SCI Equipment & Fct Outcomes Flashcards
what is the primary function of these bad boys - i.e. when would you use them
to prevent PF contracture
in what level SCI would you consider a wrist splint
C5 b/c no wrist extension
what is a classic wheelchair adaptation for C5 patients to use their UE for control
goal post joy stick
when would you consider using a feeding “see-saw” adaptation
if you have C4 but not C5
what are the two primary modalities used for SCI
biofeedback and e-stim
what are the four likely e-stim techniques encountered for SCI
- FES
- FES bike
- PENS - sensory e-stim
- epidural stim
what are the three criteria for tendon transfer surgery
- 1 year post SCI
- minimal spasticity
- good muscle strength in donor muscle
what muscle may aid in elbow extension, where can donor tissue be found to facilitate this tendon transfer?
Deltoid C4,5 may require TFL to connect to elbow extension C7
what muscle may aid in wrist extension? key pinch?
brachioradialis C5,6 can help wrist extension C6-8 and thumb flexion/adduction C8-T1
For C1-4 complete injury, what are the important muscles and contributing myotomes?
- diaphragm (C3-5)
- Cx extensors (C1-8) and flexors (C1-5)
- Scap control
- trap (CN XI and C3-4) and lev scap (C3-5)
- rhomboids (C4-5)
For C1-4 complete injury, how do they perform ADLs, transfers, and bed mobility?
dependent but the pt must know how to direct care
For C1-4 complete injury, how is WC mobility
independent with power chair for mobilty and pressure relief (with adaptations such as sip and puff and tilt in space)
For C1-4 complete injury, how is respiratory function
ventilator dependent for C1 and C2 and potentially C3; C1-4 require assistance in airway clearance
For C1-4 complete injury, do they need an attendant
require full time attendant and environmental control unit
For C5 complete injury, what are the important muscles and contributing myotomes
- scap control
- levator C3-5, rhomboids C4,5, and SA C5-7
- shoulder
- delt C5/6, RTC and teres maj C4-7, lats C5-8, and pec major clavicle C5-6
- elbow flexion and supination
- biceps, brachialis, and brachioradialis C5-6
For C5 complete injury, how are ADLs, transfers, and bed mobility
requires assitance/dependent - must be able to direct care
For a C5 complete injury, how is WC mobility
may push manual WC on level surface with adaptations, power assist option, independent with power WC
For C5 complete injury how is pulm function
requires assitance with cough
For C5 complete injury how is driving
C5 can drive
For C5 complete, do they need an attendant
part-time attendant
for C6 complete, what are the important muscles and contributing myotomes
- shoulder
- same as C5 but improved
- pec major sternal fibers C6-T1 and supinator C6-7
- radial wrist extensors ECRL C6-8
- pronator teres C6-7
For C6 complete, how are ADLs, transfers, and bed mobility
will likely require some assitance, especially with set up, and will require adaptive equipment
For C6 complete how is WC mobility
can push a manual WC, independent with power chair w joy stick
For C6 complete, how is pulm function
independent with self-assisted cough
For C6 complete, how is driving
can drive with adaptive controls
For C6 complete, do they need an attendant
requires part-time attendant
For C7 complete. what are the important muscles and contributing myotomes
Same as C5 and 6 but includes
- scap and shoulder stability
- strong wrist ext (ECRB and ECU) and pronation
- triceps C6-8
- wrist flexion FCR C6-7 and FCU C7-T1
For C7 complete, how are ADLs, transfers, bed mobility
likley independent but will require adaptive equipment
For C7 complete, how is WC mobility
community manual WC, may benefit from power assist
For C7 complete, how is pulm function
independent for self-assisted cough
For C7 complete, how is driving
can drive with adaptive control
For C7 complete, do they need an attendant
requires assist with heavy household tasks
For C8 complete, what are the important muscles and contributing myotomes
- long finger and thumb extensors (C7/8)
- long finger flexors C8-T1
- hand intrinsics C8-T1
For C8 complete, how are ADLs, transfers, and bed mobility
independent, may require adapative equipment
For C8 complete, how is WC mobility
can push manual chair in community, may benefit from power assist
For C8 complete, how is pulm function
independent with self assisted cough
For C8 complete, how is driving
can drive with adapted controls
For C8 complete, do they need an attendant
may require assist for heavy household activities
for T1-T12 complete, what are the important muscles and contributing myotomes
- Abs T6-T12
- extensors T1-T12
- QL T12
- intercostals T1-T11
For T12 complete, how are ADL, transfers, bed mobility, WC mob, respiratory, and driving
independent
For T1-T12 complete, how is ambulation
HKAFO or KAFO, physiological or exercise ambulation - full time WC users in the community
For L1-3 complete, what are important muscles and contributing myotomes
- hip flexion (iliopsoas L2-4) (sartorius L2-3)
- knee extension (quads L2-4)
For L1-3 complete, how are ADL, transfers, bed mobility, WC mobility, pulm function, and driving?
independent
For L1-3, how is ambulation
KAFO or AFO - exercise or household with possible short distance community
is L1-3 likely to use a wheelchair or orthotics to community ambulate?
WC most likely
hip extension uses which muscles/groups and their myotomes
glut max L5-S2 and hams L5-S2
hip abduction requires what muscles and innervation
glute med, min, TFL L4-S1
hip adduction requires which muscles and innervation
adductor group L2-4
knee flexion requires which muscles and innervation
hams L5-S2
Ankle DF requires which muscle and innervation
tib ant L4-S1
PF requires which muscle and innervation
gastroc-soleus S1-2
describe ambulation for L4-S1 complete
- AFO
- household ambulation
- short community ambulation
- L4 may use WC for long distances in the community
