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Adult Neuro > Functional Expectations for Patients With Spinal Cord Injury > Flashcards

Functional Expectations for Patients With Spinal Cord Injury Flashcards

1
Q

key muscles available in a C1, C2, C3, C4 injury

A
  • Face and neck muscles
  • cranial nerve innervation
  • diaphragm (partial innervation at C3 and C4)
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2
Q

available movements in a C1, C2, C3, C4 injury

A
  • Talking
  • Mastication
  • Sipping
  • Blowing
  • Scapular elevation
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3
Q

key muscles available in a C5 injury

A
  • Biceps
  • Brachialis
  • Brachioradialis
  • Deltoid
  • Infraspinatus
  • Rhomboid (major and minor)
  • Supinator
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4
Q

available movements in a C5 injury

A
  • Elbow flexion and supination
  • Shoulder external rotation
  • Shoulder abduction and flexion to ~90°
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5
Q

Equipment and Assistance Required

C5 injury, bowel and bladder

A

Dependent, directs care provided by attendants

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6
Q

Equipment and Assistance Required

C5, transfers

A
  • Dependent, attendants use mechanical lift
  • Directs care provided by attendants
  • May be able to perform with assistance and transfer board
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7
Q

available key muscles in C6 injury

A
  • Extensor carpi radialis (tenodesis grasp)
  • Infraspinatus (shoulder ER)
  • Latissimus dorsi (shoulder IR, EXT, ADD)
  • Pectoralis major (clavicular portion) (shoulder FLX, IR)
  • Pronator teres
  • Serratus anterior (protraction and superior rotation of the scapula)
  • Teres minor (shoulder ER)
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8
Q

available movements in a C6 injury

A
  • Shoulder flexion, extension, internal rotation, and adduction
  • Scapular abduction, protraction, and upward rotation
  • Forearm pronation
  • Wrist extension (tenodesis grasp)
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9
Q

Equipment and Assistance Required

C6 injury, bowel and bladder care

A

May be able to be independent with adaptive equipment, likely to require assistance/dependent

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10
Q

Equipment and Assistance Required

C6 injury, transfers

A
  • Independent to some assistance with transfer board
  • Assistance with uneven transfers
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11
Q

C5 injury, driving

A

Independent with van with adaptive controls

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12
Q

available key muscles in C7 injury

A
  • Extensor pollicus longus and brevis
  • Extrinsic finger extensors
  • Flexor carpi radialis Triceps
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13
Q

available movements in a C7 injury

A
  • Elbow extension
  • Wrist flexion
  • Finger extension
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14
Q

Equipment and Assistance Required

C7 injury, ADL

A

Independent with most ADL with adaptive equipment

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15
Q

avalaible key muscles in a C8 injury

A
  • Extrinsic finger flexors
  • Flexor carpi ulnaris
  • Flexor pollicis longus and brevis
  • Intrinsic finger flexor
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16
Q

avalaible movements in a C8 injury

A

finger flexion

17
Q

avalaible key muscles in a T1 to T12 injury

A
  • Intercostals
  • Long muscles of back (sacrospinalis and semispinalis)
  • Abdominal musculature (~T7 and below)
18
Q

avalaible movements in T1 to T12 injury

A
  • Improved trunk control with more caudal SCI
  • Increased respiratory reserve
  • Pectoral girdle stabilized for lifting objects
19
Q

Equipment and Assistance Required

T1 to T12 injury, ambulation

A
  • Independent with physiological standing and ambulation for exercise over short distance in the home Assistive devices (e.g., forearm crutches)
  • Orthoses: hip-knee-ankle-foot-ortho- sis (HKAFO), knee-ankle-foot orthosis (KAFO)
20
Q

key avalable muscles in a L1, L2, L3 injury

A
  • Gracilis (hip ADD and knee FLX)
  • Iliopsoas (hip FLX)
  • Quadratus lumborum
  • Rectus femoris (hip FLX, knee EXT)
  • Sartorius (hip FLX, ABD, ER, little knee FLX)
21
Q

available movements in a L1, L2, L3 injury

A
  • Hip flexion
  • Hip adduction
  • Knee extension
22
Q

Equipment and Assistance Required

L1, L2, L3 injury, ambulation

A
  • Independent short distances in home and possibly community
  • Many choose to use wheelchair in the community due to high energy demands of community ambulation Assistive devices (e.g., forearm crutches)
  • Orthoses: HKAFO, KAFO, AFO (depending on which muscles are innervated)
23
Q

key avalable muscles in a L4, L5, SI injury

A
  • Quadriceps (L4)
  • Anterior tibialis (L5)
  • Hamstrings (L5–S1)
  • Gastrocnemius (S1)
  • Gluteus medius and maximus (L5–S1)
  • Extensor digitorum, posterior tibialis, peroneals, flexor digitorum (L5, S1)
24
Q

avalaible movements in a L4, L5, SI injury

A
  • Strong hip flexion
  • Strong knee extension
  • Knee flexion
  • Ankle dorsiflexion
  • Ankle plantarflexion
  • Ankle eversion
  • Toe extension
25
Q

Equipment and Assistance Required

L4, L5, S1 injury, ambulation

A
  • Independent ambulation in home and community (L4-level injury may elect to use wheelchairfor long distances)
  • Assistive devices (e.g., forearm crutches, canes)
  • Orthoses: AFO
  • Less supportive assistive device and orthoses the more caudal the SCI
26
Q

Individuals with complete (ASIA A) UMN injuries are not likely to regain the functional LE strength required to become independent ______ .

A

ambulators

27
Q

For individuals with ASIA B (sensory incomplete) the preservation of pinprick sensation is an important prognostic indicator of the recovery of ________

A

ambulation

28
Q

Lower extremity ASIA motor score, quadriceps strength in particular, can be a useful predictor of functional ____________ in people with motor incomplete injuries

A

walking ability

29
Q

In a cohort of almost 500 patients, findings indicated that age, motor scores of quadriceps and gastrocnemius, and light touch sensory scores at L3 and S1 were able to accurately distinguish between_____________ and those who require assistance or cannot ambulate.

A

independent home ambulators (as scored on the SCIM)

Adult Neuro (22 decks)

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