6] SCI Part 2

Question 1

Damage to central part of cord

Answer 1

Central cord syndrome

Question 2

Central cord syndromes happens with what injuries

Answer 2

HYPEREXTENSION injuries

Question 3

Central cord syndrome is seen with damage to what tracts

Answer 3

UE, trunk and LE with sacrum spared

Question 4

What’s the first thing To go with central cord syndrome

Answer 4

Their arms!!

Question 5

Ipsilateral loss of brown-sequard syndrome

Answer 5

Proprioception
Vibration
2 point discrimination
Fine touch
Stereognosis 
Motor function

Question 6

Contralateral loss of brow-sequard syndrome

Answer 6

Pain and temp

Question 7

You see anterior cord syndrome with

Answer 7

Tear drop or burst fracture

Question 8

Anterior cord syndrome results in loss of?

Answer 8

Bilateral loss of motor function, pain and temp

Question 9

Anterior cord syndrome has intact

Answer 9

Intact proprioception

Question 10

Cauda equina syndrome is damage where that results in what

Answer 10

Damages at L1 or below which results in flaccid paralysis

Question 11

Conus medullaris is injury where

Answer 11

Sacral and lumbar nerve roots

Question 12

What do you see with conus medullaris syndrome?

Answer 12

LE motor and sensory loss

Areflexic bowel and bladder

Question 13

Neuro level of Asia define

Answer 13

Most caudal level that has intact sensation and motor on BOTH sides of the body

Question 14

Motor level of Asia define

Answer 14

Most caudal level with 3/5 strength AND higher levels with 5/5 on both sides of the body

Question 15

Sensory level of ASIA define

Answer 15

Most caudal level with intact sensation on both sides of the body

Question 16

Used only with complete injuries; most caudal segment with some motor or sensory function

Answer 16

Zone of partial preservation

Question 17

Asia for the trunk

Answer 17

No motor assessment; assume motor and sensory at same level

Question 18

Complete SCI

Answer 18

Full loss of sensory and motor function below level of injury including sacral and anal

Question 19

Incomplete SCI

Answer 19

Partial loss of sensory and motor below level of injury with sacral and anal spared

Question 20

ASIA A

Answer 20

Complete motor and sensory loss below level of lesion

Question 21

ASIA B

Answer 21

Incomplete- sensory only

Question 22

ASIA C

Answer 22

More than 50% of KEY muscles below the neuro level have a muscle garden less than 3/5

Question 23

ASIA D

Answer 23

More than 50% of the KEY muscles below neuro level have muscle grade more or = to 3

Question 24

ASIA E

Answer 24

Normal

Question 25

C5 muscles

Answer 25

Elbow flexors | Biceps, brachialis

Question 26

C6 muscles

Answer 26

Wrist extensors | ECRL and ECRB

Question 27

C7 muscles

Answer 27

Elbow extensors | Triceps

Question 28

C8 muscles

Answer 28

Finger flexors | Flexor digitorum profundus

Question 29

T1 muscles

Answer 29

Small finger abductors | Abductor digiti minimi

Question 30

L2 muscles

Answer 30

Hip flexors | Iliopsoas

Question 31

L3 muscles

Answer 31

Knee extensors | Quads

Question 32

L4 muscles

Answer 32

Ankle DF | Tibialis anterior

Question 33

L5 muscles

Answer 33

Long toe extensors | Extensor hallucis longus

Question 34

S1 muscles

Answer 34

Ankle PF | Gastro/soleus

Question 35

Examples of SCI functional outcome measures

Answer 35

``` FIM SCIM QIF WISCI Wheelchair skills test FEW ```

Question 36

◦ Better able to distinguish paraplegia vs. tetraplegia ◦ Items are valid and responsive ◦ Items represent different aspects of mobility & locomotor function

Answer 36

FIM

Question 37

◦ 17 items ◦ Good reliability and validity ◦ Average change pre/post rehab for 114 pts was 5 points (statistically significant) ◦ Scale has some ceiling and floor effects

Answer 37

SCIM - spinal cord independence measure

Question 38

Specific to cervical SCI, reliable, validity needs more research

Answer 38

QIF - quadriplegia index of function

Question 39

Valid and most clinically useful

Answer 39

10 meter walk test

Question 40

◦ 19 point scale that rates walking ability ◦ based on devices used, braces used, assistance required, and distance ◦ Good reliability and construct validity ◦ Most clinically useful with incomplete SCI

Answer 40

WISCI - walking index for SCI

Question 41

50 skills, good reliability and construct validity

Answer 41

Wheelchair skills test

Question 42

10 items, assesses ability to function in specific w/c

Answer 42

FEW - functioning everyday in a wheelchair

Question 43

What are the medical complications of SCI?

Answer 43

``` Autonomic dysfunction, autonomic dysreflexia, Respiratory complications Skin compromise DVT UTI complications Osteoporosis GI complications HO Pain Spasticity ```

Question 44

What is considered a medical emergency

Answer 44

Autonomic dysfunction

Question 45

What is autonomic dysfunction

Answer 45

Sensory loss, motor paralysis, | Loss of bowel and bladder control

Question 46

Autonomic dysreflexia happens what levels

Answer 46

T6 and above

Question 47

What do you see with autonomic dysreflexia?

Answer 47

``` Increased BO Bradycardia Nasal congestion Pounding headache Anxiety Flushing Profuse sweating ```

Question 48

Causes of autonomic dysreflexia

Answer 48

Anything that can be perceived as a noxious stimulation

Question 49

Treatment for autonomic dysreflexia

Answer 49

Immediately sit them upright and fix the problem

Question 50

Autonomic dysreflexia and what happens to the vessels

Answer 50

Vasodilation ABOVE level of injury | Vasoconstriction BELOW level of injury (pale, cool no sweating)

Question 51

Most common cause of autonomic dysreflexia

Answer 51

Kinked catheter

Question 52

Where is diaphragm innervated

Answer 52

C3-C5

Question 53

Benefits of the patient sleeping prone

Answer 53

Air-ates different lobes of the lung but also prevents hip contractures that they might get from wheelchair

Question 54

Best way to prevent DVT

Answer 54

Activity

Question 55

Medication for HO

Answer 55

Didronel- slows it down

Question 56

Muscle substitution is used for

Answer 56

Tetraplegia

Question 57

What is muscle substitution?

Answer 57

Using fixation of distal extremity to achieve movement

Question 58

Examples of muscle sub

Answer 58

1] shoulder ER with distal end fixed and elbows extended | 2] pulling on bedrails or using loops

Question 59

2 movement strategies

Answer 59

Head/hips relationship Angular momentum (throwing the extremity) Muscle substitution