Spinal Cord

Spinal Tracts

100

Spinal tract that senses proprioception, vibration, and 2 point discrimination

Dorsal column tract

200

Spinal tract that senses pain, touch, temperature, and pressure

Anterolateral spinothalamic tract

300

The tract that is responsible for motor output

Corticospinal tract

400

Describe the difference between afferent and efferent nerves. Give an example of where in the spinal cord an afferent nerve would be. 

Afferent = Ascending = Sensory

Efferent = Descending = Motor

Afferent nerves are more posterior in the dorsal aspect of the spine

500

Draw a polysynaptic reflex and explain what would happen if you were to touch a stove

• Nociceptors stimulate the 1st order neuron in the peripheral nerve -> peripheral nerve towards spinal nerve -> dorsal root ganglion -> dorsal root -> dorsal horn -> neurotransmitter is released to the alpha neuron of the biceps in the ventral horn, stimulating the biceps to contract
• At the same time, the interneuron is stimulated to release an inhibitory neurotransmitter to the alpha neuron of the triceps that prevents it from firing
• Also at the same time, the 1st order neuron crosses and synapses with a second order neuron to the anterior lateral column -> up the brainstem to the thalamus where it synapses with a 3rd order neuron -> 3,1,2 sensory area to feel pain

Spinal Cord Injuries

100

This is considered a peripheral nerve injury that occurs below L1 that presents with flaccidity, areflexia, and impairments of bowel and bladder function. 

Is full recovery typical or atypical?

Cauda Equina Injury

Not typical for full recovery

200

The corticospinal and spinothalamic tracts are injured in this cervical flexion injury that results in loss of motor function and pain and temperature below the level of the lesion

Anterior Cord Syndrome

300

Loss of proprioception, 2 point discrimination, and stereognosis but motor function is preserved in this rare syndrome

Posterior Cord Syndrome

400

Cervical hyperextension injury that damages the spinothalamic, corticospinal, and DCT tracts that affects the UE more than LE and motor more than sensory

Central Cord Syndrome

500

Describe the impairments at and below the level of the lesion in a Right Brown-Sequard's Syndrome

At the lesion - lose all sensory and motor information from the right side of the body; maintain DCT and corticospinal on the left side of the body

Below the level lesion - lose anterolateral spinothalamic of the left side, maintain it on the right side; lose DCT on the right side, maintain it on the left side, lose corticospinal on the right side of the body, maintain it on the left

Muscles and other things

100

Name the Key muscles of the UE for each spinal level from C4-T1

C4 - Diaphragm

C5 - Biceps

C6 - Extensor carpi radialis

C7 - Triceps

C8 - Flexor digitorum profundus (middle finger)

T1 - Abductor digiti minimi

200

Name the key muscles for each LE spinal level from L2 - S1

L2 - Iliopsoas

L3 - Quads

L4 - Tibialis Anterior 

L5 - Extensor hallucis

S1 - Gastroc/Soleus

300

What is the highest level possible for functional ambulation? Above this level is considered what?

T10

Above T10 are considered physiological ambulators - will stand for the physiological benefits of weight bearing

400

At what SCI level can you propel a wheelchair and why?

C6. At C6 you have wrist extensor muscles and can utilize a tenodesis grip to propel the wheelchair forward on level surfaces 

500

What is the first thing you do if someone is experiencing autonomic dysreflexia? At what level will this occur at?

SIT THEM UP

T6 or above

More Other Stuff

100

What level and below will someone be independent with coughing?

C6

200

If I have a lesion between L1-L3 I will require this orthotic to ambulate

KAFO

300

Discuss the perfect quad picture and the ROM needed

:)

400

At what level may someone be independent with feeding and not require any adaptive equipment? 

T1

500

At a C4 lesion, what kind of wheelchair is required?

Power chair with head, chip, or sip and puff control

Terminology

100

Define Raimiste's phenomenon

The involved LE will ABD or ADD with applied resistance to the uninvolved LE in the same direction

200

Raising the involved UE above 100* with elbow extension will produce extension and ABD of the fingers

Souques' phenomenon 

300

Perform all PNF patterns

:D

400

Name at least 4 facilitation techniques and at least 2 inhibition techniques. 

For bonus points, what theory are these mainly used with?

Facilitation - approximation, joint compression, icing, light touch, quick stretch, resistance, tapping, traction

Inhibition - deep pressure, prolonged stretch, warmth, prolonged cold

Rood!

500

Describe/Perform the common UE and LE limb synergies seen in SCI patients

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