SCI & Cranial Nerves

Question 1

CN V (dermatome, muscles, function)

Answer 1

dermatome: anterior face, mm: mastication, fx: ingestion

Question 2

C3

Answer 2

dermatome: neck region, muscles: sternocleidomastoid, upper trapezius, function: head control. Could operate power chair independently with head movements or breath controls

Question 3

C4

Answer 3

dermatome: upper shoulders , muscles: trapezius (diaphragm), function: head control. Self-Care: Dependent for all self-care but can suck from straw.

Question 4

C5

Answer 4

dermatome: lateral shoulders , muscles: deltoid, biceps, rhomboids, function: elbow flexion, supination, shoulder flexion/abduction/extension. Self-care: feeding requires total assist for set up then independent with equipment. Equipment that may be used: suspension sling or mobile arm support, dorsal wrist splint with universal cuff, dycem, scoop dish or plate guard, angled utensils, long opponens splint. Dressing: UE with min to mod, LE dependent. Bathing: min to mod. Grooming: assist with set up, can be independent with splint and U-cuff with teeth, hair, shaving. Bowel & Bladder: total A. Could propel manual chair indoors with some assist. Driving: could drive independently with highly-specialized equipment. Requires 6-10 hours per day of assist.

Question 5

C6

Answer 5

dermatome: thumb & radial forearm , muscles: extensor carpi radialis, biceps, latissimus dorsi, supinator, function: wrist extension. Feeding: independent with or without AE which may include: u-cuff or tenodesis splint, rocker knife, scoop dish or plate guard, cup with large handles. Dressing: LB: independent in bed, max A for shoes/socks. UB: indep. with button hook, zipper pull, velcro. Bathing: min A using hand-held shower, tub bench, & slide board t/f. Grooming: indep. using tenodesis grasp. Bowel/bladder: some assist. T/fs: can be indep on level t/fs. Propel manual w/c independent indoors. Independent with driving. Requires 4-6 hrs per day of assist.

Question 6

C7

Answer 6

dermatome: middle finger , muscles & function: triceps, wrist flexion, finger extensors. Independent with feeding, dressing, bathing, and grooming. Can be indep with bed mobility & t/fs with or without t/f board.

Question 7

C8

Answer 7

dermatome: little finger, ulnar forearm , muscles: wrist and finger flexors , function: finger flexion.

Question 8

T1

Answer 8

dermatome: axilla & proximal medial arm , muscles: hand intrinsics, function: abduction and adduction of fingers. Can perform w/c<>floor t/fs with SBA.

Question 9

CN I

Answer 9

Olfactory: sensory: smell. Test: sniff various aromatic substances

Question 10

CN II

Answer 10

Optic: Sensory: vision. Test: Eye-chart, visual fields

Question 11

CN III

Answer 11

Oculomotor: Motor: eye muscles for medial and vertical movements, and pupillary constrictor and lens accommodation. Sensory: proprioception of eye.

Question 12

CN IV

Answer 12

Trochlear: Proprioceptors and motor fibers superior oblique eye muscles (downward and inward eye movements), tested: visual tracking

Question 13

CN V

Answer 13

Trigeminal: sensory for face, motor fibers for mastication,. Test: corneal reflex with cotton swab, move jaw through full ROM

Question 14

CN VI

Answer 14

Abducens: motor for lateral rectus of eye, lateral eye movements. Tested in conjunction with CN III relative to moving eye laterally

Question 15

CN VII

Answer 15

Facial: Motor to muscles of facial expression and salivary glands, sensory to taste buds and anterior 2/3 of tongue. Test: symmetry of face, facial expressions, taste

Question 16

CN VIII

Answer 16

Vestibulocochlear: Sensory of equilibrium and hearing. Test: hearing with tuning fork

Question 17

CN IX

Answer 17

Glossopharyngeal: Sensory to posterior tongue, gag reflex. Test: gag and swallow reflexes, posterior tongue for taste

Question 18

CN X

Answer 18

Vagus: Motor and sensory for larynx and pharynx, parasympathetic motor fibers supply smooth muscles of abdominal organs. Test: Elevation of palate, swallowing, speaking (raspy voice, palate will elevate to good side)

Question 19

CN XI

Answer 19

Spinal Accessory: sensory/motor to sternocleidomastoid, trapezius

Question 20

CN XII

Answer 20

Hypoglossal: Motor/sensory for tongue. Test: controlled tongue movements (when tongue is out it will deviate to affected side)

Question 21

ASIA A

Answer 21

Complete lesion

Question 22

ASIA B

Answer 22

Incomplete lesion: sensory (but not motor) is preserved below the level

Question 23

ASIA C

Answer 23

Incomplete lesion: motor function is preserved below the level but more than half of they key muscles have a muscle grade of less than 3.

Question 24

ASIA D

Answer 24

Incomplete lesion: motor function is preserved below the level with more than half of the muscles have muscle grade of 3 or more.

Question 25

ASIA E

Answer 25

Motor and sensory is normal.

Question 26

Brown Sequard Syndrome

Answer 26

When only one side of the spinal cord is damaged. Ipsilateral loss of light touch, motor, and proprioception, contralateral loss of temperature and pain.

Question 27

Anterior Spinal Cord Syndrome

Answer 27

Bilateral loss of motor and pain/temp sensation.

Question 28

Anterior Spinal Cord Syndrome

Answer 28

Paralysis and loss of pain, temperature, and touch. Proprioception is preserved.

Question 29

Posterior Cord Syndrome

Answer 29

Bilateral loss of light touch & proprioception.

Question 30

Posterior Cord Syndrome

Answer 30

Bilateral loss of light touch & proprioception.