| Question | Answer |
| What does lesion level indicate? | Most distal uninvolved nerve root segment with normal function MMT 3+/5 |
| Characteristics of UMN lesion. | Hypertonia
Hyperreflexia
Spacticity
CNS |
| Characteristics of LMN lesion. | Hypotonia
Hyporeflexia
Flaccidity
PNS |
| Central Cord losses | UE > LE involvement
Motor > Sensory |
| Central Cord Complete Preservation | Sacral tracts
Normal Sexual Function
B & B |
| Type of injury sustained from Central Cord | Hyperextension (less common) |
| Type of injury sustained from Anterior Cord | Flexion Injury |
| Anterior Cord losses | Motor function (Corticospinal tract)
Pain and Temp (spinothalamic tract) |
| Generally Preserved in Anterior Cord injury | Proprioception
Kinesthesia
Vibration Sense |
| Sign of Corticospinal tract damage | Positive Babinski |
| Level of Cauda Equina | L1 or below |
| Syndrome associated with LMN and potential to regenerate | Cauda Equina (full innervation not typical) |
| Frequently incomplete due to large number of nerve roots | Cauda Equina |
| Cord level associated with tetraplegia/quadraplegia | C1 - C8 |
| Cord level associated with Paraplegia | T1 - T12 |
| Involving bilateral LE and varying trunk levels | Paraplegia |
| Common SCI mechanisms of injury | Flexion (most Common)
Flexion Rotation (most common cervical injury)
Compression
Hyperextension |
| Mode of injury associated with Brown-Sequard syndrome | Gunshot or stabbing |
| Presents with ipsilateral loss of sensation in corresponding dermatome | Brown-Sequard |
| Decreases associated with Brown-Sequard | reflexes, proprioception, kinesthesia, vibration |
| Lateral Dorsal Column injury | Brown-Sequard |
| Syndrome presenting with clonus and/or positive Babinski | Brown-Sequard |
| Cause associated with Central Cord syndrome | Progressive stenosis or hyperextension injury |
| Cause of Posterior/Dorsal Cord Syndrome | Compression of posterior spinal artery by tumor or vascular infarction (Rare) |
| Intact functions of Posterior Syndrome | Motor, light touch and pain |
| Losses associated with Posterior Syndrome | Proprioception and Somatic sensation i.e. 2 point discrimination and graphesthesia |
| S & S of Sacral Sparing | Perianal Sensation and external anal sphincter contraction |
| Explain Sacral Sparing | Occurs in incomplete injuries. Because sacral tracts run most medially within spinal cord, they are often salvaged. Patients may be able to flex great toe and have B&B control. |
| Most caudal segment with some sensory or motor function (or both) and applies to complete injuries only. | Zone of partial preservation |
| Asia Scale Level and Key Muscles | C5 Elbow Flexors
C6 Wrist Extensors
C7 Elbow Extensors
C8 Finger Flexors
T1 Finger Abductors
L2 Hip Flexors
L3 Knee Extensors
L4 Dorsiflexors
L5 Big Toe Extensors
S1 Ankle Plantar Flexors |
| Asia Impairment Scale | A = Complete - no motor/sensory S4-5
B = Incomplete - sensory in S4-5
C = Incomplete - Motor preserved,> 50% key muscles have grade < 3
D = Incomplete - Motor preserved, 50% key muscles grade 3 or more
E = Normal |
| Muscles and Functional Expectations
C1,2,3 | Facial muscles , SCM, upper traps
I= Power WC
Total dependence ADL's
Requires Ventilator |
| Muscles and Functional Expectations
C4 | Diaphragm and Upper Traps
Power WC w/chin cup or mouth stick
Total dependence ADL's
Glossopharyngeal Breathing |
| Muscles and Functional Expectations
T4-6 | Top 1/2 of intercostals, erector spine, semispinalis
I in all areas: Bed skills, WC transfers, Housekeeping |
| Muscles and Functional Expectations
T9-12 | Abdominals and all intercostals
Household Ambulation with AD - KAFO/crutches/walker
I WC mobility |
