National Physical Therapy Examination (NPTE) Practice Exam

A patient with cervical hyperextension injury exhibiting bleeding into the central spinal cord is likely to achieve which of the following functional levels?

1. Inability to transfer without assistance and use of a motorized wheelchair

2. Ability to propel a wheelchair independently but unable to walk

3. Independence in bed mobility and self-care but requires a sliding board for transfers

4. Ability to walk but with distal upper extremity and hand function difficulties

The correct answer is: Ability to walk but with distal upper extremity and hand function difficulties

The scenario describes a patient with a cervical hyperextension injury and bleeding into the central spinal cord, which is characteristic of a central cord syndrome. This condition often leads to more significant impairment of the upper extremities compared to the lower extremities. Given this context, the ability to walk with difficulties in distal upper extremity and hand function is consistent with the typical presentation of central cord syndrome. Patients frequently retain the ability to walk but may struggle with fine motor skills and other hand functions that are essential for daily activities. This pattern of impairment is directly related to the anatomical principles of how the spinal cord is organized, where the more proximal parts of the limbs are more robustly preserved despite the injury. This answer reflects the expected functional outcome based on the described condition, acknowledging that while the person may retain some degree of ambulation, their upper extremity functionality may be limited, supporting the correctness of this choice.