Spinal Cord Injury Review

Question 1

What are the 3 most common causes of SCI?

Answer 1

MVA (most common)
Jumps and falls
Diving
Gunshot wounds

Question 2

What are the most common movement patterns.

Answer 2

Low back - Flexion (most common lumbar)
Cervical - flexion, rotation (most common cervical)
General - compression, hyperextension

Question 3

What levels are most often affected?

Answer 3

C5, C7, T12, and L1

Question 4

Describe the ASIA scale

Answer 4

A = Complete: no motor or sensory function in sacral segments (S4-S5)
B = Incomplete: Sensory, but not motor function is preserved below neuro level and includes scares segments
C = Incomplete: motor function is preserved below near level, and most key muscles below level have a muscle grade of less than 3/5
D = Incomplete: Motor function is preserved below near level, most key muscles below level have grade 3 or higher
E = Normal

Question 5

What happens is a patient is suffering from central cord syndrome?

Answer 5

Loss of more central located tracts/arm, function, with preservation of more peripherally located lumbar and sacral tracts/leg function;
Typically caused by hyperextension of cervical spine

Question 6

What is seen in Brown-Sequard Syndrome?

Answer 6

Hemisection of the spinal cord typically caused by penetration wounds (gunshot/knife) with asymmetrical symptoms

Question 7

Describe how Anterior cord syndrome looks in a patient.

Answer 7

Results in loss of motor function, pain and temp with preservation of light tough, proprioception, and position sense.
Typically caused by flexion injury of cervical spine

Question 8

What is the presentation look like for posterior cord syndrome?

Answer 8

Loss of posterior columns with preservation of motor function, sense of pain and light touch;
(Extremely rare)

Question 9

What does caudal equina syndrome present like?

Answer 9

Injury below L1 results in injury to lumbar and sacral roots of peripheral nerves (LMN) with sensory loss and paralysis and some capacity for regeneration;
Flaccid paralysis with no spinal reflex activity
Flaccid paralysis of bladder and bowell

Question 10

What is autonomic dysreflexia?

Answer 10

An emergency situation where a noxious stimulus precipitates a pathological autonomic reflex. Is more common in patients with a T6 or above injury.

Question 11

What are symptoms of autonomic dysreflexia?

Answer 11

Paroxysmal hypertension, bradycardia, headache, diaphoresis, flushing, diplopia, or convulsions

Question 12

What do you need to do with a patient suffering from autonomic dysreflexia

Answer 12

Position the patient upright
Locate possible stimuli
Treat as a medical emergency and discontinue treatment