SCI

Question 1

While a patient recovering from spinal cord injury was attending his exercise session, he declared that he will walk again. Which of these injuries would make functional ambulation most unrealistic?
a. Brown Sequard Syndrome
b. Posterior Cord Syndrome
c. Complete T9 Paraplegia
d. Cauda Equina Injury

Answer 1

c. Complete T9 Paraplegia

Question 2

A universal cuff is available in the following complete SCI levels:
a. C2-C3
b. C4-C5
c. C6-C7
d. T1-T2

Answer 2

c. C6-C7

Question 3

Projected functional outcome at 1 year post SCI in terms of bed mobility. Which level would be independent?
a. C7
b. T1
c. C5
d. C3

Answer 3

b. T1

because it has a time element of 1 year

Question 4

Impaired proprioception and 2-point discrimination involves what central tract?
a. Spinothalamic
b. Spinocerebellar
c. Dorsal column
d. Corticospinal

Answer 4

c. Dorsal column

Question 5

SCI patient B: deficits are 0/5 both biceps and the entire UE; 0/5 both LE; sensory normal over shoulder area only. What is the injury?
a. C4
b. C6
c. C8
d. Jefferson’s Fracture

Answer 5

a. C4

Question 6

In a C5 lesion, the following may be expected of the client, EXCEPT
a. Can give minimal to moderate assistance resulting to bed mobility dependency
b. Can assist with limited transfers due to involved musculature
c. Can propel manual wheelchair on level surfaces with the assistance of projection handrims
d. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus
e. None of these

Answer 6

b. Can assist with limited transfers due to involved musculature

Question 7

Fracture at the first lumbar vertebra will involve which spinal segment?
a. L4
b. L5
c. L2
d. Sacral and Coccygeal

Answer 7

d. Sacral and Coccygeal

note:
cervical = add 1 in sc segment
upper thoracic = add 2 in sc segment
lower thoracic (T7-T9) = add 3 sc segment
T10 = L1L2 sc segments
T11 = L3L4 sc segments
T12 = L5 sc segments
L1 = sacral & coccygeal segments

Question 8

A T10 female with complete paraplegia will:
a. Have normal orgasm
b. Experience labor pain
c. Still be capable of having children
d. Have decreased libido

Answer 8

c. Still be capable of having children

Question 9

In Central Cord Syndrome:
I. Occurs with hyperextension injuries of the neck
II. Motor function of the upper extremity is more affected than that of the lower Extremity
III. Motor impairments are more severe than sensory deficits
IV. Associated with congenital narrowing of the spinal canal
a. All of these
b. I,II, and III
c. I and III
d. II and IV
e. None of these

Answer 9

a. All of these

Question 10

In a C6 Lesion, the following may be expected of the client:
a. Bed mobility independent
b. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus
c. Involves the wrist extensors, latissimus dorsi, pectoralis, serratus anterior, pronator teres and teres minor
d. Cannot assist in independent transfers

Answer 10

c. Involves the wrist extensors, latissimus dorsi, pectoralis, serratus anterior, pronator teres and teres minor

Question 11

Which objective finding is the strongest indication that a C7 SCI is not complete?
a. Absent triceps reflex
b. Weakness of biceps muscle
c. Intact sensation on the lateral portion of the shoulder
d. Diminished sensation on the medial arm
e. None of these

Answer 11

d. Diminished sensation on the medial arm

Question 12

The therapist receives ab order to treat a 42yo man admitted to the hospital 3 days ago with a stab wound to the left lower thoracic spine. The patient is unable to move the left LE and cannot feel pain or temperature differences in the right LE. What is the most likely type of the lesion?
a. Anterior Cord Syndrome
b. Brown Sequard Syndrome
c. Central Cord Syndrome
d. Posterior Cord Syndrome

Answer 12

b. Brown Sequard Syndrome

Question 13

The muscle stretch reflexes during the period of spinal shock are:
a. Absent
b. Diminished
c. Normal
d. Increased can be quite variable

Answer 13

a. Absent

Question 14

The major area of concern in managing a C3 quadriplegic patient is:
a. Maintaining proper nutrition
b. Preventing pressure ulcers
c. Preventing contractures
d. Strengthening the tongue and muscles of mastication
e. Maintaining adequate respiration

Answer 14

e. Maintaining adequate respiration

Question 15

patient sustains a severe fracture of the L1 vertebral body and is left with a neurological deficit. What type of deficit is expected?
a. Spastic paraplegia with spastic bladder
b. Spastic paraplegia with flaccid bladder
c. Flaccid paraplegia with spastic bladder
d. Flaccid paraplegia with flaccid bladder
e. Paraplegia with no bladder involvement

Answer 15

d. Flaccid paraplegia with flaccid bladder

bc L1 affects sacral and coccygeal segments indicating LMNL

Question 16

Blood supply to the spinal cord is not equal at all spinal segments, some areas are better vascularized than others. Which segment is most poorly vascularized?
a. C3
b. C8
c. T4
d. T9
e. L3

