SCI

Question 1

A _ lesion is a lesion to the spinal cord where there is NO preserved motor or sensory function below the level of the lesion.

Answer 1

A COMPLETE LESION is a lesion . . .

Question 2

An _ _ is a lesion to the spinal cord in which there may be scattered motor function, sensory function or both below the level of the lesion.

Answer 2

An INCOMPLETE LESION is a lesion to the

Question 3

_ _ _ is an incomplete lesion that results from compression and damage to the anterior part of the spinal cord or anterior spinal artery. Mechanism of injury is usually _ _. There is loss of _ function, _ and _ sense below the lesion due to damage to the corticospinal and Spinothalamic tracts.

Answer 3

ANTERIOR CORD SYNDROME is an incomplete . . .

Mechanism of injury is usually CERVICAL FLEXION

There is loss of MOTOR function, PAIN AND TEMPERATURE sense below the lesion due to . . .

Question 4

_ _ _ is an incomplete lesion usually caused by a stab wound, which induces hemi section of the spinal cord. There is _ and loss of _ and _ sense on the same side as the lesion due to damage to the corticospinal tract and dorsal columns. There is loss of _ and _ sense on the contralateral side of the lesion for damage to the lateral Spinothalamic tract.

Answer 4

BROWN SEQUARD SYNDROME is an incomplete . . .

There is PARALYSIS and loss of VIBRATORY AND POSITIONAL sense on the SAME SIDE

There is loss of PAIN AND TEMPERATURE sense on the- CONTRALATERAL SIDE

Question 5

_ _ _ are injuries that occur below the L1 spinal leve wher the long nerve roots transcend. Can be _, however they are frequently _ due to the large number of nerves in the area. Is considered a _ _ injury.

Answer 5

CAUDA EQUINA INJURIES are injuries that . . .

Can be COMPLETE, however they are frequently INCOMPLETE due to the large. . . .

Is considered a PERIPHERAL NERVE injury

Question 6

_ _ _ is an incomplete lesion that results from compression and damage to the central portion of the spinal cord. Mechanism of injury is usually _ _ that damages the Spinothalamic and corticospinal tracts and the dorsal columns.

Answer 6

CENTRAL CORD SYNDROME is an incomplete . . .

Mechanism of injury is usually CERVICAL HYPEREXTENSION that damages . . .

Question 7

With central cord syndrome the _ _ present with greater involvement than the _ _ and greater _ deficits exist compared to _ deficits.

Answer 7

The UPPER EXTREMITIES present with greater involvement than the LOWER EXTREMETIES and greater MOTOR deficits exist compared to SENSORY deficits.

Question 8

_ _ _ is a relatively rare syndrome that is caused by compression of the posterior spinal artery. It is characterized by loss of _, - _, and _. Motor function is _.

Answer 8

POSTERIOR CORD SYNDROME is relatively rare . . .

It is characterized by loss of PROPRIOCEPTION, TWO-POINT DISCRIMINATION and STEREOGNOSIS.

Motor function is PRESERVED.

Question 9

How many grades are there on the ASIA scale?

Answer 9

5 (A-E)

Question 10

Level _ on the ASIA scales is a complete spinal cord injury with no sensory or motor function preserved in the sacral segments (S4-S5)

Answer 10

Level A On the ASIA . . .

Question 11

Key UE muscles tested during ASIA for C5? C6? C7?

Answer 11

C5- Elbow flexors (biceps, brachioradialis)

C6- Wrist extensors (ECRL, ECRB)

C7- Elbow extensors (triceps)

Question 12

Key muscles tested during ASIA assessment for C8? T1?

Answer 12

C8- finger flexors (flexor digitorum profundus) at middle finger

T1- small finger abductors (adductor digiti minimi)

Question 13

Key muscles tested during ASIA assessment for L2? L3? L4?

Answer 13

L2- hip flexors (Iliopsoas)

L3- knee extensors (quadriceps)

L4- ankle dorsiflexors (tibialis anterior)

Question 14

Key muscles tested during ASIA assessment for L5? S1?

Answer 14

L5- big toe extension (extensor hallucis longus)

S1- ankle plantar flexors (gastroc, Soleus)

Question 15

With ASIA B, _ but not _ function is preserved below the level of lesion AND includes the _ _ of _ and _ (can _ but cannot _ bowel function)

Answer 15

With ASIA B (incomplete), SENSORY but not MOTOR function is preserved below the level of the lesion and includes the SACRAL SEGMENTS of S3 and S4 (can FEEL but cannot CONTROL bowel function)

Question 16

With ASIA C motor function is _ below the neurological level and _ than 1/2 of the key muscles below the neurological level have a muscle grade of _ than _/5.

Answer 16

With ASIA C motor function is PRESERVED below the neurological level and MORE than half of the key muscle below the neurological level have a muscle grade of LESS THAN 3/5

Question 17

With ASIA D, motor function is _ below the neurological level and _ _ _ of key muscles below the neurological level have a muscle grade of _/5 _ _.

