Neural Prostheses 1

Question 1

What is the average age for SCI?

Answer 1

52 years old

Question 2

What impairment (tetraplegia or paraplegia) corresponds with the following levels of SCI: cervical, thoracic, lumbar, sacral?

Answer 2

• cervical = tetraplegia
• thoracic, lumbar, sacral = paraplegia

Question 3

What kind of impairments are associated with tetraplegia?

Answer 3

• impairment of ARM and LEG function
• impaired respiratory function and truncal balance

Question 4

What kind of impairments are associated with paraplegia?

Answer 4

• impaired leg function
• MAY be associated with impaired respiratory function and truncal balance

Question 5

What is death usually caused by in SCI?

Answer 5

• pressure sores
• pneumonia

Question 6

What are the respiratory muscles affected by SCI?

Answer 6

• diaphragm (C3,4,5)
• intercostals
• accessory muscles

Question 7

What level of SCI may affect diaphragmatc function where mechanical ventilation may be needed?

Answer 7

C3

Question 8

Difference between restrictive vs obstructive pattern on spirometry testing.

Answer 8

• restrictive: FEV1/FVC diminished; cannot breathe IN or OUT well
• obstructive: FEV1/FVC ratio changed; muscles still present, but cannot breathe well

Question 9

Which sensory modalities are impaired depends on the ______________ tracts affected in the spinal cord.

Answer 9

ascending

Question 10

Which ascending tracts can be affected in spinal cord? What are the associated sensory impairments?

Answer 10

• dorsal column: vibration, proprioception
• LATERAL ST tract: pain and temperature
• spinocerebellar tract: proprioception in joints and muscles

Question 11

impairments vs disabilities vs handicaps

Answer 11

• impairments: abnormalities/disturbances of body structure and appearance (PHYSICAL)
• disabilities: consequences of impairments in terms of functional performance and activity (SOCIAL)
• handicaps: disadvantages as a result of impairments and disabilities

Question 12

TRUE or FALSE: impairment leads to disability, which leads to handicap

Answer 12

FALSE: impairment may not necessarily lead to disability, and disability may not lead to handicap

Question 13

What is spasticity?

Answer 13

abnormal increase in muscle tone or stiffness of muscle

Question 14

Spasticity affects ___ - ___ % of individuals with chronic SCI.

Answer 14

65-78

Question 15

TRUE or FALSE: spasticity is velocity-independent

Answer 15

FALSE: velocity dependent

Question 16

TRUE or FALSE: spasticity involves the contraction of flexors

Answer 16

FALSE: contraction of extensors (stretching)

Question 17

TRUE or FALSE: Spasticity involves damage to the lower motor neuron

Answer 17

FALSE: upper motor neuron

Question 18

What maladaptive neural changes occur in spasticity? (consider spinal tracts)

Answer 18

• loss of inhibitory control by descending pyramidal and reticulospinal tracts
• maladaptive branching of residual CST and RST
• hyperexcitability of RST, VST, rubrospinal tract
• increased sensitivity of stretch-activated muscle spindles

Question 19

What are some conventional treatments for spasticity?

Answer 19

• appropriate positioning of the body
• stretching exercises
• oral meds
• chemodenervation
• intrathecal baclofen

Question 20

Which division of the ANS dominates after SCI? What is the physiological result?

Answer 20

• parasympathetic
• cardiac dysrhythmias, hypotension, bronchoconstriction, respiratory secretions, bowel, bladder, and sexual dysfunctions