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WorksheetsSCI
Total questions: 30
Worksheet time: 15mins
What is the leading cause of death among chronic SCI patients
Respiratory Disease
Metabolic Syndrome
Cardiovascular Disease
Complications from musculoskeletal injury
What are 1st and 2nd most common locations of Heterotopic Ossification?
Hip, Shoulder
Shoulder, Hip
Knee, Hip
Hip, Knee
Besides the hips, which of the following is the next most common location for heterotopic ossification in SCI patients?
Fingers
Knees
Shoulders
Elbows
Which is the gold standard for diagnosing pulmonary embolisms:
d-dimer
Perfusion lung scan
Pulmonary Arteriogram
MRI
Which of the following pairs of key myotomes is incorrectly paired?
C6: extensor carpi radialis
C7: Triceps
C8: Flexor Digitorum Profundus of the 2nd Digit
T1: Abductor Digiti Minimi
An 18yoM is stabbed in the back with a knife and sustains a hemisection of the right spinal cord at T8, which of the following would NOT apply to his clinical picture:
A. Of all SCIs, he has clinical syndrome has the best prognosis for ambulation
B. On exam, he has paralysis of right hemibody below T8, inability to distinguish light touch and proprioception on the right hemibody below T8, and inability to distinguish pain and temperature on the left hemibody below T8
C. This is the most common of all incomplete SCI syndromes
D. Immediately after the injury, it is possible that he will experience arreflexia below the level of injury
You are performing an ASIA exam on a patient you suspect has an SCI. Which of the following statements is true?
A. The motor level of injury is the most caudal segment with 5/5 strength
B. If a patient has intact sensation to light touch and sharp/dull at S4/S5, you do not need to perform deep anal pressure
C. In cases where there is no key muscle level available, the neurologic level of injury defaults to the most caudal tested muscle level
D. The motor and sensory level of injury are the same in >50% of injuries
What is the recommended order for determining a patient's AIS level?
A. sensory level; motor level; NLI; complete vs incomplete; AIS grade
B. motor level; sensory level; NLI; complete vs incomplete; AIS grade
C. sensory level; motor level; complete vs incomplete; NLI, AIS grade
D. motor level; sensory level; NLI; complete vs incomplete; AIS grade
What is the only anticonvulsant that is FDA approved for the indication of neuropathic pain in SCI?
Pregabalin
Gabapentin
Keppra
Valproic Acid
Testing which of the following dermatomes for light touch and pinprick sensation is crucial for distinguishing between a neurological complete and incomplete injury?
L1
L5
S1
S4
Which of the following injury mechanisms would be more likely to cause a complete lesion vs an incomplete lesion?
Thoracolumbar flexion-rotation injury
Fall in a patient with cervical spondylosis
Unilateral facet joint dislocations
Superficial penetrating stab injury
Which of the following is NOT correct regarding central cord syndrome?
A) Most common of the incomplete SCI syndromes
B) Produces greater motor weakness in the lower limbs than the upper limbs
C)Recovery typically includes LEs recover first and to a greater extent. This is followed by improvement in bladder function, then proximal UE, and finally intrinsic hand function.
D) Often associated with cervical hyperextension injury
E) Age below 50 is a key positive prognostic indicator of functional recovery.
All of the following would be true of a patient with spinal shock EXCEPT:
A) Temporary loss or depression of all spinal reflex activity below the level of the lesion
B) Loss of motor function and sensation
C) Paralysis of the bladder and bowel.
D) Muscles below the level of the lesion become hypertonic
E) Patients would exhibit hyporeflexia or temporary loss of piloerection, sweating, and vasomotor tone in the lower parts of the body
Which of the following is FALSE regarding SCI and pregnancy?
A) Hormonal changes following SCI leads to impaired fertility in females, making it more difficult to get pregnant
B) Pregnant women with SCI are at higher risks of pressure injuries and UTIs
C) Autonomic Dysreflexia must be carefully monitored as it can be a sign of labor
D) Epidural anesthesia should extend to T10 in order to treat labor associated autonomic dysreflexia
Which of the following is TRUE regarding the GI system and its innervation?
