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FF SCI EXAM WITH CORRECT ANSWERS 100% VERIFIED!!
Typology: Exams
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Ascending Tracts -DCML -ALST, LST
Descending Tracts -Corticospinals
Function of DCML -vibration -proprioception -stereognosis -2 point discrimination
Function of ALST tract -crude touch
Function of LST Tract -pain -temperature
Function of Corticospinal Tracts -movements
DCML Segmental Sensory Medial to Lateral -sacral -lumbar -thoracic -cervical
LST Tract Sensory Medial to Lateral -cervical -thoracic -lumbar -sacral
Lateral Corticospinal Tract Motor Medial to Lateral -cervical -thoracic -lumbar -sacral
Posterior Cord Syndrome
-loss of motor function, vibration, position sense, and deep touch ipsilateral
Conus Medullaris location
-bilateral and symmetrical in perineum and thighs
sensory
-saddle distribution bilateral and symmetric
motor
-symmetric
type
-UMN + LMN
Cauda Equina location
-unilateral and asymmetrical in perineum, thighs, leg, back
sensory
-saddle distribution unilateral and asymmetrical
motor
-asymmetric
type
-LMN
Cauda Equina Syndrome -injury to the nerve roots and not the SC itself -below L2 after the SC ends -muscle weakness and decreased sensation in affected dermatomes -incomplete lesions commonly seen -flaccid paralysis with no spinal reflex activity -flaccid bowel and bladder: autonomous or non-reflexive
Tetraplegia -impairment of loss of motor and/or sensory function in the cervical segments of the SC
-most caudal segment of the SSC with normal sensory and motor function on BOTH sides of the body
Sensory Level of Injury -the most caudal segment of the SC with normal sensory function on BOTH sides of the body
Motor Level of Injury -the most caudal segment of the SC with normal motor function on BOTH sides of the body -lowest key muscle that has a grade of at least 3, providing the key muscles represented by segments above that level are judged to be 5
Asia A -complete injury -no motor or sensory function at S4-
Asia B -incomplete injury -sensory bot not motor function present below NLI and S4-
Asia C -incomplete injury -less than half of key muscle functions below the single NLI have a muscle grade >/= 3
Asia D -incomplete injury -at least half or more of key muscle functions below the single NLI having a muscle grade >/= 3
Asia E -normal, no injury -motor and sensory function is normal
Spinal Shock -occurs immediately after the trauma -abrupt withdrawal of connection between SC and higher center -absence of all reflex activity and impairment of autonomic regulation resulting in hypotension and loss of sweating and piloerection
C1-C2 Injury respiratory muscles
-SCM
-upper traps
intervention
respiratory muscles
-diaphragm
-pec major and minor
-serratus anterior
-rhomboid
-lats
intervention
-weak cough
-must teach assistive coughing to people with respiratory compromise
T1-T5 Injury respiratory muscles
-some intercostals
-erector spinae
intervention
-none needed
T6-T10 Injury respiratory muscles
-intercostals
-abdominals
intervention
-none needed
T11 and Below Injury respiratory muscles
-all
intervention
-non needed
-bowel/bladder irritation: increase in SBP 20-30 mmHg -painful stimulus below level of lesion: decreased HR -Gi irritation: severe HA, anxiety -sexual activity: constricted pupils, blurred vision -labor: flushing, piloerection above level of lesion -fracture below level of lesion: increased spasticity
Intervention for AD -sit up and lower the legs -remove painful stimuli: loosen clothing or abdominal binder, check bladder distension and unclamp catheter and drain it -monitor vitals and if still no change get medical/nursing assistance and they give meds to lower BP (nifedipine, nitrates, and captopril)
Tone and Spasticity -abnormal muscle tone in an UMN lesion characterized by increased resistance of an initially passive limb to externally imposed joint motion -velocity dependent -increased muscle tone also known as hypertonia, hyperreflexia, and clonus -has potential positive and negative impacts -seen in patients with injury above T10 after resolution of spinal shock
Therapeutic Options for Spasticity Management -modalities -superficial heat/cold
-deep heat -stretching -splinting -serial casting -exercise -standing program
Oral Pharmacological Options for Spasticity Management -baclofen (lioresal) -neurotin (gabapentin) -zanaflex (tizanidine) -dantrium (dantrolene) -clonidine -klonopin (clonazepam) -valium (diazepam)
Spastic/Reflexic Bladder -UMN -seen in patients with injury at or above T -usually a combination of bladder and sphincter dyssynergia -bladder contracts and reflexively empties in response to a certain level of filling pressure -requires intermittent catheterization every 3-6 hours -suprapubic tapping -many patients require anti cholinergic medications to help decrease bladder spasms and leakage
Mobilization for Tissue Integrity -in bed every 2 hours -in wheelchair every 15 minutes -push-ups -leaning side to side -leaning forward >45 deg -tilt wheelchair back by >65 deg -maintain position for at least 2 minutes -contour cushion to redistribute pressure
Complications with SCI and PT Interventions -pressure ulcers -DVT -AD -OH -spasticity -urinary and bowel retention and/or incontinence -contractures -osteoporosis -pain -sexual dysfunction
C1-C4 Injury Dependence bed skills
-dependent
transfer
-dependent
wheelchair
-power: head/chin/mouth breathing control
-manual: dependent
ambulation
-none
C5 Injury Dependence bed skills
-some assistance
transfer
-dependent
-manual: IND indoors and leveled surfaces, assistance outdoors, plastic coated handrim
ambulation
-none
C7-C8 Injury Dependence bed skills
-IND to some assist
transfer
-even: IND without sliding board
-uneven: IND to some assist
wheelchair
-manual: IND indoors and outdoors on level surface
-C7 may need assistance with ramp
-C8 IND with ramps and curbs
ambulation
-none
T1-T9 Injury Dependence bed skills
-IND
transfer
-IND in even and uneven surface transfer
-may be able to do floor to wheelchair transfer
wheelchair
-manual: IND indoors and outdoors on leveled and unleveled surfaces
ambulation
-functional ambulation not typical
