Spinal Cord Injury Terminology. Neurogenic Bladder

Question 1

What is the Neurological Level?

Answer 1

The most caudal level of the spinal cord with normal motor and sensory function on both the left and right sides of the body.

Question 2

How is Motor Level Determined?

Answer 2

Via strength testing of key muscles.

The lowest myotome with a key muscle that has a grade of at least 3. All key muscles above this level are normal (MMT = 5).

Question 3

How is the Sensory Level Determined?

Answer 3

Via patients sensitivity to light touch and pinprick on the left and right sides of the body.

0 = Absent
1 = Impaired
2 = Normal

Sensory Level = Most caudal level with normal (2/2); light touch and pinprick sensation.

Question 4

How are myotomes that are not clinically testable graded?

Answer 4

Motor level is the same as the sensory level.

Question 5

What is Sacral Sparing?

Answer 5

Sensory function at the [S4-S5 dermatome] or voluntary anal contraction.

Question 6

What is a zone of partial preservation?

Answer 6

An individual who does not have sacral sparing, but has areas of intact motor and/or sensory functional below the neurological level.

Only in patients considered to be Complete SCI, or ASIA A

Question 7

What is Paradoxical Breathing?

Answer 7

Form of abnormal breathing common in tertraplegia.

Inspiration: abdomen rises and chest is pulled inward.

Expiration: Abdomen fall and chest expands

Question 8

What is Paraplegia?

Answer 8

Term that describes injuries that occur at the level of the thoracic, lumbar or sacral spine.

Paralysis of legs or lower body

Question 9

What is Tetraplegia?

Answer 9

Aka “Quadriplegia”

Term that describes injury at the cervical spine.

Inability to voluntarily move the upper and lower parts of the body.

Question 10

What is neurogenic non-reflexive bladder?

Answer 10

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

(AKA LMN Bladder)

Question 11

What is neurogenic reflexive bladder?

Answer 11

Bladder able to empty reflexively for a patient with an injury above the level of T12. The sacral reflex arc remains intact.

(AKA UMN Bladder)

Question 12

Treatment for a Spastic/UMN Bladder?

Answer 12

Suprapubic Tapping

Question 13

Treatment for a Flaccid/LMN Bladder?

Answer 13

Valsalva or Crede’s Maneuver