Exam 1

Question 1

is the dorsal column medial lemniscal tract ascending or descending

what is the DCML’s function

Answer 1

ascending tract - carries sensory info

carries vibration, proprioception, light touch

Question 2

where does the DCML cross

where is its location on a cross-section

Answer 2

medulla

posterior

Question 3

is the spinal thalamic tract ascending or descending

what information does the spinal thalamic tract carry

Answer 3

ascending

sensory information

Question 4

where does the spinal thalamic tract cross

where is its location in a cross-section

Answer 4

spinal cord

anterior-lateral

Question 5

is the corticospinal tract ascending or descending

what information does it carry

Answer 5

descending

motor

Question 6

where does the corticospinal tract cross

where is its location in a cross-section

Answer 6

crosses in brain stem

lateral

Question 7

what is the most common age range and gender for SCI

why

Answer 7

males ages 15-29 d/t decreased executive function

65+ d/t increase fall risk

Question 8

describe SCI diagnoses that indicate a longer life expectancy

Answer 8

incomplete > complete
paraplegia > tetraplegia
lower cervical tetraplegia > higher cervical tetraplegia

mortality rate higher in the first year following injury

Question 9

describe spinal shock

Answer 9

happens immediately after SCI

period of areflexia that lasts

reflexes return over 1-3 day

hyperreflexia possible 1-4 weeks following

Question 10

how is SCI named

Answer 10

spinal level of injury
anatomical location of injury in cord
completeness of injury

Question 11

describe ASIA A

Answer 11

complete

no motor or sensory function is preserved in the sacral segments S4-5

Question 12

describe ASIA B

Answer 12

incomplete

sensory but no motor function preserved below neurological level and includes sacral segments S4-5

Question 13

describe ASIA C

Answer 13

incomplete

motor function is preserved below the neurological level and more than half of key muscles below the neurological level have a muscle grade <3

Question 14

describe ASIA D

Answer 14

incomplete

motor function is preserved below the neurological level and at least half of key muscles below the neurological level have a muscle grade of >3

Question 15

Describe ASIA E

Answer 15

normal

motor and sensory function is normal

Question 16

how is motor level of injury evaluated and decided

Answer 16

determined by testing 10 key muscles on R and L side of the body

the lowest myotome that has a grade of at least 3 if the one above it is a 5

Question 17

how is sensory level of injury evaluated and decided

Answer 17

determined by light touch and pin prick on both R and L side of the body

the most caudal level with normal light touch and pinprick sensation

Question 18

define neurologic level of injury

Answer 18

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

Question 19

define zone of partial preservation

Answer 19

dermatomes and myotomes caudal to the sensory or motor level that remain partially innervated

used to apply only to complete injuries (ASIA A)

Question 20

sensory but not motor preserved at sacral segments describes…

Answer 20

ASIA B
incomplete sensory

Question 21

motor below injury at 3/5 or less for more than half of muscle groups describes…

Answer 21

ASIA C

incomplete motor

Question 22

motor below injury at 3/5 or more for more than half of muscle groups describes…

Answer 22

ASIA D
incomplete motor

Question 23

no motor or sensory at sacral level describes..

Answer 23

ASIA A
complete

Question 24

injury that occurs d/y hyperextension injury

B loss of DCML

Answer 24

posterior cord syndrome

Question 25

injury that occurs d/t hyperflexion B loss of CST and STT

Answer 25

anterior cord syndrome

Question 26

injury d/t hyperextension in a pt that already has stenosis UE > lE affected varying degrees of sensory impairment sacral sparing

Answer 26

central cord syndrome

Question 27

rare injury d/t shot or stab that can interfere with ipsilateral blood supply to the spinal cord ipsilateral loss of DCML and CST contralateral loss of STT

Answer 27

brown sequard syndrome

Question 28

what symptoms would you expect with conus medullaris syndrome

Answer 28

mixed LMN and UMN

Question 29

what symptoms would you expect with cauda equina syndrome

Answer 29

LMN flaccid paresis saddle anesthesia

Question 30

would you expect (UMN/LMN/mixed) symptoms with an injury T7-9

Answer 30

UMN

Question 31

would you expect (UMN/LMN/mixed) symptoms with an injury T10-12

Answer 31

Mostly LMN, but possibly some mixe

Question 32

would you expect (UMN/LMN/mixed) symptoms with an injury L1-3

Answer 32

LMN

Question 33

descibe the symptoms you would expect with a LMN injury

Answer 33

injury below T12 hyporeflexia flaccidity decreased tone/spasticity negative UMN signs flaccid bladder and bowel psychogenic responses for sexual function

Question 34

describe the symptoms you would expect with a UMN injury

Answer 34

injury above T12 hyperreflexia increased tone/spacisity positive UMN signs spastic/hyperreflexive bladder and bowel reflexogenic arcs for sexual function

Question 35

what are symptoms of autonomic dysreflexia

Answer 35

HTN bradycardia headache sweating increased spasticity vasodilation above level of injury constricted pupils nasal congestion pilirecition blurred vision dry, pale skin

Question 36

define a stage 1 pressure injury

Answer 36

intact skin non-blanchable

Question 37

define a stage 2 pressure injury

Answer 37

partial thickness looks like a blister or scrape

Question 38

define a stage 3 pressure injury

Answer 38

full thickness into the subcutaneous fat layer

Question 39

degine a stage 4 pressure injury

Answer 39

full thickness involving muscle or bone

Question 40

at what levels should you be concerned with autonomic dysreflexia

Answer 40

above T6