A) Pudendal nerve - Parasympathetic - S2-S4 - External Anal Sphincter control
B) Pelvic nerve - Sympathetic - S2-S4 - Internal Anal Sphincter relaxation
C) Pudendal nerve - Somatic - S2-S4 - External Anal Sphincter Control
D) Pelvic nerve - Parasympathetic - T12-L2 - Internal Anal Sphincter relaxation
Which medication can be used in LMN bladder (failure to empty)?
A. Tolterodine
B. Mirabegron (Myrbetriq)
C. Bethanecol
D. Botulinum toxin
Which medication/maneuver is commonly used in UMN bladder (failure to store)
Oxybutynin (Ditropan)
Bethanecol
Crede maneuver
Valsalva maneuver
Subacute combined degeneration involves degeneration of which of the following?
Dorsal Columns
Lateral Columns
Dorsal and Lateral Columns
Anterior Columns
Which of the following is most likely as a result from an axial loading injury in the neck, such as a headfirst football spearing injury.
A. C1 Burst fracture (Jefferson)
B. C2 Burse Fracture (hangman)
C. Odontoid (dens) fracture
D. C5 Vertebral Body Compression fracture
At what spinal cord injury level are patient’s to be considered most at risk for BP dysregulation?
A. T6 and above
B. T8 and above
C. T10 and above
D. L2 and above
Which receptors are not found on the bladder wall?
A. Cholinergic muscarinic receptors
B. Beta-3 adrenergic receptors
C. Alpha-1 adrenergic receptors
D. Baroreceptors
Which of the following innervations are NOT significant in gastrointestinal complications with spinal cord injuries?
A. Hypogastric nerve
B. Vagus nerve
C. Pelvic splanchnic nerves
D. Stellate ganglion
Which is NOT true when considering pregnancy in spinal cord injury patients?
A. Pre-eclampsia is a complication to be aware of that can present similar to autonomic dysreflexia
B. During labor and delivery, the risk of autonomic dysreflexia is 85-90% of patients with lesions at T6 and above
C. After initial return of menstruation after spinal cord injury, fertility continues to be impaired
D. Pregnant women with SCI may develop pressure injuries and recurrent UTIs
In the acute phase of SCI, which of the following is the leading cause of death after SCI?
A. Septicemia
B. Genitourinary Disease (i.e. renal failure)
C. Pulmonary Disease
D. Heart Disease
Which of the following is the most common presentation of cervical myelopathy?
A. Gait disturbance and decreased balance
B. Upper extremity paresthesias
C. Decreased fine motor coordination
D. Unilateral or bilateral arm/hand weakness
What percent of patients with SCI develop detrusor sphincter dyssynergia?
45%
50%
65%
85%
What is the most common complication following SCI?
Depression
UTI
Spasticity
HO
How does detrusor-sphincter-dyssynergia present?
A) Tight Bladder, loose internal sphincter
B) Loose bladder, tight internal sphincter
C) Loose sphincter, loose internal bladder
D) Tight bladder, tight internal sphincter
29 year male dives into a pool and sustains a spinal cord injury. He was found to have a brown Sequard type incomplete spinal cord injury. Which of the following is NOT a likely deficits in this patient?
Ipsilateral paralysis
Ipsilateral loss of light touch
Contralateral loss of proprioception
Contralateral loss of pain
A 70 year old male with a history of cervical spondylosis presents to the ED after a fall with head strike. He is eventually found to have a central cord type spinal cord injury with both arm and leg weakness. Which of the following describes the most likely mechanism of injury and likely recovery pattern?
a. Cervical flexion, uppers recover before lowers
b. Cervical extension, lowers recover before upper
c. Cervical flexion, lowers recover before uppers
d. Cervical extension, uppers recover before lower.
