National Physical Therapy Examination (NPTE) Practice Exam

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A patient with a T7 spinal injury is likely to experience which type of bladder dysfunction?

  1. Spastic urinary dysfunction, suprapubic tapping

  2. Flaccid urinary dysfunction, suprapubic tapping

  3. Spastic urinary dysfunction, Crede's maneuver

  4. Flaccid urinary dysfunction, Valsalva maneuver

The correct answer is: Spastic urinary dysfunction, suprapubic tapping

In the context of a T7 spinal injury, the patient is likely to experience spastic urinary dysfunction. This condition arises due to an interruption of the neural pathways between the bladder and the brain, which typically occurs in individuals who have sustained injuries at the thoracic level or above. In these cases, the bladder reflexes remain intact, allowing for involuntary contractions, also known as hyperreflexia. The use of suprapubic tapping as a management strategy aligns with this type of dysfunction. Suprapubic tapping can facilitate voiding by stimulating the bladder through pressure, often leading to the reflexive contraction necessary for urination. Understanding the physiology behind bladder function in relation to spinal cord injuries emphasizes that above the injury level, reflex pathways may still operate while communication with higher centers is disrupted. This results in the spastic nature of bladder contractions in such patients. Therefore, the first option accurately captures this relationship and appropriate management technique for a patient with a T7 spinal cord injury.