Deck 23: Traumatic Spinal Cord Injury

Question 1

According to the International Standards of Neurological Classification of Spinal Cord Injury,

A)the neurological level is the most caudal level with normal sensory and motor function.
B)the neurological level is the most caudal level with normal sensory function.
C)the neurological level is the most caudal level with normal motor function.
D)the neurological level is the level where the most neurological damage occurred.

Answer 1

A

Question 2

When treating a patient with mid- to low-level cervical injuries,a mat program

A)would include rolling,prone on elbows,and supine on elbows because these are important positions for dressing and transitioning to sitting.
B)would include rolling for dressing and pressure relief but would not include prone and supine on elbows positions because they are not functional.
C)should be initiated as soon as the patient is cleared for activity.
D)both A and C

Answer 2

A

Question 3

A patient with a C7 complete SCI would most likely

A)require a power wheelchair for mobility.
B)require a lightweight manual wheelchair for mobility.
C)require a power wheelchair for community mobility but use a manual wheelchair for short distances.
D)require a lightweight manual wheelchair for community distances but ambulate for short distances.

Answer 3

B

Question 4

Autonomic dysreflexia typically occurs in patients with

A)lesions above C5.
B)lesion above T6.
C)lesions above L5.
D)cauda equina lesions.

Question 5

Following SCI,spinal shock is characterized by

A)absence of all reflex activity below the level of lesion.
B)loss of motor function below the level of lesion.
C)loss of sensation below the level of lesion.
D)all of the above.

Question 6

You have just received a referral for a patient with a SCI.When you go to his room,he is in a halo device.Halo devices are

A)typically used to immobilize cervical fractures; patients with halos are usually on bedrest for 3 to 4 weeks until the fracture begins to heal.
B)typically used to immobilize thoracic fractures; patients with halos are usually on bedrest for 3 to 4 weeks until the fracture begins to heal.
C)typically used to immobilize cervical fractures; in general halo devices allow an earlier progression to upright activities and involvement in rehabilitation.
D)typically used to immobilize thoracic fractures: in general,halo devices allow an earlier progression to upright activities and involvement in rehabilitation.

Question 7

Which of the following impairments is NOT common following a spinal cord injury?

A)Impaired temperature control
B)Cognitive deficits
C)Bowel and bladder dysfunction
D)Impaired sensation

Question 8

When doing lateral transfers,a patient with a complete SCI at C6

A)will use the triceps to actively extend the elbow and lift.
B)will not be able to extend the elbow-transfers will be done with elbow flexion by pulling on a trapeze.
C)should be able to use the deltoid and pectoralis muscles to adduct the humerus and extend the elbow if the wrist and hand are fixed.
D)should be able to use the wrist extensors to substitute for triceps and extend the elbow if the wrist and hand are fixed.

Question 9

Which of the following statements is true with regard to exercise following an SCI?

A)Resistance and endurance training are not recommended; patients with SCI exert a tremendous amount of energy on everyday tasks,so fitness is not an issue.
B)Although strength and endurance programs would be beneficial for patients with SCIs,they are not realistic because of physical limitations and should not be recommended.
C)Endurance exercise but not strength training is recommended in patients with SCI.
D)Well-designed strength and endurance programs may improve health and quality of life in patients with an SCI.

Question 10

When sitting in their wheelchairs,patients with SCI should do pressure relief for 10 to 15 seconds

A)every 10 minutes.
B)every 20 minutes.
C)every 1 to 2 hours.
D)every 3 to 4 hours.

Question 11

Following an SCI,allowing some muscles to tighten/shorten may improve function.For example,in patients with tetraplegia

A)allowing tightness to develop in the long finger flexors will allow a tenodesis grip.
B)allowing tightness in the hip flexors to develop will help with sitting balance.
C)allowing tightness in the ankle plantarflexors to develop will provide stability for transfers.
D)all of the above.

Question 12

Pressure relief can be performed by

A)wheelchair push-ups.
B)leaning forward or laterally in the wheelchair.
C)tilting back a tilt-in-space chair.
D)all of the above.

Question 13

Your patient looks flushed and is complaining of a pounding headache.You suspect these symptoms may be indicative of autonomic dysreflexia.In this case all of the following would be appropriate responses EXCEPT

A)lie the patient down immediately.
B)check the patient's catheter and if it is clamped,release it.
C)check for irritating stimuli such as tight clothing or abdominal binder and remove source of irritation.
D)seek medical attention if symptoms do not resolve.

Question 14

Central cord syndrome is typically characterized by

A)loss of pain and temperature with no loss of proprioception; UEs and LEs affected equally.
B)motor deficits that are more severe than sensory deficits; UE involvement is greater than LE.
C)sensory deficits that are more severe than motor deficits; LE involvement is greater than UE.
D)loss of proprioception with no loss of pain and temperature; UE and LE involvement is based on level of lesion.

Question 15

When training patient with paraplegia (T12 neurological level)to ambulate

A)a wheeled walker is the most commonly utilized assistive device because the patient does not have to pick it up to advance it.
B)a standard walker is the most commonly utilized assistive device because it is the most stable.
C)forearm crutches are the most often utilized assistive device because they allow full hip extension and unrestricted shoulder movement.
D)standard crutches are the most often utilized assistive device because they provide more support than forearm crutches and are less expensive.

Question 16

According to data collected in the National Spinal Cord Injury Database,spinal cord injuries most commonly occur in

A)men between the ages of 16 and 30.
B)men between the ages of 25 and 40.
C)women between the ages of 16 and 30.
D)women between the ages of 25 and 40.

Question 17

Which of the following injuries results in a lower motor neuron injury?

A)Cauda equina injuries
B)Posterior cord syndrome
C)Brown-Sequard syndrome
D)Incomplete spinal cord injuries

Question 18

According the International Standards of Neurological Classification of Spinal Cord Injury,an incomplete injury

A)is classified as having any motor or sensory function below the neurological level.
B)is classified as having motor but not sensory function below the neurological level.
C)is classified as having motor and/or sensory function at the S4-S5 level.
D)is classified as having motor and sensory function at the L2-L3 level.

Question 19

Which of the following is the best description of the head-hips relationship?

A)When a patient moves the head and shoulders in one direction,the hips/buttocks will move in the opposite direction.
B)When a patient moves the head and shoulders in one direction the hips/buttocks will move in the same direction.
C)The head,shoulders,and buttocks will always move together because they are attached by the trunk.
D)When a patient flexes the head and neck the hips will also flex.

Question 20

Which of the following can be used to help prevent postural hypotension when reacclimating to the vertical position?

A)An abdominal binder
B)A cervical collar
C)Elastic stockings
D)Both A and C