OCCTH 585 Final Exam Questions And
Answers
spinal shock acute phase - 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 - 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 - 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
, OCCTH 585 Final Exam Questions And
Answers
- requires emergency medical attention
- if observed, have patient sit-up and dangle legs at bedside
orthostatic hypotension (postural) low BP that occurs when standing from sitting or lying
down - can make you feel dizzy and lightheaded (falls risk)
anterior cord syndrome - 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 - loss of proprioception
- motor and pain preserved
- poor prognosis for ambulation due to impact on proprioception
central cord syndrome - associated with cervical region injury
- greater weakness in the upper limbs than the lower limbs
, OCCTH 585 Final Exam Questions And
Answers
- pain, temperature sensation preserved
- usually due to hyperextension (whiplash in MVA)
- seen in older age
brown-sequard syndrome - 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 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+)
, OCCTH 585 Final Exam Questions And
Answers
E - normal
C4 - 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 - 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 - 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
Answers
spinal shock acute phase - 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 - 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 - 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
, OCCTH 585 Final Exam Questions And
Answers
- requires emergency medical attention
- if observed, have patient sit-up and dangle legs at bedside
orthostatic hypotension (postural) low BP that occurs when standing from sitting or lying
down - can make you feel dizzy and lightheaded (falls risk)
anterior cord syndrome - 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 - loss of proprioception
- motor and pain preserved
- poor prognosis for ambulation due to impact on proprioception
central cord syndrome - associated with cervical region injury
- greater weakness in the upper limbs than the lower limbs
, OCCTH 585 Final Exam Questions And
Answers
- pain, temperature sensation preserved
- usually due to hyperextension (whiplash in MVA)
- seen in older age
brown-sequard syndrome - 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 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+)
, OCCTH 585 Final Exam Questions And
Answers
E - normal
C4 - 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 - 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 - 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
