Quiz Questions Exam 2 Flashcards
In the upper spinal cord, the first two cervical cord segments roughly match the first two cervical vertebral levels.
A) True
B) False
A) True
In the thoracic spinal cord, the first five thoracic cord segments roughly match first five thoracic vertebral levels.
A) True
B) False
B) False
Lumbar cord segments are situated at the: A) T3 through T8 vertebral segments B) T9 through T11 vertebral segments C) T12 through L2 vertebral segments D) L3 through S2 vertebral segments
B) T9 through T11 vertebral segments
Usually only the cauda equina, which is less sensitive than the cord, is present and not the spinal cord itself, caudal to (below) what vertebral levels: A) T11 or T12 B) L1 or L2 C) L4 or L5 D) S2 or S3
B) L1 or L2
The lateral horn contains which of the following?
A) Preganglionic parasympathetic cell bodies
B) Preganglionic sympathetic cell bodies
C) Postganglionic parasympathetic cell bodies
D) Postganglionic sympathetic cell bodies
B) Preganglionic sympathetic cell bodies
Reciprocal activation of a stepping pattern generator (SPG) is thought to be coordinated by signals conveyed in the: A) DCML. B) Golgi tendon organs C) Posterior commissure of spinal cord. D) Anterior commissure of spinal cord. E) Ventral horn gamma motor neurons.
B) Golgi tendon organs
Autonomic dysreflexia is characterized by which one of the following?
A) Abrupt decrease in blood pressure because of sympathetic vasoconstriction
B) Abrupt increase in blood pressure and pounding headache
C) Profuse sweating below the level of the lesion
D) Excessive activation of the parasympathetic nervous system
E) Excessive shivering associated with hyperthermia
B) Abrupt increase in blood pressure and pounding headache
Loss of descending sympathetic control as a result of complete spinal cord lesions above T6 result in which of the following? A) Orthostatic hypotension B) Autonomic dysreflexia C) Poor thermoregulation D) Both A and B E) A, B, and, C
E) A, B, and, C
Vertebral canal stenosis is associated with which one of the following?
A) Narrowing of the vertebral canal caused by bone growth or tissue hypertrophy
B) Compression of neural and vascular structures of the spinal cord
C) Radiating pain with numbness and loss of proprioception
D) All of the above
E) None of the above
D) All of the above
Loss of pain and temperature sensation in a capelike distribution over the shoulders, lower limb paresis, hyperreflexia, and loss of bowel and bladder function are characteristic of which of the following? A) Multiple sclerosis B) Cervical spondylosis C) Meningomyelocele D) Syringomyelia E) Erb’s paralysis
D) Syringomyelia
Following an SCI, allowing some muscles to tighten/shorten may improve function. For example, in patients with tetraplegia:
A) Allowing tightness to develop in the long finger flexors will allow a tenodesis grip
B) Allowing tightness in the hip flexors to develop will help with sitting balance.
C) Allowing tightness in the ankle plantarflexors to develop will provide stability for transfers.
D) All of the above.
A) Allowing tightness to develop in the long finger flexors will allow a tenodesis grip
Which of the following injuries result in a lower motor neuron injury? A) Cauda equina injuries B) Posterior cord syndrome C) Brown–Sequard syndrome D) Incomplete spinal cord injuries
A) Cauda equina injuries
Following SCI, spinal shock is characterized by:
A) Absence of all reflex activity below the level of lesion
B) Loss of motor function below the level of lesion
C) Loss of sensation below the level of lesion
D) All of the above
D) All of the above
Autonomic dysreflexia is often indicated by all of the following EXCEPT?
A) Severe headache
B) Positive bulbocavernosus reflex (indicating reflexive bowel)
C) Sudden decrease in systolic blood pressure of 20-40 mmHg below baseline
D) Sweating and “goosebumps” above the level of injury
E) “Flushing” of skin due to vasodilation above the level of injury
C) Sudden decrease in systolic blood pressure of 20-40 mmHg below baseline
Your SCI patient is complaining of symptoms which may be indicative of autonomic dysreflexia. In this case all of the following would be appropriate responses EXCEPT?
A) Lie the patient down immediately
B) Check the patient’s catheter and if it is clamped, release it
C) Check for irritating stimuli such as tight clothing or abdominal binder and remove source of irritation
D) Seek medical attention if symptoms do not resolve
A) Lie the patient down immediately
Characteristics of urinary and bowel dysfunction whose prognosis for bowel control includes loss of spinal defecation reflex activity and LMN innervation and whose response to medications is less effective and nonresponsive to digital stimulation with manual removal of stool from rectum may being required, while whose prognosis for bladder control is intermittent catheterization secondary to inability to establish reflux voiding, describes a: A) Spastic Bladder, Spastic Bowel B) Spastic Bladder, Flaccid Bowel C) Flaccid Bladder, Spastic Bowel D) Flaccid Bladder, Flaccid Bowel
D) Flaccid Bladder, Flaccid Bowel
You have just received a referral for a patient with a SCI with a halo device. Halo devices are:
A) Typically used to immobilize cervical fractures; patients with halos are usually on bedrest for 3 to 4 weeks until the fracture begins to heal.
B) Typically used to immobilize thoracic fractures; patients with halos are usually on bedrest for 3 to 4 weeks until the fracture begins to heal.
C) Typically used to immobilize cervical fractures; in general halo devices allow an earlier progression to upright activities and involvement in rehabilitation.
