It is tricky wording! Basically, if deep anal pressure sensation (DAP) is present, then there is NO sensory ZPP. And if voluntary anal contraction (VAC) is present, then there is NO motor ZPP. If either is absent, then there is a ZPP.
Sensory:
– DAP present = ZPP not applicable
– DAP absent = ZPP is lowest dermatome on each side with some light touch or pinprick preservation (assuming LT and PP in S4-5 are scored as 0)
Motor:
– VAC present = ZPP not applicable
– VAC absent = ZPP is lowest myotome on each side with some preservation