Week 7: Spinal Region

Question 1

Important Myotomes

Answer 1

Elbow flexion: C6
Elbow Extension: C7
Wrist extension: C6
Hip Flexion: L2
Ankle Dorsiflexion: L5

Question 2

Anterior Cord Syndrome

Answer 2

Damage to anterior portion w/spinal cord
- Paralysis and loss of temperature sensation

Question 3

Central Cord Syndrome

Answer 3

Usually has paralysis too, despite the textbook there is also some loss of temperature sensation

Question 4

Brown-Sequard syndrome

Answer 4

After stabbings, bilateral impairments, paralysis all loss of sensory info and temperature info

Question 5

Cauda equina syndrome

Answer 5

Lumbar and sacral regions, pain, muscle weakness, and loss of sensation

Question 6

Tethered cord syndrome

Answer 6

Cord stretched out: Pain and bowel impairments

Question 7

Complete vs. incomplete injuries

Answer 7

Complete = no motor, no, sensory, and no sacral sparing. Incomplete = Only has one or 2 of these things

Question 8

Cervical Stenosis

Answer 8

Cervical stenosis is a common cause of neck pain. It happens as there are changes with the vertebrae of the neck and the joints between those vertebrae. Bone spurs begin to form, causing cervical spinal stenosis.

Question 9

Lumbar stenosis

Answer 9

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of your back. Stenosis, which means narrowing, can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles

Question 10

Autonomic Dysreflexia

Answer 10

Autonomic dysreflexia is an abnormal, overreaction of the involuntary (autonomic) nervous system to stimulation. This reaction may include: Change in heart rate. Excessive sweating. High blood pressure.

Question 11

Orthostatic hypotension

Answer 11

Orthostatic hypotension is a condition in which your blood pressure suddenly drops when you stand up from a seated or lying position signs are dizziness, sweating, and pale

Question 12

Neurogenic Bladder

Answer 12

Flaccid: complete injury in S2-S4
- No reflexive bladder emptying
- Bladder will continue to fill and stretch until at full capacity, then dribble out
Spastic: Complete injury above the sacrum
- Intact reflexive bladder emptying via sacral parasympathetic nerves
- Impaired descending tonic inhibition of bladder constriction
- Overactive bladder constriction can cause intermittent urine discharge or back flow to the kidneys

Question 13

Myotomes C2-T1

Answer 13

C2 - head and neck
C3 - breathing
C4 - Scapula elevation
C5 - Elbow flexion
C6 - Wrist extension
C7 - Elbow extension
C8 - Finger Flexion
T1 - Finger abduction

Question 14

Light Touch

Answer 14

1. Occlude the pt. vision
2. Lightly stroke a small region of the pt. skin using a cotton swab or fingertip (apply stimulus based on case)
3. Apply the stimulus 3 times to a specific area (dermatomes or nerves)
4. Ask the pt. to indicate yes or no when the stimulus is felt
5. Document whether the pt. presents with sensory loss along specific dermatome regions

Question 15

Pain

Answer 15

1. Occlude the pt. vision
2. Randomly apply either a dull or sharp end of a safety pin or paper clip to the screening area
3. Apply the stimulus to where we are told
4. Apply the stimulus 3 times to a specific area
5. Ask the pt. to indicate sharp or dull when the stimulus is felt. If sharp or dull verbalizations are not possible, have the pt. respond with alternative communication method
6. Document whether the pt. presents with sensory loss along specific dermatome regions

Question 16

Temperature

Answer 16

1. Occlude the pt. vision
2. Randomly apply test tubes containing hot and cold water
3. Apply the stimulus to where we are told
4. Apply the stimulus 3 times to each area
5. Ask the pt. to indicate hot or cold when the stimulus is felt
6. Document whether the pt. presents with sensory loss along specific dermatome regions

Question 17

An OTR assesses a patient with post stroke upper extremity hemiplegia. Pain: Intact Temperature: Impaired Proprioception: Intact Light Touch: Intact, which of the following cooking tasks most presents a safety risk

Answer 17

Cooking on the stove

Question 18

Which of the following would a person with a C4 spinal cord injury be able to do

Answer 18

Turn their head left and right

Question 19

A new outpatient with SCI presents for evaluation. You note that outpatient is in a manual wheelchair and has good hand function including the ability to use a pen to sign his name. Which of the following is the most likely level injury.

Answer 19

T2

Question 21

Where does the spinal cord end

Answer 21

L1-L2

Question 22

Which dermatome includes the thumb

Answer 22

C6

Question 23

A complete spinal cord injury above ____ makes someone at risk to autonomic dysrflexia

Answer 23

T5-T6

Question 24

How would an individual with an AIA B spinal cord present

Answer 24

No motor control below injury, but some sensation