SCI and ASIA Impairment Scale Flashcards

Questions and Answers

What is the most common cause of a spinal cord injury?

Gunshot wound

Sports injury

Fall

MVA (correct)

What often dictates the type of SCI?

Mechanism of injury

Where do flexion injuries usually occur?

C5-C6

Where do extension injuries usually occur?

C4-C5 Signup and view all the answers

What type of damage can occur in the SC?

Primary (initial trauma) and secondary (extension of injury down the cord) Signup and view all the answers

What are the two types of general SCI?

Complete and incomplete Signup and view all the answers

What is Anterior Cord Syndrome?

Caused by flexion injuries, it results in loss of motor function, pain, and temperature sensation bilaterally below the lesion. Signup and view all the answers

What characterizes Brown-Sequard Syndrome?

Hemi-section of the cord; ipsilateral spastic paralysis and contralateral loss of pain and thermal sense. Signup and view all the answers

What is Cauda Equina Syndrome?

Injury at the L1 level and below resulting in a lower motor neuron lesion. Signup and view all the answers

What occurs in Central Cord Syndrome?

Compression and damage to the central cord, leading to greater weakness in upper extremities. Signup and view all the answers

What causes Posterior Cord Syndrome?

Compression of the posterior spinal artery, leading to loss of proprioception and vibration. Signup and view all the answers

What is the motor level of an SCI?

Determined by the most caudal key muscles that have strength 3 or greater. Signup and view all the answers

What is the Motor Index Scoring for an SCI?

Testing each key muscle using the 0-5 scoring system. Signup and view all the answers

What is the Sensory Level of an SCI?

Determined by the most caudal dermatome with a normal score of 2/2. Signup and view all the answers

What is the ASIA Impairment Scale?

A scale that grades the degree of impairment and severity of injury. Signup and view all the answers

What are the different grades of the ASIA Impairment Scale?

D - Motor Incomplete (more function) Signup and view all the answers

What is ASIA Impairment level A?

Complete with no sensory or motor function preserved in sacral segments S4-S5. Signup and view all the answers

What is ASIA Impairment level B?

Sensory Incomplete with preserved sensory function but no motor function. Signup and view all the answers

What is ASIA Impairment level C?

Motor Incomplete with preserved voluntary anal contraction or sensory incomplete status. Signup and view all the answers

What is ASIA Impairment level D?

Motor Incomplete with at least half or more key muscle functions having strength. Signup and view all the answers

What is ASIA Impairment level E?

Sensory and motor functions are normal in a patient that had prior deficits. Signup and view all the answers

What are the key muscles tested for C5-8, T1, and L2-S1?

C5 - Elbow Flexors; C6 - Wrist Extensors; C7 - Elbow Extensors; C8 - Fingers 1-3 Flexors; T1 - Small Finger Abductors; L2 - Iliopsoas; L3 - Quadriceps; L4 - Dorsi Flexors; L5 - Long Toe Extensors; S1 - Plantar Flexors. Signup and view all the answers

What are the key locations for sensory testing of light touch and pinprick for C2-S5?

Graded as: 0 = absent, 1 = impaired/hyperesthesia, 2 = intact. Signup and view all the answers

Study Notes

Spinal Cord Injury (SCI) Overview

Most common cause of spinal cord injury is motor vehicle accidents (MVA).
Mechanism of injury often dictates the type of SCI.

Sites of Injury

Flexion injuries typically occur at C5-C6.
Extension injuries usually occur at C4-C5.

Types of Damage

Two types of spinal cord damage include primary (initial trauma) and secondary (extension of injury).

General Types of SCI

Complete SCI: No motor or sensory function preserved below the injury.
Incomplete SCI: Some motor or sensory function preserved below the injury.

Anterior Cord Syndrome

Caused by flexion injuries.
Results in loss of motor function, pain, and temperature sensation bilaterally below the lesion.
Injuries spinothalamic and corticospinal tracts.

Brown-Sequard Syndrome

Characterized by hemi-section of the spinal cord.
Ipsilateral spastic paralysis and loss of position sense, with contralateral loss of pain and thermal sense.

Cauda Equina Syndrome

Injury occurs at L1 level and below, resulting in lower motor neuron lesions.
Symptoms include flaccid paralysis, areflexia, and bowel/bladder impairments.

Central Cord Syndrome

Results from compression and damage to the central cord, often due to cervical hyperextension.
Symptoms include weakness or paresthesia, with upper extremities affected more than lower.

Posterior Cord Syndrome

Rare injury from compression of the posterior spinal artery.
Causes bilateral loss of proprioception, vibration, and pressure while preserving motor function and pain sensation.

Assessment of SCI

Motor level is determined by the most caudal key muscles with a strength of 3 or greater with the immediately superior segment being normal.
Motor Index Score: Tests key muscles using a scale of 0-5, totaling 100 points across extremities.
Sensory Level: Identified by the most caudal dermatome with normal scores for pinprick and light touch.

ASIA Impairment Scale

A grading scale for assessing degree of impairment and injury severity.
Various grades:
- A: Complete - No function preserved in S4-S5.
- B: Sensory Incomplete - Sensory function preserved below neurologic level, no motor function more than 3 levels below.
- C: Motor Incomplete - Voluntary anal contraction or sensory incomplete with less than half key muscles graded 3 or more.
- D: Motor Incomplete - At least half key muscles functioning at grade 3 or more.
- E: Normal - Sensory and motor functions normal after prior deficits.

Key Muscles for Testing

C5: Elbow flexors
C6: Wrist extensors
C7: Elbow extensors
C8: Finger flexors (1-3)
T1: Small finger abductors
L2: Iliopsoas
L3: Quadriceps
L4: Ankle dorsiflexors
L5: Long toe extensors
S1: Plantar flexors

Sensory Testing

Test light touch and pinprick for C2-S5 with grading:
- 0 = Absent
- 1 = Impaired/Hyperesthesia
- 2 = Intact

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Description

Test your knowledge about spinal cord injuries (SCI) and the ASIA impairment scale with these flashcards. Learn about causes, types of injuries, and specific vertebral regions affected by different mechanisms. Perfect for students and professionals in health science or rehabilitation fields.