Spinal Cord Injury

Question 1

ASIA A

Answer 1

Complete impairment (no sacral sparing)

Question 2

ASIA B

Answer 2

Incomplete: Sn preserved but no Motor fx including S4 & S5

Question 3

ASIA C

Answer 3

Incomplete: Motor preserved + >1/2 of key muscles have grade <3

Question 4

ASIA D

Answer 4

Incomplete: Motor preserved + >1/2 of key muscles have grade >3

Question 5

ASIA E

Answer 5

Motor and Sn normal

Question 6

Motor grade 3

Answer 6

Movt against gravity

Question 7

Descending motor pathway (cortex -> internal capsule & crus cerebri)

Answer 7

Corticospinal tracts

Question 8

Corticospinal tract damage

Answer 8

IPSILAT muscle weakness, spasticity, DTR, babinski

Question 9

Dorsal gray matter

Answer 9

Spinothalamic tracts

Question 10

Spinothalamic tract damage

Answer 10

Loss of pain & temp sn in CONTRALAT

Question 11

Ascending pathway

Answer 11

Dorsal posterior columns

Question 12

Dorsal (posterior) column

Answer 12

IPSILAT loss of vibration and proprioception

Question 13

3 incomplete spinal cord syndromes

Answer 13

1. Anterior cord syndrome
2. Central cord syndrome
3. Cauda equina syndrome

Question 14

Damage to corticospinal and spinothalamic pathways with preservation of posterior column fx (poor prog)

Answer 14

Anterior cord syndrome

Question 15

Usually seen on patients wth cervical spondylosis who sustain a hyperextension injury; dec strength, pain & temp sn in UE>LE

Answer 15

Central cord syndrome

Question 16

Not a true spinal cord syndrome, more of peripheral nerve injuries; sciatica, sadle anesthesia, variable motor and sn loss in LE, dec LE reflexes

Answer 16

Cauda equina syndrome

Question 17

Distributive shock -> warm vasodilated, dec BP, relative bradycardia, loss of SY tone

Answer 17

Neurogenic shock

Question 18

temp loss/ depression of spinal reflex activity -> flaccidity, loss of reflexes/ voluntary movt

Answer 18

Spinal shock

Question 19

Intubate patients with spinal injury C_ and above

Answer 19

C5 (C3-C5 affect phrenic nerve)

Question 20

Maintain MAP >__ mm Hg for 7 days

Answer 20

85

Question 21

Spinal-dose steroid

Answer 21

Methylprednisione 30 mg/kg IV bolus over 15 mins ff by 45-min pause then continuous infusion at 5.4 mg/kg/h for 23 hours (within 8 h of injury)

Question 22

Rigid external orthotic devices

Answer 22

Philadelphia, miami-J collars

Question 23

Cervicothoracic orthoses

Answer 23

Minerva braces

Question 24

External cervical stabilization

Answer 24

Halo vest assemblies

Question 25

Provides lumbar stabilization

Answer 25

Thoracolumbosacral orthoses