Spinal Cord Injury

Question 1

Anterior Cord Syndrome

Answer 1

an incomplete lesion that results from compression and damage to the anterior part of the spinal cord or anterior spinal artery.
MOI: typically cervical flexion
Result: loss of motor function and pain and temperature sense below the lesion

Question 2

Brown-Sequard’s Syndrome

Answer 2

An incomplete lesion of a hemisection of the spinal cord
MOI: typically a stab wound
Result: paralysis and loss of vibratory and position sense on the ipsilateral side, and loss of pain and temperature sense on the contralateral side.

Question 3

Cauda Equina Syndrome

Answer 3

An injury that occurs below L1 spinal level where the long nerve roots transcend.
Result: flaccidity, areflexia, impairment of bowel and bladder function

Question 4

Central Cord Syndrome

Answer 4

an incomplete lesion that results from compression and damage to the central portion of the spinal cord.
MOI: usually cervical hyperextension.
Result: UE > LE involvement, motor > sensory

Question 5

Posterior Cord Syndrome

Answer 5

A relatively rare syndrome that is caused by compression of the posterior spinal artery
Result: loss of proprioception, two point discrimination, and stereognosis

Question 6

ASIA A

Answer 6

Complete: no sensory or motor function is preserved in sacral segments S4-S5

Question 7

ASIA B

Answer 7

Sensory Incomplete: sensory but not motor function is preserved below the neurologic level and extends through sacral segments S4-S5

Question 8

ASIA C

Answer 8

Motor Incomplete: motor function is preserved below the neurologic level, and most key muscles below neurologic level have a muscle grade less than 3

Question 9

ASIA D

Answer 9

Motor Incomplete: Motor function is preserved below the neurologic level and most key muscles below the neurologic level have a muscle grade greater than or equal to 3

Question 10

ASIA E

Answer 10

Normal: sensory and motor functions are normal

Question 11

Motor Level

Answer 11

determined by the most caudal key muscles that have muscle strength of 3 or greater with the superior segment tested as normal or 5

Question 12

Motor index scoring

Answer 12

testing each key muscle using the 0-5 scoring, with total points of 25 per extremity for a total possible score of 100

Question 13

Sensory level

Answer 13

determined by the most caudal dermatome with a normal score of 2/2 for pinprick and light touch

Question 14

Heterotopic Ossification (Ectopic Bone)

Answer 14

spontaneous formation of bone in the soft tissues

Question 15

Orthostatic Hypotension

Answer 15

characterized by a decrease in systolic blood pressure greater than 20 mmHg or a decrease in diastolic blood pressure greater than 10 mmHg after moving from supine to sitting position

Question 16

C1-C5 Injury - Functional Outcomes

Answer 16

Dependent 100%

C5 = max assist for bed mobility, dependent for everything else

Question 17

C6 Injury - Functional Outcomes

Answer 17

Bed Mobility: min assist
Transfers: min assist with sliding board
Weight shifts: Mod I to Min A
Wheelchair Management: Min to Mod A for smooth terrain
ROM/Positioning: Mod A to Mod I with all
Feeding: Mod I with adaptive equipment
Grooming: Mod I with adaptive equipment

Question 18

C7-C8 Injury - Functional Outcomes

Answer 18

Bed Mobility: Independent
Transfers: Mod I to independent with sliding board
Weight shifts: Mod I
Wheelchair Management: Mod I with smooth terrain
ROM/Positioning: Min A
Feeding: Mod I with adaptive equipment (C7)
Grooming: Mod I

Question 19

Paraplegia - Functional Outcomes

Answer 19

Bed Mobility: Independent
Transfers: Independent
Weight Shifts: Mod I
Wheelchair Management: Independent to min A with curbs
ROM/Positioning: Independent
Feeding: Independent
Grooming: Independent

Question 20

Myelotomy

Answer 20

A surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function

Question 21

Neurectomy

Answer 21

removal of a segment of a nerve in order to decrease spasticity and improve function

Question 22

Neurogenic nonreflexive bladder

Answer 22

the bladder is flaccid as a result of cauda equina or conus medullaris lesion. The sacral reflex arc is damaged

Question 23

Neurogenic reflexive bladder

Answer 23

The bladder empties reflexively for a patient with an injury above the level of T12. The sacral reflex arc remains intact

Question 24

Neurologic level

Answer 24

the lowest segment of the spinal cord with intact strength and sensation with a muscle grade of fair

Question 25

Paradoxical breathing

Answer 25

A form of abnormal breathing that is common in tetraplegia where the abdomen rises and the chest is pulled inward during inspiration. On expiration the abdomen falls and the chest expands

Question 26

Rhizotomy

Answer 26

resection of the sensory component of a spinal nerve in order to decrease spasticity and improve functino

Question 27

Sacral sparing

Answer 27

an incomplete lesion where some of the innermost tracts remain innervated, leaving sensation of the saddle area, movement of the toe flexors, and rectal sphincter contraction

Question 28

Spinal shock

Answer 28

a physiologic response that occurs between 30 to 60 minutes after trauma to the spinal cord and can last up to several weeks, presenting with total flaccid paralysis and loss of all reflexes below the level of the injury

Question 29

Tenodesis

Answer 29

tight finger flexors in combination with wrist extension to produce a form of grasp

Question 30

Tenotomy

Answer 30

a release of a tendon in order to decrease spasticity and improve function

Question 31

Zone of preservation

Answer 31

describes poor or trace motor or sensory function for up to three levels below the neurologic level of injury