An American Spinal Injury Association (ASIA) exam is the standard test after a spinal cord injury (SCI). Doctors across the U.S. use it to assess the extent of a spinal injury.
This exam helps the doctor to:
The exam is extensive because it covers the whole body.
A doctor trained in doing the ASIA exam will test the strength and sensation of various parts of your body.
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A doctor should do an ASIA exam within 72 hours of an SCI injury.
During the assessment, you lie on a hospital bed.
The exam has three parts: motor, sensory, and anal.
The motor part measures function in 20 key muscles — 5 in each arm and leg.
Your doctor will ask you to contract these various muscles.
Each key muscle corresponds to a level in the spinal cord, for instance:
The sensory exam measures feeling in points in the neck, arms, legs, chest, hands, and feet.
There are two parts of the sensory exam: light touch and pinprick. Your doctor will do these tests separately because they travel in different nerve pathways in the spinal cord.
Each spot on your skin corresponds to a level in the spinal cord.
For instance, sensation:
The pinprick pathway travels closer to the motor pathway than the light touch pathway.
That's why regaining sensation in the pinprick pathway can better predict recovery from an SCI.
For example, if you have:
Then you have:
If there were:
Then you have:
This vital last step in the ASIA exam tests whether you can voluntarily contract the anal muscle.
The very end of the spinal cord sends motor signals to the external anal sphincter. This is the muscle that contracts when you're trying to hold a bowel movement.
The same nerves that control that muscle also send light touch and pinprick signals back to the spinal cord.
The anal exam shows whether the spinal cord is fully severed (a complete injury) or not fully severed (an incomplete injury).
During anal muscle exam, the doctor will:
If you can feel the pinprick and touch, and you can contract the anal muscle, you have an incomplete SCI. This means function below the point of injury is possible.
If you can't contract the anal muscle and cannot feel light touch and pinprick, you have a complete SCI.
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