SCI part 1

Question 1

What does the anterior horn of the gray matter contain?

Answer 1

efferent (motor) neurons

Question 2

What does the posterior horn of gray matter contain

Answer 2

afferent (sensory) neurons

Question 3

Sympathetic nervous system arises where?

Answer 3

thoracolumbar, T1-L2

Question 4

What is the sympathetic nervous system responsible for?

Answer 4

Prepares body for flight or fight, emergency responses
Increases HR, BP
Constricts peripheral blood vessels and redistributes blood
Inhibits peristalsis

Question 5

Where does the parasympathetic nervous system arise from?

Answer 5

craniosacral division, CN III, VII, IX, X, pelvic nerves

Question 6

What is the parasympathetic nervous system responsible for?

Answer 6

Conserves and restores homeostasis
Slows HR and reduces BP
Increases peristalsis and glandular activity

Question 7

What modulates the autonomic nervous system?

Answer 7

Brain Centers
Descending Autonomic System (hypothalamus and lower brainstem)
Cranial Nerves

Question 8

What are autonomic plexus?

Answer 8

cardiac, pulmonary, celiac, hypogastric, pelvis

Question 9

What are the mechanisms of SCI?

Answer 9

flexion
flexion-rotation
compression
hyperextension

Question 10

What is the most common lumbar injury?

Answer 10

flexion

Question 11

The most common cervical injury?

Answer 11

flexion-rotation

Question 12

Spinal areas of greatest frequency of injury:

Answer 12

C5, C7, T12, L1

Question 13

Non Traumatic Causes

Answer 13

Disc prolapse, vascular insult, infections

Question 14

What does the lesion level indicate?

Answer 14

most distal uninvolved nerve root segment with normal function; muscles must have a grade of at lease a 3+/5 or fair+ function

Question 15

Tetraplegia (quadriplegia):

Answer 15

injury occurs between C1 and C8 > involves all 4 extremities and trunk

Question 16

Paraplegia

Answer 16

injury occurs between T1 and T2-L1, involves both lower extremities and trunk (varying levels)

Question 17

Grade A ASIA Impairment Scale

Answer 17

Complete lack of motor and sensory function below the level of injury (including the anal area, S4 and S5)

Question 18

Grade B ASIA Impairment Scale

Answer 18

Incomplete: sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5

Question 19

Grade C ASIA Impairment Scale

Answer 19

Incomplete: motor function is preserved below the neurological level, and most key muscles below the neurological level have a muscle grade of less than 3

Question 20

Grade D ASIA Impairment Scale

Answer 20

Incomplete: motor function is preserved below the neurological level, and most key muscles below the neurological level have a muscle grade of 3 or more

Question 21

Grade E ASIA Impairment Scale

Answer 21

All neurologic function has returned.

Question 22

Complete SCI:

Answer 22

Absence of sensory and motor function below lesion level

Question 23

Incomplete SCI:

Answer 23

Involves partial preservation of sensory and motor functions below the lesion level

Question 24

Common causes of SCI:

Answer 24

Transection
Compression
Infection
Degenerative Disorders

Question 25

Transection

Answer 25

Complete severance of the cord | All sensory & motor information is interrupted at or below lesion level

Question 26

Compression

Answer 26

Impingement of the cord | Symptoms depend on the severity of the injury

Question 27

Non-traumatic SCI:

Answer 27

narrowing spinal canals | disc prolapse, vascular insult, TA

Question 28

Traumatic SCI:

Answer 28

Most involve a single level or limited number of contiguous vertebrae Result from forces that create violent motions of head or trunk

Question 29

Most often areas of injury in traumatic cervical injury?

Answer 29

C5 and C7 | Flexion, vertical loading, and extension accompanied by rotation or lateral flexion

Question 30

Why is the thoracic area less likely to be injured from traumatic causes?

Answer 30

rib cage and higher stability as compared to cervical region

Question 31

Most common site of injury in thoracic region:

Answer 31

T12-L1 junction

Question 32

Mechanisms of Secondary Tissue Destruction

Answer 32

ischemia edema demyelination and destruction

Question 33

What is spinal shock?

Answer 33

Temporary phenomenon that occurs after trauma to the spinal cord in which the cord ceases to function below the lesion

Question 34

When does spinal shock usually resolve?

Answer 34

Usually resolves within 24 hours of the injury with the return of the anal and bulbocavernosus reflexes

Question 35

What is affected with spinal shock?

Answer 35

Spinal reflexes, voluntary motor control, sensory function, and autonomic control are absent below the level of the lesion

Question 36

5 Most Important Tracts to Clinically Evaluate

Answer 36

``` Lateral Costicospinal Dorsal Column Lateral Spinothalamic Spinocerebellar Vestibulospinal ```

Question 37

Lateral Corticospinal Tracts

Answer 37

Voluntary motor control on the contralateral side

Question 38

Dorsal Column

Answer 38

Conscious discriminative touch, pressure, vibration, and proprioception on the contralateral side

Question 39

Lateral Spinothalamic Tracts

Answer 39

Conscious pain & temperature on the contralateral side

Question 40

Spinocerebellar Tracts

Answer 40

Unconscious proprioception

Question 41

Vestibulospinal Tracts

Answer 41

Facilitation of extensor tone (important to assess in neurologic injury)