SCI

Question 1

total absence of sensation in dermatomes below level of lesion

Answer 1

complete lesions

Question 2

sensory loss related to damage within specific spinal tracts

Answer 2

incomplete lesions

Question 3

C5 controls which myotome

Answer 3

elbow flexors

Question 4

C6 controls which myotome

Answer 4

wrist extensors

Question 5

C7 controls which myotome

Answer 5

elbow extensors

Question 6

C8 controls which myotome

Answer 6

finger flexors

Question 7

NEUROLOGIC level of injury is the lowest level on the spinal cord where key muscles test at least / and sensation intact for this level dermatome

Answer 7

3/5

Question 8

FUNCTIONAL level lowest segment which strength of key muscles graded at / or higher and sensation intact

Answer 8

3+/5

Question 9

A lesion to the centrally located structures of region, that produces sacral sparing and greater weakness in the upper limbs than in the lower limbs. Typically seen in older adults

Answer 9

central cord syndrome

Question 10

Hemisection of the cord which produces ipsilateral (same-sided) proprioceptive and motor loss and contralateral (other side) loss of pain and temperature

Answer 10

Brown-Sequard syndrome

Question 11

Rare, results from compression by tumor or infarction of the posterior spinal artery. Proprioception, stereognosis, two-point discrimination, and vibration sense are lost below the lesion.

Answer 11

posterior cord syndrome

Question 12

A lesion that produces variable loss of motor function and of sensitivity to pin and temperature, while preserving proprioception, touch and vibration.

Answer 12

anterior cord syndrome

Question 13

Injury of the sacral cord (conus) and lumbar nerve roots within the neural canal that usually results in nonreflexive bladder, bowel and lower limbs. Sacral segments may occasionally show preserved reflexes (bulbocavernosus and micturition reflexes).

Answer 13

conus medullaris syndrome

Question 14

Injury to the lumbosacral nerve roots within the neural canal resulting in nonreflexive bladder, bowel and lower limbs.

Answer 14

cauda equina syndrome

Question 15

what movement is possible if you have a C1-C3 SCI

Answer 15

neck flexion
neck extension
neck rotation

Question 16

what movement is possible if you have a C4 SCI

Answer 16

neck flexion
neck extension 
neck rotation 
scapular elevation 
inspiration

Question 17

what movement is possible if you have a C5 SCI

Answer 17

Shoulder flexion
Shoulder abduction
Shoulder extension
Elbow flexion
Supination
Scapular adduction & abduction

Question 18

what movement is possible if you have a C6 SCI

Answer 18

Scapular protraction
Horizontal adduction (some)
Forearm supination
Radial wrist extension

Question 19

what movement is possible if you have C7-C8 SCI

Answer 19

Elbow extension
Ulnar wrist extension
Wrist flexion
Finger flexion & extension
Thumb flexion, extension, & abduction

Question 20

what movement is possible if you have a T1-T4 SCI

Answer 20

Upper extremity
Limited trunk stability
Increasing lung capacity

Question 21

what movement is possible if you have T10-L1 SCI

Answer 21

trunk stability

Question 22

what movement is possible if you have L2-S5 SCI

Answer 22

trunk stability

partial to full control of LE

Question 23

A L2 SCI is classified as motor function in what muscle

Answer 23

ilipsoas

Question 24

A L3 SCI is classified as motor function in what muscle

Answer 24

quadriceps femori

Question 25

A L4 SCI is classified as motor function in what muscle

Answer 25

tibialis anterior

Question 26

A L5 SCI is classified as motor function in what muscle

Answer 26

Extensor hallucis longus

Question 27

What education should you provide a patient with a SCI

Answer 27

Levels & Outcomes Positioning to manage tone Body mechanics to minimize injury (both to pt and family) Use of adaptive equipment for independence Sensory awareness Handling architectural barriers (what does their home look like) Managing complications (AD, OH) Sexual counseling

