Deck 20: Traumatic Spinal Cord Injury

Question 1

When using the International Standard of Neurological Classification of Spinal Cord Injury,which clinical findings are MOST likely to support the assessment that the patient presents with a C4,ASIA C spinal cord injury with a central cord clinical syndrome?

A)Upper limb total motor score = 2/50;lower limb total motor score = 20/50;impaired light touch and pin prick throughout all extremities;positive anal sensation and contraction
B)Upper limb total motor score 50/50;lower limb total motor score = 0/50;intact upper extremity sensation and absent sensation in the lower extremities;absent anal sensation and contraction
C)Upper limb total motor score of 28/50;lower limb total motor score 25/50;impaired light touch on the right and absent sharp/dull on the left arm and leg;positive anal contraction
D)Upper limb total motor score of 0/50;lower limb total motor score of 0/50;absent light touch and pin prick in all extremities;negative anal sensation and contraction

Answer 1

A

Question 2

Based on the scenario presented,what is the MOST likely cause of the patient's signs and symptoms and what is the most appropriate response by the therapist?

A)Autonomic dysreflexia;the therapist should stop the intervention,immediately sit the patient upright,loosen the patient's clothing,and begin looking for anything that may be causing a noxious stimuli.
B)Autonomic dysreflexia;the therapist should stop the intervention and let the patient rest while continuing to observe the patient's pattern of spasms.
C)Positional vertigo;the therapist should stop the rolling component of the session and allow the patient to rest until the patient's blurry vision subsides.
D)Positional vertigo;the therapist should continue the rolling session to aid in adaptation and assess the patient for nystagmus.

Answer 2

A

Question 3

When prescribing a wheelchair for a patient with C6,ASIA A injury,which concepts are MOST important when making recommendations between a power versus manual wheelchair?

A)Funding,caregiver support,transportation options,and the age of the patient
B)Patient goals,pushing endurance,living environment,and history of shoulder pain
C)Frame of the wheelchair,caregiver support,living location,and funding
D)Caregiver choice,patient age,living location,and body mass index

Answer 3

B

Question 4

Which of the following examples BEST reflects the concepts of selective stretching that may directly impact functional recovery for a patient who has sustained a C6,ASIA A injury?

A)Stretching of the low back muscles to enhance rolling
B)Stretching the hamstring muscles to 120 degrees to enhance floor transfers
C)Encouraged adaptive shortening of the long finger flexors to enhance grasp
D)Encourage adaptive shortening of the ankle plantarflexors to enhance wheelchair positioning

Question 5

Which combination of tests and measures are MOST efficient and effective to provide information about the patient's quality of walking and utilization of any assistive devices while also capturing information about the patient's prognosis for community ambulation?

A)Walking Index for Spinal Cord Injury,Functional Independence Measure,and 6-Minute Walk Test
B)Spinal Cord Injury-Functional Ambulation Inventory,Walking Index for Spinal Cord Injury,and 6-Minute Walk Test
C)Spinal Cord Independence Measure,Spinal Cord Injury-Functional Ambulation Inventory,and 10-Meter Walk Test
D)10-Meter Walk Test,Walking Index for Spinal Cord Injury,and 6-Minute Walk Test

Question 6

Which interventions for patients with spinal cord injury focus primarily on compensatory strategies instead of recovery of function?

A)Locomotor training overground with a patient who has an L1,ASIA C injury and using neuromuscular stimulation to the tibialis anterior
B)Body weight-supported robotic treadmill ambulation with a patient who has a T12,ASIA C injury and floor transfers
C)Exercises to enhance tenodesis and focusing on the head-hip relationship while teaching sliding board transfers
D)Pressure relief weightshift training using side-to-side maneuvers and rolling activities while performing trunk muscle facilitation

Question 7

Which of the following patients with spinal cord injury is MOST likely to regain some level of ambulation via neurological motor recovery?

A)C3,AIS C,tetraplegia
B)T6,AIS B,paraplegia
C)L1,AIS A,paraplegia
D)C7,AIS B,tetraplegia

Question 8

Which complications of spinal cord injury may impact long-term functional outcomes can be effectively prevented and treated via physical therapy interventions?

A)Contractures,deep vein thrombosis,neuropathic pain
B)Deep vein thrombosis,heterotopic ossification,osteoporosis
C)Contractures,pressure sores,pneumonia
D)Neuropathic pain,heterotopic ossification,contractures