USAHS COMPREHENSIVE EXAM STUDY
GUIDE WITH COMPLETE SOLUTIONS
●● 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.
GUIDE WITH COMPLETE SOLUTIONS
●● 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.
