OCCTH 585 Final Exam UPDATED
ACTUAL Exam Questions and CORRECT
Answers
spinal shock acute phase - CORRECT ANSWER - - occurs in the first several weeks after
SCI
- state of transient physiological reflex depression
- suspension of function and reflexes below the level of injury - loss of all sensorimotor functions
- an initial increase in BP
- flaccid paralysis, including bowel and bladder
neurogenic shock - CORRECT ANSWER - - disruption of the autonomic pathways within
the spinal cord
- shock tends to occur more commonly in injuries around T6
- due to disruption of the sympathetic outflow from T1 to L2 resulting in supraspinal control over
the sympathetic nervous system
- results in severe hypotension (low BP) and bradycardia (low HR)
- can lead to organ dysfunction and requires immediate treatment
autonomic dysreflexia - CORRECT ANSWER - - life threatening condition that occurs in
SCI above T5-T6 (can occur lower)
- massive imbalanced reflex sympathetic discharge resulting from non-noxious stimuli
- pounding headache, sudden increase in BP, sweating above the injury level, flushed face
- requires emergency medical attention
- if observed, have patient sit-up and dangle legs at bedside
orthostatic hypotension (postural) - CORRECT ANSWER - low BP that occurs when
standing from sitting or lying down - can make you feel dizzy and lightheaded (falls risk)
,anterior cord syndrome - CORRECT ANSWER - - loss of touch, pain, temperature
sensation
- loss of motor
- proprioception, kinaesthesia, and vibratory sense intact
- poor prognosis for neural recovery
- commonly caused by infarct, traumatic bending, or spinal stenosis
posterior cord syndrome - CORRECT ANSWER - - loss of proprioception
- motor and pain preserved
- poor prognosis for ambulation due to impact on proprioception
central cord syndrome - CORRECT ANSWER - - associated with cervical region injury
- greater weakness in the upper limbs than the lower limbs
- pain, temperature sensation preserved
- usually due to hyperextension (whiplash in MVA)
- seen in older age
brown-sequard syndrome - CORRECT ANSWER - - hemi-section
- ipsilateral motor and proprioception loss (flaccid at level of injury; spasticity paralysis below
lesion)
- contralateral pain and temperature sensation loss
- favourable prognosis for ambulation, ADL independence, and bladder control
ASIA impairment scale - CORRECT ANSWER - A - complete, no motor or sensory
B - incomplete, sensory preserved (no motor)
C - incomplete, motor preserved (>50% muscle grade less than 3)
, D - incomplete, motor preserved (>50% muscle grade 3+)
E - normal
C4 - CORRECT ANSWER - - some resp issues (unable to cough), not usually on vent
- have control of diaphragm, trapezius
- communication - computer, environmental control unit
- require transportation and access
- need 24 hour care
C5 - CORRECT ANSWER - - shoulder abduction, elbow flexion, supination
- eating - universal cuff, plate guard, cup holder, straw
- able to assist with upper extremity dressing and grooming
- independence with eating, drinking, face washing, tooth brushing, shaving, hair care, with set-
up and equipment
C7 - CORRECT ANSWER - - elbow extension, wrist flexion, shoulder abduction, elbow
flexion, supination
- manual wheelchair possible
- more ease with household transfers, wheelchair pushups, and pressure relief
- less adaptive equipment needed
- fatigue easily
T6 - CORRECT ANSWER - - finger flexors, abductors
- upper extremity control
- better rib, chest and trunk control as higher thoracic levels are innervated
- independent with ADL (with AT)
ACTUAL Exam Questions and CORRECT
Answers
spinal shock acute phase - CORRECT ANSWER - - occurs in the first several weeks after
SCI
- state of transient physiological reflex depression
- suspension of function and reflexes below the level of injury - loss of all sensorimotor functions
- an initial increase in BP
- flaccid paralysis, including bowel and bladder
neurogenic shock - CORRECT ANSWER - - disruption of the autonomic pathways within
the spinal cord
- shock tends to occur more commonly in injuries around T6
- due to disruption of the sympathetic outflow from T1 to L2 resulting in supraspinal control over
the sympathetic nervous system
- results in severe hypotension (low BP) and bradycardia (low HR)
- can lead to organ dysfunction and requires immediate treatment
autonomic dysreflexia - CORRECT ANSWER - - life threatening condition that occurs in
SCI above T5-T6 (can occur lower)
- massive imbalanced reflex sympathetic discharge resulting from non-noxious stimuli
- pounding headache, sudden increase in BP, sweating above the injury level, flushed face
- requires emergency medical attention
- if observed, have patient sit-up and dangle legs at bedside
orthostatic hypotension (postural) - CORRECT ANSWER - low BP that occurs when
standing from sitting or lying down - can make you feel dizzy and lightheaded (falls risk)
,anterior cord syndrome - CORRECT ANSWER - - loss of touch, pain, temperature
sensation
- loss of motor
- proprioception, kinaesthesia, and vibratory sense intact
- poor prognosis for neural recovery
- commonly caused by infarct, traumatic bending, or spinal stenosis
posterior cord syndrome - CORRECT ANSWER - - loss of proprioception
- motor and pain preserved
- poor prognosis for ambulation due to impact on proprioception
central cord syndrome - CORRECT ANSWER - - associated with cervical region injury
- greater weakness in the upper limbs than the lower limbs
- pain, temperature sensation preserved
- usually due to hyperextension (whiplash in MVA)
- seen in older age
brown-sequard syndrome - CORRECT ANSWER - - hemi-section
- ipsilateral motor and proprioception loss (flaccid at level of injury; spasticity paralysis below
lesion)
- contralateral pain and temperature sensation loss
- favourable prognosis for ambulation, ADL independence, and bladder control
ASIA impairment scale - CORRECT ANSWER - A - complete, no motor or sensory
B - incomplete, sensory preserved (no motor)
C - incomplete, motor preserved (>50% muscle grade less than 3)
, D - incomplete, motor preserved (>50% muscle grade 3+)
E - normal
C4 - CORRECT ANSWER - - some resp issues (unable to cough), not usually on vent
- have control of diaphragm, trapezius
- communication - computer, environmental control unit
- require transportation and access
- need 24 hour care
C5 - CORRECT ANSWER - - shoulder abduction, elbow flexion, supination
- eating - universal cuff, plate guard, cup holder, straw
- able to assist with upper extremity dressing and grooming
- independence with eating, drinking, face washing, tooth brushing, shaving, hair care, with set-
up and equipment
C7 - CORRECT ANSWER - - elbow extension, wrist flexion, shoulder abduction, elbow
flexion, supination
- manual wheelchair possible
- more ease with household transfers, wheelchair pushups, and pressure relief
- less adaptive equipment needed
- fatigue easily
T6 - CORRECT ANSWER - - finger flexors, abductors
- upper extremity control
- better rib, chest and trunk control as higher thoracic levels are innervated
- independent with ADL (with AT)
