SCI

Question 1

Anterior cord syndrome

Answer 1

• Incomplete lesion
• Results from compression and damage to anterior spinal cord or anterior spinal artery.
• Usually cervical flexion injury
• Damage of corticospinal and spinothalamic tracts
• Loss of motor function, pain, and temperature below lesion

Question 2

Brown-Sequard’s Syndrome

Answer 2

• Incomplete lesion
• Usually a stab or gunshot wound
• Loss of vibratory and position sense on same side as lesion d/t damage to corticospinal tract and dorsal columns.
• Loss of pain and temperature sense on opposite side as lesion d/t damage to lateral spinothalamic tract.

Question 3

Cauda Equina injuries

Answer 3

• Lesion below L1 where long nerve roots start.
• Considered LMN lesions
• Usually incomplete d/t large number of nerves in the area.
• Considered a peripheral nerve injury
• Flaccidity, areflexia, impairment of bowel and bladder function.
• Full recovery is not typical d/t long distance needed for axonal regeneration.

Question 4

Central Cord Syndrome

Answer 4

• Incomplete lesion
• Results from compression and damage to central portion of spinal cord.
• Usually caused by cervical hyperextension injury
• Damage to spinothalamic tract, corticospinal tract, and dorsal columns.
• UE>LE
• motor deficits > sensory deficits

Question 5

Posterior Cord Syndrome

Answer 5

• Caused by compression of posterior spinal artery
• Relatively rare
• Loss of proprioception, 2-point discrimination, stereognosis.
• Motor function is preserved

Question 6

ASIA scale: Level A

Answer 6

• Complete
• No sensory of motor function preserved in sacral segments S4-5

Question 7

ASIA scale: Level B

Answer 7

• Sensory Incomplete
• Sensory function is preserved below the neurologic level, including S4-5
  AND
• No motor function is preserved more than 3 levels below the motor level on either side of the body.

Question 8

ASIA scale: Level C

Answer 8

• Motor incomplete
• Motor function is preserved for voluntary anal contraction
  OR
• Pt meets sensory incomplete status but has motor function more than 3 levels below the motor level on either side of the body.
• Less than half of key muscle functions below neurologic level have muscle grade of < or = 3.

Question 9

ASIA scale: Level D

Answer 9

• Motor incomplete
• Status as previously defined but with at least half (or more) of key muscle functions below neurologic level have muscle grade > or = 3.

Question 10

ASIA scale: Level E

Answer 10

• Normal
• Sensory and motor functions are normal in a pt that had prior deficits

Question 11

Neurologic level

Answer 11

Lowest segment of spinal cord with intact sensation AND strength (at least grade 3).