Spinal Cord Injury NCLEX Quiz Questions And Answers

Spasticity refers to the involuntary muscle stiffness or tightness that can occur in various medical conditions. It is triggered by the hyperexcitability of the spinal reflexes. Environmental factors such as temperature changes, noise, or bright lights can trigger spasticity. Stress can also exacerbate spasticity as it affects the nervous system. Urinary tract infections (UTIs) and impaction (severe constipation) can both cause inflammation and irritation in the body, leading to increased muscle tone and spasticity. Therefore, all of the mentioned factors - environment, stress, UTI, and impaction - can trigger spasticity.

Teaching a wheelie is important because it helps in pressure relief while riding a bike. It allows the rider to lift the front wheel off the ground, reducing the pressure on the back wheel and providing relief to the body. Additionally, wheelies are useful for navigating uneven terrains, such as bumps or potholes, as they help to maintain balance and control. They are also beneficial for tackling ramps, as the rider can lift the front wheel to gain momentum and smoothly transition onto the ramp. Furthermore, wheelies are helpful for making sharp turns, as they enable the rider to maneuver the bike more effectively. Therefore, teaching a wheelie is important for all of these reasons.

The key muscle group for L2 is the hip flexors. The hip flexors are responsible for flexing the hip joint and bringing the thigh towards the abdomen. As L2 is the second lumbar vertebra, it is located in the lower back region. The hip flexors, including muscles like the psoas major and iliacus, play a crucial role in stabilizing and mobilizing the lower back and pelvis. Therefore, the hip flexors are the most relevant muscle group for L2.

During Mr. Johnson's rehabilitation process, it is important to emphasize all of the above options. As a C6 complete tetraplegia, he will need to use his upper extremities (UE) effectively, so using UE as a hook is crucial. Additionally, keeping the long finger flexors tight for tenodesis will help him achieve functional hand movements. Lastly, maintaining a proper head-hips relationship is essential for overall stability and balance. Therefore, emphasizing all of these aspects will contribute to Mr. Johnson's successful rehabilitation.

Clara is classified as ASIA B because she has sensory function below the level of impairment, but no motor function. ASIA B is used to describe individuals with incomplete spinal cord injuries who have preserved sensory function but have no motor function below the level of impairment.

Bladder distention is the most common cause of AD among the given options. Autonomic dysreflexia (AD) is a condition that occurs in individuals with spinal cord injuries, causing a sudden and dangerous rise in blood pressure. Bladder distention, which refers to the overfilling of the bladder, can trigger AD by stimulating the autonomic nervous system. This stimulation leads to the release of neurotransmitters that cause blood vessels to constrict, resulting in increased blood pressure. Therefore, bladder distention is the most likely cause of AD in this scenario.

Based on the given information, Josh has deep anal sensation, which indicates that he has sensory function below the neurological level of injury (C6). Additionally, he has motor function below the neurological level of injury and more than half of his muscles are grade 3 or below. According to the ASIA impairment scale, a person who has sensory function below the neurological level and motor function below the neurological level with more than half of the muscles grade 3 or below is classified as a "C" on the scale.

Anterior cord syndrome is a spinal cord injury that typically occurs due to a flexion injury. It is characterized by the loss of motor function below the level of injury, as well as the loss of pain and temperature sensation. However, proprioception and vibration sensation are typically preserved in anterior cord syndrome. Therefore, the statement "loss of proprioception/vibration" is not true regarding anterior cord syndrome.

The diaphragm is the functionally relevant muscle at C4. The diaphragm is a dome-shaped muscle located at the base of the lungs and plays a crucial role in the process of breathing. It contracts and relaxes to control the volume of the thoracic cavity, allowing air to enter and leave the lungs. As C4 is the level where the phrenic nerve originates, which innervates the diaphragm, any damage or dysfunction at this level can affect the function of the diaphragm and lead to respiratory problems.

Dilated pupils are not a sign/symptom of AD. AD, or Autonomic Dysreflexia, is a condition that occurs in individuals with spinal cord injuries. It is characterized by a sudden and severe rise in blood pressure, often caused by a noxious stimulus below the level of injury. Symptoms of AD include severe, pounding headache, hypertension, bradycardia, and profuse sweating/flushing above the level of the spinal cord lesion. However, dilated pupils are not typically associated with AD.

