SC lesions/injury

Question 1

Outcome for C3 complete SCI

Answer 1

Transfers: Total dependence. W/C powered with breath

Key movements: Mouth, face, head. (talking, sipping, chewing, blowing) Ventilator required.

Question 2

Outcome for C4 complete SCI

Answer 2

Transfers: Total dependence. W/C powered with moith or chin. Key movements: Scap elevation, respiration. Traps & deltoid

Question 3

Outcome for C5 complete SCI

Answer 3

Transfers: Can assist with transfers. W/C with hand controls. Key movements: Elbow flx, Sh. ER, Sh. Abd to 90. Biceps & deltoid.

Question 4

Outcome for C6 complete SCI

Answer 4

Transfers: Independent with slide board. W/C (I) with wheel projections, likely to still use power w/c. Key movements: Sh. flx, wrist ext, Tenodesis grasp, bed mob with rails, (I) with pressure relief. Pec major, Ext. Carpi Radialis, Teres major.

Question 5

Outcome for C7 complete SCI

Answer 5

Transfers/Mob: (I) transfers, (I) w/c propulsion, (I) living possible. Key movements: Elbow ext, wrist flx, finger ext. Triceps, lats, extrinsic finger extensors, flexor carpi radialis.

Question 6

Outcome for C8-T1 complete SCI

Answer 6

Transfers/Mob: (I) with transfers & w/c. Key movements: Full innervation of UE. Intrinsic & extrinsic muscles of hand, flexor carpi ulnaris.

Question 7

Outcome for T1-T8 complete SCI

Answer 7

Mobility: T6-T8 physiological standing with orthoses in parallel bars. Fair trunk control. Top half of intercostals.

Question 8

Outcome for T9-T12 complete SCI

Answer 8

Mobility: Household ambulation with KAFOs and assistive device, (I) with household ADLs. Good trunk control. Abdominals innervated.

Question 9

Outcome for T12 complete SCI

Answer 9

Mobility: Community ambulation with bilateral KAFOs and assistive device. W/C still may be used for primary mobility due to no hip flexor function.

Question 10

Outcome for L1-L2 complete SCI

Answer 10

Mobility: (I) with community ambulation using KAFOs and assistive device. May still use w/c as primary mobility. Key movements: Hip hiking, weak hip flexion. Quadratus lumborum, illiopsoas and sartorious.

Question 11

Outcome for L3-L5 complete SCI

Answer 11

Mobility: Ambulation with AFOs and canes possible. May continue to use w/c for efficiency. Key movements: hip flexion, knee ext. L3-L4 strong illiopsoas, L4-L5 strong quads, medial hamstrings.

Question 12

Outcome for S1-S2 complete SCI

Answer 12

Mobility: May ambulate with articulated AFOs. Key movements: plantar flexion, hip extension. Plantar flexors and hip extensors.

Question 13

What to know about Autonomic dysreflexia

Answer 13

Can occur with SCI at or above T6. Caused by noxious stimulus below the level i.e. full bladder, occluded urinary catheter, extreme temperature change. Symptoms: High BP, blurred vision, vaso dilation above level of injury and goosebumps below. Lying a pt down is contraindicated!!!

Question 14

Cauda equina injury

Answer 14

Injury that occurs below below L1 of the spine. Considered LMNL.

Question 15

Spinal Shock

Answer 15

A physiological response that occurs 30-60 minutes after trauma to the SC, presenting with total flaccid paralysis and loss of reflexes below the level of injury. Can last several weeks.

Question 16

Anterior cord syndrome

Answer 16

Incomplete lesion. MOI: Cervical flexion, compression and damage to the anterior part of the SC or anterior spinal artery. Loss of motor, pain, and temperature sense below the lesion.

Question 17

Central cord syndrome

Answer 17

Incomplete lesion. MOI: Cervical hyperextension resulting in compression and damage to the central portions of the SC. UE motor deficits > LE. Motor loss > sensory loss.

Question 18

Posterior cord syndrome

Answer 18

Relatively rare incomplete lesion. MOI: Caused by compression to the posterior spinal artery. Los of pain, perception, proprioception, and 2-point discrimination & stereognosis. Motor function preserved.

Question 19

What level SCI would have adequate muscle control to drive an adapted van?

Answer 19

C6

Question 20

What is Brown-Sequard’s syndrome?

Answer 20

Incomplete lesion typically from a stab wound causing a hemisection of the spinal cord. Ipsilateral loss of vibratory & proprioception, contralateral loss of pain and temperature sense.

Question 21

Typical level for a lumbar puncture (spinal tap)?

Answer 21

Below level of L2, typically between L3 & L4 vertebrae