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ClinEd 1 > MIDTERMS: SCI > Flashcards

MIDTERMS: SCI Flashcards

1
Q

Spinal cord injury often results in a loss of ________, ________, or ________ function.

A

motor, sensory, autonomic

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2
Q

The most common cause of SCI in older adults is ________.

A

falls

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2
Q

Partial preservation of motor and/or sensory function below the level of injury, including some sensory and/or motor function below the neurological level.

A

Incomplete SCI

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3
Q

What are the potential outcomes of SCI?

A

Temporary or permanent loss of motor, sensory, or autonomic function, leading to varying degrees of paralysis or functional impairments.

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3
Q

Total loss of motor and sensory function below the level of injury, including no sensory or motor function in the lowest sacral segments (S4 and S5).

A

Complete SCI

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4
Q

What are the major causes of traumatic SCI?

A

Motor Vehicle Accidents (38%)
Falls (30.5%)
Violence (13.5%)
Sports-related injuries (9%)

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4
Q

True or False: In anterior cord syndrome, proprioception is preserved

A

True

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5
Q

True or False: Central cord syndrome usually results from hyperflexion injuries.

A

False — It usually results from hyperextension injuries.

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5
Q

A lesion to the corticospinal tract leads to ________ or ________ below the level of the injury.

A

muscle weakness, paralysis

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5
Q

A lesion of the dorsal column-medial lemniscus (DCML) results in the loss of ________, ________, and ________

A

fine touch, vibration, proprioception

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5
Q

True or False: Brown-Séquard syndrome leads to ipsilateral loss of pain and temperature sensation

A

False — Pain and temperature loss occur on the contralateral side.

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5
Q

Which of the following is a motor control deficit typically associated with a lesion in the anterior corticospinal tract?

A) Trunk and proximal muscle weakness
B) Limb movement control deficits
C) Loss of proprioception
D) Spasticity

A

A) Trunk and proximal muscle weakness

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5
Q

Lesion of the spinothalamic tract causes loss of ________ and ________ sensation below the level of the injury.

A

pain, temperature

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5
Q

What are the key components of early medical management for spinal cord injuries?

A

Stabilizing the spinal column, fracture stabilization (conservative or operative), and immobilization using devices such as cervical collars, spinal boards, and thoracolumbosacral orthosis (TLSO).

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6
Q

: Which of the following is associated with a lesion of the spinothalamic tract?

A) Loss of fine touch and proprioception
B) Loss of pain and temperature sensation
C) Muscle weakness
D) Hyperreflexia

A

B) Loss of pain and temperature sensation

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6
Q

What syndrome?
Loss of motor function, pain, and temperature sensation; proprioception preserved

A

Anterior Cord Syndrome

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7
Q

A 62-year-old male with a spinal cord injury from a fall has preserved motor function in the upper extremities but cannot move his lower extremities against gravity. Sensory testing shows decreased pain and temperature sensation below the injury level, but proprioception and vibration sense are intact. What is the ASIA impairment scale classification and possible SCI syndrome?

A

AIS B: Incomplete. Likely an Anterior Cord Syndrome, characterized by loss of motor function and pain/temperature sensation but preserved proprioception and vibration sense.

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7
Q

True or False: Tetraplegia refers to paralysis of all four extremities and the trunk.

A

True

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7
Q

What SCI syndrome?
Greater motor deficit in upper extremities; variable sensory loss

A

Central Cord Syndrome

7
Q

: A 50-year-old male was injured in a stabbing incident. He presents with right-sided paralysis, loss of proprioception, and light touch on the same side, and loss of pain and temperature sensation on the opposite side. What is the ASIA impairment scale classification and the likely SCI syndrome?

A

AIS B: Incomplete. Likely Brown-Sequard Syndrome, characterized by ipsilateral loss of motor function and proprioception, and contralateral loss of pain and temperature sensation.

8
Q

Which diagnostic test is used to assess somatosensory pathways in SCI?

A) X-ray
B) CT scan
C) MRI
D) Somatosensory Evoked Potentials (SSEP)

A

D) Somatosensory Evoked Potentials (SSEP)

8
Q

What SCI syndrome?
Ipsilateral motor and proprioceptive loss; contralateral pain and temperature loss

A

Brown-Séquard Syndrome

8
Q

Which SCI syndrome is characterized by more severe involvement of the upper extremities than the lower extremities?

A) Anterior cord syndrome
B) Central cord syndrome
C) Brown-Séquard syndrome
D) Posterior cord syndrome

A

B) Central cord syndrome

9
Q

A 25-year-old female with a history of multiple sclerosis (MS) presents with progressive weakness and sensory loss. Sensory testing reveals loss of pain and temperature sensation in the lower extremities, but proprioception and vibration sense are preserved. What should be considered in the differential diagnosis?

