SCI pt function Flashcards
Key muscles intact with high cervical injuries (C1-4)
- face and neck muscles
- CN innervation
- partial innervation of diaphragm if C3-4 injury
available motions for high cervical injuries (C1-4)
- talking
- mastication
- sipping
- blowing
- scapular elevation
Functional capabilities for high cervical injuries (C1-4)
- ADLs → dependent
- independent to direct care
- Dependent bed mobility and transfers
- independent to direct care
- Mod I with pressure relief in chair
- dependent in bed but can direct care
- Wheelchair mobility
- Mod I with PWC using mouth controls
required equipment for high cervical injuries (C1-4)
- PWC with appropriate driving control adaptations
- portable ventilator (C1-2/3)
- Hospital bed with air mattress
- Hoyer lift
- Bathroom DME (TIS shower chair)
High cervical injuries (C1-4) respiratory function
- C1, 2, 3 will be ventilatory dependent
- removes ability to vocalize → adaptive equipment for communication needed
- may elect for phrenic nerve stimulator placement
- C4 should be able to eventually wean off vent
- weak cough, often need cough-assist
- may be able to use CN 9 breathing to assist with cough as well
high cervical injuries care requirements
- around the clock care → will require 1-2 caregivers
- huge burden on family
- dependent for driving
key muscles intact with C5 injuries
- biceps
- brachialis
- brachioradialis
- deltoid
- infraspinatus
- rhomboids
- supinator
available motions for C5 injuries
- elbow flexion and supination
- shoulder ER
- shoulder ABD and flexion to ~90
Functional capabilities for C5 injuries
- ADLs → min A (setup) for feeding and grooming with adapative equipment
- dependent for bathing, bowel/bladder
- Max A bed mobility
- dependent transfers (independent to direct care)
- Mod I pressure relief in PWC, in bed they can direct care
wheelchair mobility for C5 injuries
- Mod I with PWC with use of hand controls
- Mod I short distances/levels and smooth surfaces with MWC
- some to total assist outdoors
required equipment for C5 injuries
- PWC w/appropriate driving control adaptations
- may have lightweight MWC but will need increased trunk supports
- may have power asssit push rims
- hospital bed with air mattress
- hoyer lift
- bathroom DME (TIS shower chair)
- mobile arm supports, adapative ADL equipment, wrist supports with cuffs
key muscles intact with C6 injuries
- ECR
- infraspinatus
- latissimus dorsi
- pec major (clavicular portion)
- pronator teres
- SA
- teres minor
available movements for C6 injuries
- shoulder flexion, extension, ER, IR, and adduction
- scapular ABD, protraction, and UR
- forearm pronation
- wrist extension
ADL functional capabilities for C6 injuries
- Mod I with adapative equipment for feeding, grooming
- Mod I UB dressing, assistance for LB
- likely require assist for bowel/bladder
Functional capabilities and bed mobility in C6 injuries
- Mod I bed mobility with hospital bed components, leg loops
- min A → mod I with level surface transfers
- assistance needed with uneven surface transfers
- Mod I pressure relief in PWC
- mod-max A for pressure relief in bed
wheelchair mobility C6 injuries
- Mod I PWC
- mod I MWC on smooth surfaces and low-grade ramps
- assistance with uneven surfaces, D curbs
required equipment for C6 injuries
- PWC with appropriate driving control adapations
- Lightweight MWC
- Hospital bed w/air mattress
- Slideboard
- Bathroom DME (upright shower chair)
- Adaptive ADL equipment, universal cuffs, tenodesis splints