Neuromuscular: Spinal Cord Injury: Examination

Question 1

SCI: Examination: Respiration

Answer 1

• Respiratory failure occurs in lesions above:
• C4, phrenic nerve
• C3-C5, innervates the diaphragm

Question 2

SCI: Examination: Sensation

Answer 2

• Check to see if sensory level corresponds to motor level of innervation

Question 3

SCI: Examination: Motor

Answer 3

• Lowest segmental level of innervation includes 3+/5 MMT.

Question 4

SCI: Autonomic Dysreflexia: Presentation

Answer 4

• Hypertension
• Bradycardia
• Severe Headache
• Constricted pupils
• Blurred vision
• Flushing and piloerection
• Increased spasticity

Question 5

SCI: Autonomic Dysreflexia: Response

Answer 5

• Treat as an emergency
• If patient is flat bring to upright
• Loosen any tight clothing or restrictive devices
• Examine/reduce blockage of urinary drainage
• Monitor BP and HR

Question 6

SCI: Examination: Exercise precautions for Tetraplegia/Quadraplegia

Answer 6

• Patients may experience blunted tachycardia
• Lack of pressor response
• Very low VO2 peak
• Substantially higher variability
• Monitor HR and BP closely

Question 7

SCI: Examination: Absolute contraindications to exercise testing and training of individuals with SCI from ACSM

Answer 7

• Autonomic dysreflexia
• Severe infected skin on weight bearing surfaces
• Symptomatic hypotension
• Urinary Tract Infection
• Unstable fracture
• Uncontrolled hot and humid environments
• Insufficient ROM to perform exercise task