Answer 16

c. T4

Question 17

Potential serious side effect of autonomic hyperreflexia is:
a. Myocardial Infarction
b. Renal failure
c. Dehydration
d. Gastric Ulceration
e. Cerebral Hemorrhage

Answer 17

e. Cerebral Hemorrhage

Question 18

A paraplegic patient sustains a fracture of the femur during stretching exercises. What is the probable underlying reason for this fracture?
a. Osteoporosis
b. Osteomalacia
c. Muscle paralysis
d. Muscle contracture
e. Ligamentous laxity

Answer 18

a. Osteoporosis

Question 19

The most common UE contracture in a C6 quadriplegic patient is:
a. Adduction of the arm
b. Elbow flexion
c. Supination of the forearm
d. Extension of the shoulder
e. Finger extension

Answer 19

b. Elbow flexion

Question 20

Which of the following is not an acceptable long term- goal for a patient with a complete C7 spinal cord injury?
a. Independent with dressing
b. Driving an automobile
c. Balance wheelchair in a wheelie for 30 secs
d. Independence in performing a manual cough
e. None of these

Answer 20

c. Balance wheelchair in a wheelie for 30 secs

Question 21

Recommended orthosis for a patient with C5 SCI:
a. Universal cuff
b. Short opponens splint
c. BFO
d. Lapboard and Mouthstick
e. All of these

Answer 21

c. BFO

Question 22

A patient with quadriplegia at C6 level should be instructed to transfer using a sliding board with his:
a. Forearms pronated, wrists and fingers extended
b. Forearms pronated, wrists extended and fingers flexed
c. Forearms pronated, wrists and fingers flexed
d. Forearms supinated, wrists and fingers extended

Answer 22

b. Forearms pronated, wrists extended and fingers flexed

tenodesis effect

Question 23

A therapist orders a wheelchair for a patient in a rehabilitation hospital. Which of the following patients would be most in need of a wheelchair with handrim projections?
a. A patient with C3 SCI
b. A patient with C5 SCI
c. A patient with hemiparesis
d. A patient with cauda equina lesion

Answer 23

b. A patient with C5 SCI

Question 24

A therapist works on ROM of the LEs with a patient rehabilitating from SCI. independent ROM of the LE is a realistic goal for which spinal cord injury level?
a. C2
b. C4
c. C5
d. C7

Answer 24

d. C7

Question 25

The following descriptions best describe a patient with SCI at ______ level: Biceps, deltoids and rotator cuff musculature are intact. Independent transfer with a sliding board may be possible. a. C2 b. C4 c. C6 d. C8

Answer 25

c. C6

Question 26

The normal diameter of the spinal cord: a. 1-1.5 mm b. 1-1.5 inches c. 1-1.5 cm d. 10-15 cm

Answer 26

c. 1-1.5 cm

Question 27

Brown Sequard Syndrome, Except: a. Ipsilateral loss of pain and temp sensation below the level of injury b. Ipsilateral loss of proprioception below the level of injury c. Ipsilateral loss of motor below the level of injury d. Contralateral loss of pain and temperature below the level of injury

Answer 27

a. Ipsilateral loss of pain and temp sensation below the level of injury

Question 28

Compute for the total sensory index score of a patient who has intact sensation from T10 and above; impaired sensation on T11 and T12, no sensation from L1 and below: a. 70 b. 72 c. 74 d. 76

Answer 28

b. 72

Question 29

Compute for the total motor index score of an SCI patient whose muscles at L3 level and above are graded normal. Muscles at L4 and L5 levels are graded fair. The remaining muscles are graded poor. a. 86 b. 88 c. 90 d. 92

Answer 29

a. 86

Question 30

A spinal cord injured patient was noted to have the following on physical examination: motor preservation greater than 3 levels below the neurologic level and greater than half of the key muscles below the single neurologic level were less than3. This would classified as an American spinal injury association (ASIA) level: a. Asia A b. Asia B c. Asia C d. Asia D

Answer 30

c. Asia C

Question 31

A quadriplegic patient develops postural hypotension. How this can be prevented? I. Use of elastic wraps around the legs II. Ise of abdominal binder III. Vigorous exercise IV. Forcing oral fluids to increase intravascular volume a. All of these b. I, II and III c. I and III d. II and IV e. None of these

Answer 31

b. I, II and III

Question 32

Clinical signs of sacral sparing include all of the following, except: a. Perianal sensation b. Rectal sphincter contraction c. absence of toe flexion d. Cutaneous sensation in the saddle area e. None of these

Answer 32

c. absence of toe flexion

Question 33

In your C6 SCI patient, tenodesis is preserves by avoiding: a. Finger extension and wrist extension b. Finger flexion and wrist extension c. Wrist flexion and finger flexion d. Wrist flexion and finger extension

