Questions and Answers
What is the most common cause of a spinal cord injury?
What often dictates the type of SCI?
Mechanism of injury
Where do flexion injuries usually occur?
C5-C6
Where do extension injuries usually occur?
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What type of damage can occur in the SC?
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What are the two types of general SCI?
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What is Anterior Cord Syndrome?
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What characterizes Brown-Sequard Syndrome?
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What is Cauda Equina Syndrome?
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What occurs in Central Cord Syndrome?
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What causes Posterior Cord Syndrome?
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What is the motor level of an SCI?
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What is the Motor Index Scoring for an SCI?
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What is the Sensory Level of an SCI?
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What is the ASIA Impairment Scale?
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What are the different grades of the ASIA Impairment Scale?
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What is ASIA Impairment level A?
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What is ASIA Impairment level B?
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What is ASIA Impairment level C?
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What is ASIA Impairment level D?
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What is ASIA Impairment level E?
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What are the key muscles tested for C5-8, T1, and L2-S1?
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What are the key locations for sensory testing of light touch and pinprick for C2-S5?
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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.
Syndromes Related to SCI
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.