---

1) The primary indication for intervention in spasticity associated with spinal cord injury is:

One answer only.

   1. Ashworth score greater than 3

   2. sustained clonus bilaterally

   3. spasticity of the hip flexors

   4. spasticity associated problems with dressing, transfer, or other functions

---

2) A spinal cord injury is said to be incomplete if:

One answer only.

   1. there is preserved sensation below the level of the lesion

   2. there is preserved motor function below the level of the lesion

   3. there is preserved motor and/or sensory function of the sacral segments as found on rectal exam

   4. if MRI shows viable spinal cord tissue distal to the lesion

---

3) Following a complete cervical spinal cord injury, a major problem that often complicates bladder management is:

One answer only.

   1. an areflexic neurogenic bladder

   2. a large, hypotonic bladder

   3. detrusor-sphincter dyssynergy

   4. reflex voiding

   5. overflow incontinence

---

4) The management of choice for long term bladder evacuation in an SCI patient with neurogenic bladder is:

One answer only.

   1. Foley catheter

   2. suprapubic tube

   3. artificial sphincter

   4. clean intermittent catheterization

   5. neural stimulation

---

5) A person with C6 tetraplegia complains of facial flushing and mild headache. His vitals are BP 170/90, pulse of 62, respirations and temperature are unremarkable. You should:

One answer only.

   1. give the patient benadryl for an allergic reaction

   2. catheterize the patient to check for bladder distention

   3. give IV Nipride (sodium nitroprusside)

   4. elevate the patient's legs

   5. do nothing, the problem will resolve spontaneously

---

6) Which of the following describes the motor level for complete C5 Tetraplegia by American Spinal Injury Association standards?

One answer only.

   1. Biceps 4/5 bilaterally, Wrist extensors 4/5 bilaterally, Triceps 4/5 bilaterally, 0/5 motor strength below level of injury

   2. Biceps, Wrist Extensors, Triceps all 5/5, all remaining motor strength 1-2/5.

   3. Biceps 4/5 bilaterally, Wrist extensors 4/5 bilaterally, Triceps 1/5 bilaterally, 0/5 motor strength below level of injury.

   4. Biceps 5/5 bilaterally, Wrist extensors 2/5 bilaterally, triceps 1/5 bilaterally, no motor strength below the level of injury.

---

7) In autonomic hyperreflexia:

One answer only.

   1. nociceptive input below the level of the lesion causes reflex increase in parasympathetic tone below the level of the lesion

   2. reflex compensatory mechanism causes increased sympathetic activity above the level of the lesion

   3. nociceptive input below the level of the lesion causes reflex sympathetic output below the level of the lesion

   4. occurs only in paraplegics

---

8) The incidence of deep venous thrombosis in spinal cord injury is:

One answer only.

   1. sufficiently high that it requires prophylactic measures

   2. insignificant as these patients cannot perceive pain

   3. not associated with serious complications

   4. all of the above

---

9) If you were asked to test the seventh cervical (C7) dermatome for sharp/dull discrimination, what part of the body would you touch with a pin?

One answer only.

   1. Supraclavicular fossa

   2. Thumb

   3. Third digit

   4. Apex of axilla

   5. Nipple line

---

10) A good muscle group to use to test the fifth lumbar (L5) myotome is the:

One answer only.

   1. knee extensors

   2. plantar flexors

   3. long toe extensors

   4. elbow flexors

   5. diaphragm