independent bathing with AD

Answer 23

C7, C8
mod A for lower body drying

Question 24

what should you do if someone has Autonomic dysreflexia?

Answer 24

-sit upright
-monitor BP every 2-3 min
-check for sources of irritation (cath if needed)
-if BP over 150, give anti HTN (ntiro paste, nifedipine IR sublingual, IV antihypertensive if in ICU

Question 25

posterorlateral column syndrome

Answer 25

• B12 deficiency
• Copper deficiency
• Cervical spondylosis
• Paraneoplastic myelitis * HTLV1 myelopathy

CORTICOSPINAL AND DCML

Question 26

subacute combined degeneration

Answer 26

SC syndrome from B12 or copper deficiency
-post columns and corticospinal

-sensory ataxia, gait unsteady, weakness with UMN! DTRs, spasticity
-paresthesias

Question 27

in tabes dorsalis, what is clinical presentation

Answer 27

DCML: gait imbalance due to sensory ataxia
dorsal roots: absent reflexes but STRONG

Question 28

hemicord can happen due to

Answer 28

trauma
MS
epidural absess

Question 29

HEMICORD SYNDROME SYMPTOMS

Answer 29

ipsi UMN below lesion
ipsi LMN at lesion (anterior horn)
ipsi DCML loss
CONTRA ALST loss 1-2 levels below lesion

IPSI NERVE ROOT PAIN AND IPSI IMPAIRED AUTONOMIC

Question 30

central cord syndrome is due to

Answer 30

syringomyelia
* Intramedullary Tumors
* Neuromyelitis Optica
* Cervical Hyperextension

Question 31

what does syringomyelia look like

Answer 31

cape! weakness and atrophy of hands and arms, loss of DTRs