The most common clinical cord syndrome in incomplete injuries is the Central Cord syndrome. This syndrome is characterized by damage to the central portion of the spinal cord, resulting in motor weakness and sensory loss that is more pronounced in the upper extremities compared to the lower extremities. It is often caused by hyperextension injuries, such as falls or motor vehicle accidents.

Proprioception refers to the sense of body position and movement. ASIA standards assess various sensory and motor functions in individuals with spinal cord injuries. However, proprioception is not specifically mentioned as a requirement in ASIA standards. The other options, such as sharp/dull, light touch, and deep anal sensation, are all sensory functions that are evaluated according to ASIA standards.

Based on the given information, Pete is able to move through a full range of motion against gravity and can also hold against minimal resistance. This indicates that Pete has good strength and control of the key muscle for L2. According to the grading system, a grade of 4 is typically given when a patient has good strength and control of a muscle. Therefore, the correct answer is 4.

The question is asking about the neuro level if one were to have an L3 motor level and L2 sensory level. The correct answer is L2, as it is the level that matches both the motor level and sensory level mentioned in the question.

The question is asking at what level we have fully intact intercostals. The correct answer is T10-L1, which refers to the thoracic vertebrae levels 10 to lumbar vertebrae level 1. This means that the intercostal muscles, which are located between the ribs and are responsible for breathing, are fully intact at this level.

Pete is graded as a 2 because he is able to move through the full range of motion in the gravity eliminated position. However, he is unable to hold against resistance. This suggests that Pete has some level of muscle strength and control, but lacks the ability to generate significant force against resistance.

The correct answer is "must be 3 or below". This statement contradicts the requirement for the motor level of the patient. The motor level must be 3 or above, meaning that the patient should have voluntary movement and be able to overcome gravity in at least half of the key muscles tested. Therefore, the statement "must be 3 or below" is not true in order to be considered the motor level of the patient.

During spinal shock, the bladder becomes flaccid, meaning it loses its normal tone and is unable to contract. To empty the bladder in this condition, the patient would be instructed to perform either the Valsalva maneuver or the Crede maneuver. The Valsalva maneuver involves holding the breath and straining, which increases the pressure in the abdomen and helps in emptying the bladder. The Crede maneuver involves manually applying pressure to the bladder to assist in emptying. Both maneuvers help compensate for the lack of bladder muscle tone and facilitate urine elimination.

The appropriate w/c stroke is semicircular because it resembles a half circle shape. This stroke is commonly used in calligraphy and handwriting to create rounded and flowing letters. It is a smooth and continuous stroke that adds elegance and fluidity to the writing.

This answer is correct because it accurately describes the distribution of UMN (Upper Motor Neuron) and LMN (Lower Motor Neuron) signs in relation to the level of the lesion. According to this answer, LMN signs are present at the level of the lesion, while UMN signs are present below the level of the lesion. This pattern is consistent with the anatomical pathways and connections of the motor system in the nervous system.

In a patient with spinal cord injury (SCI), stretching long finger flexors is not important. This is because SCI can result in hand and finger weakness or paralysis, making it difficult for the patient to actively flex their fingers. Therefore, stretching the long finger flexors would not be a priority in their rehabilitation program.

At the C7-8 level, we would begin to expect independent transfers and independent self-care. This means that individuals with injuries at this level would have the ability to transfer themselves from one surface to another without assistance and perform self-care tasks such as dressing, grooming, and feeding independently. This level indicates a higher level of functional independence compared to the lower levels (C5 and C6), where individuals may require some assistance or adaptations for transfers and self-care activities.

The correct answer is 1; cheek. The patient can tell the difference between sharp and dull in the C5 dermatome, which indicates intact sensory function. However, they mention that it feels different than the reference point, suggesting some discrepancy in sensation. Therefore, they would be scored a 1 for the cheek, indicating impaired or altered sensation compared to the reference point.

The bulbocavernosus reflex is a reflex that is mediated by the S1-S3 nerve roots. This reflex is not only present during spinal shock but can also be present in individuals with intact spinal cord function. A physical therapist may check the bulbocavernosus reflex as part of a neurological examination. The reflex is elicited by pressure on the anal sphincter and is considered positive if contraction of the anal sphincter occurs.

The conus medullaris is the tapered end of the spinal cord, located at the level of the first or second lumbar vertebrae. Lesions above this level often result in a spastic bladder. This is because the nerves that control the bladder's voluntary control are located at the level of S2-S4, and when there is damage to the spinal cord above this level, the bladder loses its ability to relax and fill properly, leading to increased muscle tone and spasticity.