Answer 17

Motor function is PRESERVED below the neurological level and AT LEAST HALF of key muscles below the neurological level have a muscle grade of 3/5 OR GREATER

Question 18

ASIA E, motor and sensory function are? Valid for?

Answer 18

. . . Are NORMAL

Valid only for people who have had a a spinal cord injury

Question 19

The neurological level is the most caudal level that exhibits? Exceptions? Associated levels?

Answer 19

Most caudal level that exhibits intact sensory AND motor function

SCI’s that are in levels that are not testable using MMT are considered to be the same as the sensory level

Levels that cannot be tested by MMT include: C1-C4; T2-L1; S2-S5

Question 20

_ of _ _ is sensory and/ or motor function below the neurological level excluding S4-S5. Dermatomes and/ or myotomes below the neurological level remain? Only applies to?

Answer 20

ZONES OF PARTIAL PRESERVATION is sensory and motor . . .

Dermatomes and/ or myotomes below the neurological level remain PARTIALLY INNERVATED

Only applies to ASIA A (COMPLETE SCI)

Question 21

With _ _ syndrome there is flaccid paralysis of the lower extremities and areflexic bowel and bladder.

Answer 21

With CONUS MEDULLARIS syndrome there is . . .

Question 22

Most spinal cord injuries are a combination of? _ T12 is more _ () and _ T12 is more _ ().

Answer 22

Most spinal cord injuries are a combination OF UMN AND LMN

ABOVE T12 is more UMN (SPASTICITY)

BELOW T12 is more LMN (FLACCIDITY)

Question 23

What are the first and second line (2)of pharmacological agents used to treat spasticity in SCI?

Answer 23

First- BACLOFEN

Second- GABAPENTIN (also good for cerebral spasticity- in addition to spinal) and BENZIDIAZAPINE (diazepam/ Valium)

Question 24

_ _ occurs with SCI above the T1 level.

Answer 24

THERMOREGULATION DSYFUNCTION

Question 25

_ _ is ectopic bone formation in the connective tissue outside of the skeleton. Occurs at the _ joints (_, _, _), always occurs _ _ _ of the spinal lesion. May occur in / of high tetraplegics and those with accompanying TBI.

Answer 25

HETEROTOPIC OSSIFICTION is ectopic bone . . .

Occurs at the LARGE joints (HIP, KNEES, ELBOWS), always occurs BELOW THE LEVEL of the spinal lesion.

May occur in SHOULDERS/ ELBOWS of high tetraplegic . . .

Question 26

HO occurs in _% of people with SCI. Most commonly develops - _ post injury with peak incident around _ _. However it can occur _ after injury.

Answer 26

HO occurs in 50% of people with SCI

Most commonly develops 1-4 MONTHS post injury with peak incidence around 2 MONTHS

However it can occur YEARS after injury

Question 27

How many stages of HO are there? How is it diagnosed by imaging? Lab?

Answer 27

4 STAGES

It is diagnosed via BONE SCAN (most accurate test)

Lab results: ELEVATED PHOSPHATASE LEVELS

Question 28

Stage _ occurs 11-20 days after injury. Symptoms include: _, _ _ swelling, _, local _ and _ near the joint. _ _ _on X-Ray. ROM may be _ _.

Answer 28

Stage I occurs 11-20 days after . .

Symptoms include: FEVER, SOFT TISSUE swelling, local WARMTH and REDNESS near the joint

NO DETECTABLE CHANGE on X-Ray

ROM may be SLIGHTLY LIMITED

Question 29

Stage 2: symptoms are? X-Ray- _ _ is now visible. ROM?

Answer 29

Symptoms ARE SAME AS STAGE 1

X-Ray- ECTOPIC BONE is not visible

ROM: MAY BE SLIGHTLY LIMITED (same as stage 1)

Question 30

Stage 3: symptoms- __ and _ subside. X-Ray shows _ _. ROM is _ limited.

Answer 30

Symptoms- SWELLING AND REDNESS subside

X-Ray shows CONTINUED CALCIFICATION

ROM is INCREASINGLY limited

Question 31

Stage 4: _- _ _ after onset. X-Ray shows _ _. ROM- _ _. Complications include? (2)

Answer 31

2-4 WEEKS after onset

X-rays show EXTENSIVE CALCIFICATION

ROM- JOINT ANKYLOSIS

COmplications include- CONTRACTURE AND PRESSURE SORES

Question 32

ADA COMPLIANCE: handrail/ grab bar height? Toilet seat? Counter height?

Answer 32

Handrail/ grab bar height: 34-38 inches

Toilet seat height: 17-19 inches

Counter height: 34 inches MAX

Question 33

ADA Ramp requirements: width? Slope should not exceed _ _ in height for ever _ _ in length. Ramps greater than 6 feet should have?

Answer 33

Width: 36 inches

Slope should not exceed 1 INCH in height for every 12 INCHES in length

Ramps greater than 6 feet in length should have BILATERAL HANDRAILS.