USAHS ACTUAL EXAM PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
⫸ ASIA A. Answer: Complete; no motor or sensory function is
preserved in sacral segments S4-5.
⫸ ASIA B. Answer: Incomplete; Sensory but no motor function is
preserves below neurological level.
⫸ ASIA C. Answer: Incomplete; Motor function is preserved below
the neurological level and more than half of the key muscles below
the level of injury have a muscle grade of less than 3.
⫸ ASIA D. Answer: Incomplete; Motor function is preserved below
the neurological level and more than half of the key muscles below
the level of injury have a muscle grade of 3 or greater.
⫸ ASIA E. Answer: Normal motor and sensory function.
⫸ Central Cord Syndrome. Answer: An injury to the central
structures of the spinal cord that produces sacral sensory sparing and
greater weakness in the upper limbs than in the lower limbs.
,⫸ Anterior Cord Syndrome. Answer: An incomplete spinal injury in
which all functions are absent below the level of injury except
proprioception and sensation.
⫸ Brown-Sequard Syndrome. Answer: An incomplete spinal cord
injury where half of the cord has been damaged. Exhibit more loss of
motor and proprioceptive ipsilateral to injury and loss of pain and
sense of temperature on contralateral side.
⫸ Conus Medullaris Syndrome. Answer: Injury to the sacral cord
resulting in flaccid paralysis of the LE.
⫸ Cauda Equina Syndrome. Answer: Injury to the lumbar and sacral
nerve roots results in flaccid-type paralysis. Pattern of paralysis
varies.
⫸ Autonomic Dysreflexia. Answer: A sudden dangerous increase in
blood pressure is a possibility life-threatening complication associated
with lesions at the T6 level or above. Brought on by an unopposed
sympathetic response to noxious stimuli. Primary Symptoms:
hypertension, pounding headache, sweating.
⫸ Postural Hypotension. Answer: A sudden drop in blood pressure
occurring when a person assumes an upright position. Aggravated by
prolonged bed rest. Symptoms: light headedness, dizziness, may faint
on moving from supine to upright. Patients may benefit from wearing
elastic compression stockings and abdominal binders.
, ⫸ Pressure Ulcers. Answer: Caused by constant pressure by
maintaining a static position without shifting weight. All patients must
be placed on weight-shifting pressure-relief schedules. All insensate
bony areas must be inspected daily. Recommended weight shifting:
when seated -- weight shift at least one minute every hour. when in
bed -- change position every 2 hours initially. Increase as tolerated.
⫸ Deep Vein Thrombosis. Answer: Formation of a blood clot, most
often in the lower extremity, abdomen, or pelvis. May develop further,
dislodge from the venous wall, and turn into an embolus. Therapist is
apart of the team that monitors for asymmetries in color, size, and/or
temperature. Treatment involves best rest and anticoagulants to
prevent embolus.
⫸ Heterotopic Ossification. Answer: Pathological bone formation in
joints or muscle. Connective tissue calcifies around the joint affects
ROM. Symptoms in the extremity: warmth, swelling, fever, ROM
limitations.
⫸ Pain. Answer: Acute and chronic pain is common after SCI. Most
commonly classified: mechanical pain and neuropathic pain. Pain
contributes to activity limitations, lack of participation, and
depression. Crucial to communicate pain issues to the physician.
⫸ Spasticity. Answer: Uncontrolled contraction of muscles.
Spasticity can develop into clonic or tonic spasms triggered by
sensory stimuli, sudden touch, infection, other irritation. Medical
Management: oral medication, motor point block, intrathecal baclofen
pump. Not always a negative (can be used functionally).
QUESTIONS WITH SOLUTIONS GRADED A+
⫸ ASIA A. Answer: Complete; no motor or sensory function is
preserved in sacral segments S4-5.
⫸ ASIA B. Answer: Incomplete; Sensory but no motor function is
preserves below neurological level.
⫸ ASIA C. Answer: Incomplete; Motor function is preserved below
the neurological level and more than half of the key muscles below
the level of injury have a muscle grade of less than 3.
⫸ ASIA D. Answer: Incomplete; Motor function is preserved below
the neurological level and more than half of the key muscles below
the level of injury have a muscle grade of 3 or greater.
⫸ ASIA E. Answer: Normal motor and sensory function.
⫸ Central Cord Syndrome. Answer: An injury to the central
structures of the spinal cord that produces sacral sensory sparing and
greater weakness in the upper limbs than in the lower limbs.
,⫸ Anterior Cord Syndrome. Answer: An incomplete spinal injury in
which all functions are absent below the level of injury except
proprioception and sensation.
⫸ Brown-Sequard Syndrome. Answer: An incomplete spinal cord
injury where half of the cord has been damaged. Exhibit more loss of
motor and proprioceptive ipsilateral to injury and loss of pain and
sense of temperature on contralateral side.
⫸ Conus Medullaris Syndrome. Answer: Injury to the sacral cord
resulting in flaccid paralysis of the LE.
⫸ Cauda Equina Syndrome. Answer: Injury to the lumbar and sacral
nerve roots results in flaccid-type paralysis. Pattern of paralysis
varies.
⫸ Autonomic Dysreflexia. Answer: A sudden dangerous increase in
blood pressure is a possibility life-threatening complication associated
with lesions at the T6 level or above. Brought on by an unopposed
sympathetic response to noxious stimuli. Primary Symptoms:
hypertension, pounding headache, sweating.
⫸ Postural Hypotension. Answer: A sudden drop in blood pressure
occurring when a person assumes an upright position. Aggravated by
prolonged bed rest. Symptoms: light headedness, dizziness, may faint
on moving from supine to upright. Patients may benefit from wearing
elastic compression stockings and abdominal binders.
, ⫸ Pressure Ulcers. Answer: Caused by constant pressure by
maintaining a static position without shifting weight. All patients must
be placed on weight-shifting pressure-relief schedules. All insensate
bony areas must be inspected daily. Recommended weight shifting:
when seated -- weight shift at least one minute every hour. when in
bed -- change position every 2 hours initially. Increase as tolerated.
⫸ Deep Vein Thrombosis. Answer: Formation of a blood clot, most
often in the lower extremity, abdomen, or pelvis. May develop further,
dislodge from the venous wall, and turn into an embolus. Therapist is
apart of the team that monitors for asymmetries in color, size, and/or
temperature. Treatment involves best rest and anticoagulants to
prevent embolus.
⫸ Heterotopic Ossification. Answer: Pathological bone formation in
joints or muscle. Connective tissue calcifies around the joint affects
ROM. Symptoms in the extremity: warmth, swelling, fever, ROM
limitations.
⫸ Pain. Answer: Acute and chronic pain is common after SCI. Most
commonly classified: mechanical pain and neuropathic pain. Pain
contributes to activity limitations, lack of participation, and
depression. Crucial to communicate pain issues to the physician.
⫸ Spasticity. Answer: Uncontrolled contraction of muscles.
Spasticity can develop into clonic or tonic spasms triggered by
sensory stimuli, sudden touch, infection, other irritation. Medical
Management: oral medication, motor point block, intrathecal baclofen
pump. Not always a negative (can be used functionally).
