ASIA

Question 1

C5 muscles

Answer 1

elbow flexors - biceps, brachialis

Question 2

C6 muscles

Answer 2

wrist extensors - ECRL and ECRB

Question 3

C7 muscles

Answer 3

elbow extensors - triceps

Question 4

C8 muscles

Answer 4

long finger flexors - FDP

Question 5

T1 muscles

Answer 5

small finger abductor - abductor digiti minimi

Question 6

L2 muscles

Answer 6

hip flexors - iliopsoas

Question 7

L3 muscles

Answer 7

knee extensors - quads

Question 8

L4 muscles

Answer 8

ankle dorsiflexors - tibialis anterior

Question 9

L5 muscles

Answer 9

long toe extensors - extensor hallucis longus

Question 10

S1 muscles

Answer 10

ankle plantarflexors - gastroc, soleus

Question 11

ASIA A

Answer 11

complete: no motor or sensory function preserved in sacral segements

Question 12

ASIA B

Answer 12

incomplete: sensory but no motor function preserved below neurologic funciton

Question 13

ASIA C

Answer 13

incomplete: motor function preserved below the neurologic level (> 1/2 of muscles have a muscle grade <3)

Question 14

ASIA D

Answer 14

incomplete: motor function preserved below the neurologic level (1/2 of muscles have a muscle grade>/= 3)

Question 15

ASIA E

Answer 15

normal: sensory and motor function normal

Question 16

motor score meanings 0-5

Answer 16

0 - total paralysis
1 - palpable or visible contraction
2 - active movement, gravity eliminated
3 - active movement, against gravity
4 - active movement, against some resistance
5 - active movement, against full resistance
NT - not testable

Question 17

sensory scoring 0-2

Answer 17

0=absent
1=altered
2= normal

Question 18

voluntary anal contraction and deep anal pressure are both absent what is the asia

Answer 18

ASIA A (NOON sign)

Question 19

when to test non-key muscles

Answer 19

in a patient with an apparent AIS B classification, non-key muscle functions more than 3 levels below the motor level on each side should be tested to most accurately classify the injury (differentiate between ASIA B and C)

Question 20

typical presentation C4

Answer 20

muscles available: diaphragm, trapz. levator scap, rhomboids

available mvmts: BREATH INDEPENDENT of VENT
scapular elevation

Question 21

typical presentation C5

Answer 21

muscles available: deltoid, biceps, brachialis, brachioradialis, infraspinatuss/teres minor, supinator

movements available: elbow flexion, forearm supination, shoulder ER and ABD
operate power wc w joysyick

Question 22

typical presentation C6

Answer 22

muscles availableL: pec, serratus, lats, ECR, pronator teres

movement available: wrist ext, forearm pronation, shoulder scap stability/strength

significantly > functional potential than above levels

Question 23

typical presentation C7

Answer 23

muscles available: pec major, TRICEPS, FCR, EPL/B, extrinsic finger extensors

movements available: elbow ext, wrist flexion, finger ext

potential for independent function

Question 24

typical presentation C8-T1

Answer 24

muscles available: extrincis finger flexors, FCU, FPL/B, intrinsic finger flexors

movements available: fine motor skills

Question 25

typical presentation T2-T6

Answer 25

muscles available: full UE, partial intercostals, partial back extensors function: independent all mobiltiy and ADLS at manual wc level

Question 26

typical presentation T7-L1

Answer 26

muscles available: full UE, intercostals partial/full, abs & back ext(extent depend on level) function: improved effective cough, independent all mobility and ADLs at manual wc level

Question 27

typical presentation L2-L5

Answer 27

muscles available: L2- hip flexors, ADDs L3 - knee ext L4 - ankle DF L5 - hip ABD, knee flexion, ankle ambulation becomes feasblie goal w AD and LE bracing

Question 28

typical presentaation S1-S2

Answer 28

S1 - knee flexion, hip ext, ankle PF/inv/ever S2 - hip ext, rotation and full anlke community ambulation wit minimal to no bracing or AD

Question 29

types of incomplete SCI syndromes

Answer 29

anterior cord central cord posterior cord brown-sequard conus medullaris cauda equina

Question 30

anterior cord syndrome

Answer 30

Loss of movement, pain, and temp. Still able to feel position, vibration and touch. Etiology- Lesions of anterior spinal artery Presentation: Loss of motor Loss of pain & temperature Relative preservation of position sense & vibration Prognosis: Generally poor (10-20%) for motor recovery

Question 31

central cord syndrome

Answer 31

loss of movement and sensation. complete loss below level of injury? When process of central hemmorhage/necrosis due to tissue damage does not progress to full destruction of cord segmentperipherally located fiber tracts intact Spatial orientation of tracts – cervical segments located closer to central gray matterT, L, S segments located progressively more peripherally in cord. Etiology: Most common in older people following extension injuries Damage to central aspect of cord, sparing peripheral aspects Presentation: Motor & sensory loss in UEs Trunk & LEs may be affected dependent on severity Prognosis: > 50 y.o. only 41% (I) community ambulators < 50 y.o., 97% (I) community amb

Question 32

Brown Squared syndrome

Answer 32

loss of pain, temperature, and light touch of opposite side. Loss of motor function and vibration, position, and deep touch sensation on same side Etiology: damage to ½ of the cord (hemi-section) Most common cause = stab/gunshot wound Presentation: Ipsilateral side motor loss sensory loss of proprioception, vibration Contralateral side sensory loss of pain & temp Prognosis: Good for recovery – most will regain bladder/bowel function; most will become ambulatory

Question 33

Conus Medullaris

Answer 33

Terminal segment of spinal cord at bony level of L1 Affects S2 to S4-5 UMN lesion (likely LMN component) Bowel and bladder dysfunction Sexual dysfunction LE strength may remain intact Saddle anesthesia Often combination of UMN and LMN – conus and cauda Urinary and fecal incontinenceTypically symmetric presentation: Distal paresis of lower limbs is less marked

Question 34

Cauda Equina

Answer 34

Lesion below L1 LMN deficits LE motor weakness & atrophy (L2-S2) Areflexia/hypotonia Bowel & bladder involvement Pain May have spared perineum sensation - sometimes Common Causes:Traumatic injury Disk herniationSpinal stenosis Spinal tumors (neoplasms): metastatic tumors, meningiomas, schwannomas, and ependymomas Inflammatory conditionsInfectious conditionsAccidental causes by medical intervention