Answer 33

a. Finger extension and wrist extension

Question 34

Wheelchair for C4 tetraplegia, EXCEPT: a. Sip and puff b. Chin control c. Hand control d. Voice control e. None of these

Answer 34

c. Hand control

Question 35

What is the normal length of the spinal cord? a. 42-43 inches b. 42-43 cm c. 35-39 inches d. 45-56 cm

Answer 35

b. 42-43 cm

Question 36

A therapist examines a patient that recently sustained a cervical hyperextension injury. Results of the examination reveals a loss of proprioception and two point discrimination with intact motor function. This type of incomplete spinal cord injury is MOST appropriately termed: a. Anterior Cord Syndrome b. Brown-Sequard Syndrome c. Central cord syndrome d. Posterior cord syndrome

Answer 36

d. Posterior cord syndrome

Question 37

Which of the following is not characteristic of Autonomic Dysreflexia? a. Tachycardia b. Vasoconstriction below the level of the lesion c. Profused sweating d. Headache e. None of these

Answer 37

a. Tachycardia

Question 38

The filum terminale connects the tip of the spinal cord to the: a. L5 vertebra b. Sacrum c. L4 vertebra d. Coccyx

Answer 38

d. Coccyx

Question 39

A C7 quadriplegic patient should be expected to perform these activities independently, EXCEPT: a. Sliding board transfer b. Wheelchair to car transfer c. Sitting board transfer d. Floor to wheelchair transfer e. None of these

Answer 39

d. Floor to wheelchair transfer

Question 40

A realistic long term goal for T10 paraplegic is: a. Able to ambulate with bilateral KAFO with forearm crutches and swing to gait b. Able to ambulate independently in parallel bars without aids c. Able to ambulate with bilateral AFO with forearm crutches and 4pt gait d. Able to ambulate with bilateral AFO with forearm crutches and 3pt gait

Answer 40

a. Able to ambulate with bilateral KAFO with forearm crutches and swing to gait

Question 41

Effects of spinal cord injury with the sixth cervical level spares included which of the following? a. Elbow extensors present b. Triceps present c. Finger extensors absent d. Radial wrist extensors absent e. Intrinsic hand muscles present

Answer 41

c. Finger extensors absent bc the question indicates complete c6 therefore finger extensors which is c7 is absent

Question 42

A patient with cauda equina lesion would present with the following manifestations a. Hyperreflexia b. Hypertonicity both LE c. Spastic bladder d. Bladder dysfunction e. All of these

Answer 42

d. Bladder dysfunction

Question 43

The Artery of Adamkiewicz is a major feeder artery of the spinal cord between which levels is this artery most commonly found? a. C1 and C4 b. C7 and T1 c. T2 and T2 d. T9 and L1 e. L4 and S1

Answer 43

d. T9 and L1

Question 44

During a sensory examination, a patient complains of a dull, aching pain and is not able to discriminate a stimulus as sharp or dull. Two point discrimination is absent based on these findings, the pathway that is intact is the : a. Dorsal column b. Fasciculus gracilis/ medial lemiscus c. Lateral spinothalamic tract d. Anterior spinothalamic tract e. All of these

Answer 44

d. Anterior spinothalamic tract

Question 45

A 25yo male with an incomplete SCI at T12 level asks you questions about the potential sexual capabilities. An accurate response to him would indicate that erectile capability is: a. Most likely in incomplete UMNL as compared to complete upper motor and lower motor neuron lesions or incomplete LMNL b. More likely in complete LMNL than in incomplete UMNL c. More likely in incomplete LMNL than in incomplete UMNL d. Unlikely expect in cauda equina lesions

Answer 45

a. Most likely in incomplete UMNL as compared to complete upper motor and lower motor neuron lesions or incomplete LMNL

Question 46

The following can be performed by a patient with SCI level T6-T12, EXCEPT: a. Swing To gait pattern b. Use KAFO for ambulation c. 4pt gait pattern d. Use a manual wheelchair for community ambulation e. None of these

Answer 46

c. 4pt gait pattern

Question 47

The bulbocavernosus reflex is a test for the integrity of: a. L4-L5 nerve roots b. L5-S1 nerve roots c. S1-S2 nerve roots d. L1-L2 nerve roots e. None of these

Answer 47

c. S1-S2 nerve roots

Question 48

C7-C8 SCI functional movements, EXCEPT: a. Elbow extension b. Finger abduction c. Wrist extension d. Finger flexion e. Finger extension

Answer 48

b. Finger abduction

Question 49

A therapist attends an in-service on incomplete SCI. As part of the in-service the speaker describes several observed syndromes of neurological involvement. Which syndrome does not include an alteration in motor function? a. Posterior Cord Syndrome b. Anterior Cord Syndrome c. Central Cord Syndrome d. Brown Sequard Syndrome

Answer 49

a. Posterior Cord Syndrome

Question 50

The wrist driven flexor hinge splint is an adaptive equipment for tetraplegics with the level of: a. C5 b. C6 c. C4 d. C7

Answer 50

b. C6