A

Multiple sclerosis (MS). Although MS can present with sensory and motor deficits similar to SCI, it is important to differentiate between MS and SCI as the management and underlying pathology are different.

9
Q

A 45-year-old male was in a motorcycle accident and presents with no sensation or motor function below the level of T6. He has preserved sensation in the sacral segments (S4-S5) but no motor function in the same segments. What is the ASIA impairment scale classification?

A

AIS A: Complete. There is no motor or sensory function preserved below the level of the injury, including the sacral segments S4-S5.

9
Q

A 30-year-old female sustained a spinal cord injury from a fall. She has sensation in all dermatomes below the level of injury but cannot move her legs against gravity. At least half of the key muscles below the level of injury have a muscle grade less than 3. What is the ASIA impairment scale classification?

A

AIS C: Incomplete. Motor function is preserved below the neurological level, but more than half of the key muscles below the level of injury have a muscle grade less than 3.

9
Q

A 70-year-old male with a spinal cord injury from a fall presents with symptoms including pressure ulcers, spasticity, and deep vein thrombosis (DVT). What are some of the common complications associated with SCI?

A

Common complications include pressure ulcers, autonomic dysreflexia, orthostatic hypotension, heterotopic ossification, contractures, pain, spasticity, sexual dysfunction, deep vein thrombosis, and respiratory compromise.

9
Q

Which SCI syndrome is characterized by ipsilateral paralysis and loss of proprioception, with contralateral loss of pain and temperature sensation?

A

Brown-Sequard Syndrome

9
Q

What are the primary goals of physical therapy during the early stage of recovery from a spinal cord injury?

A

Stabilizing the patient, preventing secondary complications, assessing sensory and motor functions, maintaining skin integrity, managing respiratory function, and initiating early mobility skills.

10
Q

Fill in the blank: For a patient with a spinal cord injury, the use of a _______ helps in immobilizing the spine and providing excellent cervical stability.

A

Halo orthosis.

10
Q

A 40-year-old woman experiences severe neurological involvement in the upper extremities (UE > LE) following a whiplash injury. She retains normal bowel and bladder function. What is the likely SCI syndrome?

A

Central Cord Syndrome. Characterized by more severe involvement of the upper extremities compared to the lower extremities, with preservation of sacral function.

10
Q

What are the indications for surgical stabilization of spinal injuries?

A

Unstable fracture site, gross malalignment, cord compression, and deteriorating neurological status.

10
Q

Fill in the blank: _______ training can help improve respiratory function by assisting with muscle activation and improving motor control in incomplete injuries.

A

Functional Electrical Stimulation (FES).

10
Q

What is the main focus of the subacute stage of SCI recovery?

A

Early recovery phase interventions, including passive range of motion exercises, ADLs training, bladder/bowel management, and development of a comprehensive rehabilitation plan.

10
Q

According to clinical practice guidelines, what is the effect of Body Weight-Supported Treadmill Training (BWSTT) in SCI patients?

A

BWSTT leads to greater improvements in hip extension during stance and plantarflexion during preswing compared to conventional training.

10
Q

True or False: The primary goal of physical therapy during the chronic stage of SCI rehabilitation is to focus on maximizing functional independence and addressing long-term needs such as psychological support and assistive device training.

A

True

10
Q

True or False: Anterior Cord Syndrome is characterized by preserved proprioception and vibration sense, with loss of motor function and pain/temperature sensation below the level of the injury.

A

True

10
Q

True or False: Early mobilization in SCI patients should only begin after the surgeon has cleared the patient for activity.

A

TRUE

11
Q

What should be assessed during the initial physical therapy examination of a spinal cord injury patient?

A

Respiratory function, muscle strength, muscle tone, reflex activity, skin status, cardiac function, and functional mobility skills.

12
Q

What are common complications associated with spinal cord injuries that physical therapy needs to address?

A

Pressure ulcers, autonomic dysreflexia, orthostatic hypotension, heterotopic ossification, contractures, pain, spasticity, sexual dysfunction, deep vein thrombosis, and respiratory compromise.

12
Q

What are common complications associated with spinal cord injuries that physical therapy needs to address?

A

Pressure ulcers, autonomic dysreflexia, orthostatic hypotension, heterotopic ossification, contractures, pain, spasticity, sexual dysfunction, deep vein thrombosis, and respiratory compromise.

12
Q

Which breathing exercise technique is recommended for patients with high-level tetraplegia?

A

Glossopharyngeal breathing, which involves trapping air in the throat to aid breathing.

13
Q

Fill in the blank: During acute care, patients with spinal cord injuries should be evaluated for their _______ to upright positioning and be monitored for orthostatic hypotension.

A

Tolerance

13
Q

What is the main goal of rehabilitation in the chronic stage for SCI patients?

A

To maximize functional potential and independence by focusing on strengthening, conditioning exercises, assistive devices, and psychological support.

14
Q
A

ClinEd 1 (8 decks)

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