ISNCSCI

Question 1

Sensory examination purpose

Answer 1

Standardized process of assessing
dermatomal sensation to identify sensory
level of a patient with an SCI

Question 2

What should the patient not do during the exam

Answer 2

Watch the examiner

Question 3

Sensory exam components

Answer 3

Light touch:
Use tip of cotton swab and be careful to use only light touch

Pain/pin prick:
Use a safety pin, and the goal here is not to detect sensation, but discrimination between sharp vs. dull

Test key points bilaterally and score on the grid

Question 4

Sensory scoring

Answer 4

0 = absent
1 = altered
2 = normal
NT = not testable

Question 5

Motor examination purpose

Answer 5

Standardized process of assessing motor
function in a patient with an SCI

Question 6

What position does the motor exam take place

Answer 6

Supine!
Not the same as MMT

Question 7

Motor exam scoring

Answer 7

Same as MMT 0-5
NT = not testable

Question 8

How to identify the level of injury

Answer 8

Most caudal segment with intact sensation and antigravity (3,4,5) muscle function, provided there is normal (intact) sensory and motor function rostrally

Question 9

What is considered a complete injury

Answer 9

ALL conditions must be met:
Voluntary anal contraction (VAC) is no
All S4–S5 sensory scores equal zero
Deep anal pressure (DAP) is no

Question 10

Zone of Partial Preservation

Answer 10

Applicable if absent motor (no VAC) or sensory (no DAP, no LT or PP) in S4–S5

Most caudal segment with some motor function or sensation: does not need to be fully intact

Question 11

ASIA A

Answer 11

Complete.
No sensory or motor function is preserved in the sacral segments S4-5

Question 12

ASI B

Answer 12

Sensory Incomplete.
Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-5 (light touch or pin prick at S4-5 or deep anal pressure)
AND
no motor function is preserved more than three levels below the motor level on either side of the body

Question 13

ASI C

Answer 13

Motor Incomplete.
Motor function is preserved at the most caudal sacral segments for voluntary anal contraction
OR
the patient meets the criteria for sensory incomplete status (sensory function preserved at the most caudal sacral segments S4-5 by LT, PP or DAP), and has some sparing of motor function more than three levels below the ipsilateral motor level on either side of the body

(This includes key or non-key muscle functions to determine motor incomplete status)

For AIS C – less than half of key muscle functions below the single NLI have a muscle grade ≥ 3.

Question 14

ASI D

Answer 14

Motor Incomplete.
Motor incomplete status as deined above, with at least half (half or more) of key muscle functions below the single NLI having a muscle grade ≥ 3.

Question 15

How to determine the zone of partial preservation (ZPP)

Answer 15

The ZPP is used only in injuries with absent motor (no VAC)
OR
sensory function (no DAP, no LT and no PP sensation) in the lowest sacral segments S4-5, and refers to those dermatomes and myotomes caudal to the sensory and motor levels that remain partially innervated

With sacral sparing of sensory function, the sensory ZPP is not applicable and therefore “NA” is recorded in the block of the worksheet

Accordingly, if VAC is present, the motor ZPP is not applicable and is noted as “NA”.