Question 28

determines the L3 level of lesion

Answer 28

knee extensors

Question 29

determines the C6 level of lesion

Answer 29

wrist extensors

Question 30

determines the T1 level of lesion

Answer 30

small finger abductors

Question 31

determines the L2 level of lesion

Answer 31

hip flexors

Question 32

determines the C7 level of lesion

Answer 32

elbow extensors

Question 33

determines the L4 level of lesion

Answer 33

ankle dorsiflexors

Question 34

determines the C8 level of lesion

Answer 34

finger flexors

Question 35

determines the S1 level of lesion

Answer 35

ankle plantar flexors

Question 36

determines the C5 level of lesion

Answer 36

elbow flexors

Question 37

determines the L5 level of lesion

Answer 37

long toe extensors

Question 38

determines the C3 level of lesion

Answer 38

diaphragm

Question 39

what type of stimulus do you test with for a SCI patient

Answer 39

strong

Question 40

If a patient has a known complete lesion, should you test multiple sensory modalities

Answer 40

no

Question 41

If a patient has unknown or incomplete lesions, should you test multiple sensory modalities

Answer 41

yes

Question 42

When does sensory recovery typically happen

Answer 42

within the 1st year

Question 43

complete loss of neurological function that results in diminished reflex activity below level of injury. Lasts 1 day-6 weeks.

Answer 43

spinal shock

Question 44

what are symptoms of spinal shock in the affected area

Answer 44

``` Decreased sensation Decreased deep tendon reflex Decreased blood pressure Flaccid muscle function Frequent loss of bowel & bladder control ```

Question 45

what is involved with acute management of SCI

Answer 45

♣ Positioning/Deformity Control ♣ Skin integrity ♣ Initial ADL skills ♣ Education but action is primary feature ♣ Start upright tolerance ♣ Building blocks * think about what are the skills you will need them to have in order to complete ADL’s* ♣ Strengthening/ROM- this also helps to start acclimating them to their body

Question 46

what is involved with inpatient rehabilitation

Answer 46

``` ♣ Upright tolerance ♣ Deformity control ♣ Skin issues become more directive ♣ ADL’s ♣ Strengthening/ROM ♣ Learning body in space skills ♣ Teach them their head controls body movements ♣ Functional mobility ♣ Spinal shock resolves ♣ Education ```

Question 47

what is involved with outpatient/home health

Answer 47

``` Finishing what you started ROM/Strengthening Body in space ADL skills at higher level Functional mobility skills Community access Training family ```

Question 48

what are the prognosis factors for a SCI

Answer 48

``` Type of injury Motivation Socioeconomic background Education Family support Acceptance of disability Problem solving abilities ```

Question 49

what are the symptoms of OH

Answer 49

``` ♣ Dizziness ♣ Loss of consciousness ♣ Nausea ♣ Pallor ♣ Sudden weakness ```

Question 50

what is the treatment of OH

Answer 50

♣ If sitting in chair tilt chair backwards ♣ If sitting EOB lie patient back down ♣ Coming to upright position slowly can help decrease incidents of orthostatic hypotension

Question 51

prevention of OH

Answer 51

Ace wraps abdominal binder gradual increases in sitting tolerance

Question 52

treatment of autonomic dysreflexia

Answer 52

Elevate to sitting position ♣ Take blood pressure in both arms – remember systolic BP can be in 90 – 110 mmHg range normally ♣ Check for blockage/kinks in bladder & bowel system ♣ Check for areas of restriction – tight clothing ♣ Relieve urinary pressure ♣ Seek medical attention

Question 53

risk factors of DVT

Answer 53

immobilization, post-op, age>40, cardiac disease, limb trauma, coagulation d/o, obesity, advanced neoplasm (abnormal growth), pregnancy

Question 54

clinical signs of DVT

Answer 54

Pain Swelling Superficial venous distention Fever

Question 55

treatment of DVT

Answer 55

blood thinners – Coumadin, heparin compression (more as a prevention—ie TED hose) bed rest