D) Typically used to immobilize thoracic fractures: in general, halo devices allow an earlier progression to upright activities and involvement in rehabilitation
C) Typically used to immobilize cervical fractures; in general halo devices allow an earlier progression to upright activities and involvement in rehabilitation.
Central cord syndrome is typically characterized by:
A) Loss of pain and temperature with no loss of proprioception; UEs and LEs affected equally.
B) Motor deficits that are more severe than sensory deficits; UE involvement is greater than LE.
C) Sensory deficits that are more severe than motor deficits; LE involvement is greater than UE.
D) Loss of proprioception with no loss of pain and temperature; UE and LE involvement is based on level of lesion.
B) Motor deficits that are more severe than sensory deficits; UE involvement is greater than LE.
Which of the following can be used to help prevent postural hypotension when reacclimating to the vertical position? A) An abdominal binder B) A cervical collar C) Elastic stockings D) Both A and C
D) Both A and C
When sitting in their wheelchairs, patients with SCI should do pressure relief for 10 to 15 seconds: A) every 10 minutes. B) every 20 minutes. C) every 1 to 2 hours. D) every 3 to 4 hours.
A) every 10 minutes.
Pressure relief can be performed by: A) wheelchair push-ups. B) leaning forward or laterally in the wheelchair. C) tilting back a tilt-in-space chair. D) all of the above
D) all of the above
When treating a patient with mid- to low-level cervical injuries, a mat program:
A) would include rolling, prone on elbows, and supine on elbows because these are important positions for dressing and transitioning to sitting.
B) would include rolling for dressing and pressure relief but would not include prone and supine on elbows positions because they are not functional.
C) should be initiated as soon as the patient is cleared for activity.
D) both A and C
A) would include rolling, prone on elbows, and supine on elbows because these are important positions for dressing and transitioning to sitting.
When doing lateral transfers, a patient with a complete SCI at C6:
A) will use the triceps to actively extend the elbow and lift.
B) will not be able to extend the elbow—transfers will be done with elbow flexion by pulling on a trapeze.
C) should be able to use the deltoid and pectoralis muscles to adduct the humerus and extend the elbow if the wrist and hand are fixed.
D) should be able to use the wrist extensors to substitute for triceps and extend the elbow if the wrist and hand are fixed.
C) should be able to use the deltoid and pectoralis muscles to adduct the humerus and extend the elbow if the wrist and hand are fixed.
A patient with a C7 complete SCI would most likely:
A) require a power wheelchair for mobility.
B) require a lightweight manual wheelchair for mobility.
C) require a power wheelchair for community mobility but use a manual wheelchair for short distances.
D) require a lightweight manual wheelchair for community distances but ambulate for short distances.
B) require a lightweight manual wheelchair for mobility.
According to the American Spinal Injury Association (ASIA) Impairment Scale, “motor function preserved below the neurological level, and the majority of key muscles (more than ½) below the neurological level have a muscle grade less than 3” is classified as: A) B, Complete B) A, Incomplete C) E, Normal D) C, Incomplete E) D, Incomplete
D) C, Incomplete
Sensory level on the ASIA is the most caudal consecutive neurological segment of normal (2) sharp/dull and light touch. This level may differ between right and left and may differ from the motor level.
A) True
B) False
A) True
Proprioception tested by laterally grasping the bony prominences of the extremity to reduce effects of sensory input from other ascending tracts of cord at all major joints of both UE & LE (shoulder, elbow, wrist, fingers, hips, knees, ankles, and toes) is a requirement on the ASIA.
A) True
B) False
B) False
Because each spinal segment innervates more than one muscle, the motor level is determined by testing key muscles along the myotomal distribution. Motor testing on the ASIA should occur in a rostral to caudal direction, starting with the head/neck and proceeding downward.
A) True
B) False
A) True
On the ASIA for SCIs, because the particular spinothalamic tract conveys both pain and temperature, it is not necessary to repeat using hot and cold stimuli after assessing between sharp and dull sensations.
A) True
B) False
A) True
On the ASIA, the motor level is the most caudal segment where the key muscle is a grade of 2 and the next most rostral key muscle tests as a 3.
A) True
B) False
B) False
Muscle function grading is out of 5 not 2.
Recognition of an unseen object by touch and manipulation occurs in which of the following? A. Cerebellum B. Basal ganglia C. Primary somatosensory cortex D. Secondary sensory area E. Dorsolateral prefrontal association
D. Secondary sensory area
Categorizing sounds as language, music, or noise occurs in which of the following? A. Superior colliculus B. Secondary auditory cortex C. Secondary visual cortex D. Primary auditory cortex E. Cochlear nuclei
B. Secondary auditory cortex
Initiation of movement, orientation, and planning of bimanual or sequential movements are influenced by which of the following?
A. Supplementary motor area
B. Premotor area
C. Broca’s area
D. Area analogous to Broca’s area in the nondominant hemisphere
E. Primary motor cortex
A. Supplementary motor area
Trunk and girdle muscles are controlled by descending signals from neurons in which of the following?
A. Supplementary motor area
B. Premotor area
C. Broca’s area
D. Area analogous to Broca’s area in the nondominant hemisphere
E. Primary motor cortex
B. Premotor area
The parietotemporal association area is important for which of the following? A. Solving a problem B. Comprehending communication C. Understanding spatial relationships D. A and B E. A, B, and C
E. A, B, and C
