Spinal Cord Injuries

Question 1

What is the ASIA scale for spinal cord injuries?

Answer 1

A- complete; no motor or sensory in S2-S5
B- incomplete; some sensory past level of injury, no motor, no sacral sparing
C- incomplete; more than half of muscles below injury level have less than grade 3 muscle strength
D- incomplete; more than half of muscles below injury level have grade 3 or more muscle strength
E- normal

Question 2

What is spinal shock?

Answer 2

Pt is hypotensive and bradycardic (neurogenic shock) from loss of sypmpathetic tone. Flaccid areflexic paralysis, no bulbocavernosus reflex; resolves in 48 hrs
Due to hyperpolarization of neurons leaving them unable to respond to stimuli

Question 3

At what cervical level is a patient likely to require intubation?

Answer 3

C5

Question 4

What are contraindications to steroid treatment for SCI?

Answer 4

1) GSW
2) Pregnant
3) >8hrs
4) younger than 13yo
5) brachial plexus injury

Question 5

What is the NASCIS III protocol for steroid treatment in SCI?

Answer 5

Methylprednisone
load 30 mg/kg over 1st hour (2 grams for 70kg man)
drip 5.4 mg/kg/hr drip
for 23 hours if started

Question 6

At cervical level in a SCI patient are they able to feed themselves?

Answer 6

C6; much more independent than C5

Question 7

What percentage of SCI patients suffer from major depressive disorder?

Answer 7

~11%