Test 3 - SCI Flashcards
neurologic level
lowest level on the spinal cord where key muscles test at least 3/5 and sensation intact for this level dermatome
functional level
lowest segment which strength of key muscles graded at 3+/5 or higher and sensation intact
central SCI
A lesion to the centrally located structures of region, that produces sacral sparing and greater weakness in the upper limbs than in the lower limbs.
Brown-sequard Syndrome
Hemisection of the cord which produces ipsilateral (same-sided) proprioceptive and motor loss and contralateral (other side) loss of pain and temperature.
Posterior cord syndrome
Rare, results from compression by tumor or infarction of the posterior spinal artery. Proprioception, stereognosis, two point discrimination, and vibration sense are lost below the lesion.
Anterior Cord Syndrome
A lesion that produces variable loss of motor function and of sensitivity to pain and temperature, while preserving proprioception, touch and vibration.
Conus Medullaris
SyndromeInjury of the sacral cord (conus) and lumbar nerve roots within the neural canal that usually results in nonreflexive bladder, bowel and lower limbs. Sacral segments may occasionally show preserved reflexes (bulbocavernosus and micturition reflexes).
Cauda Equina Syndrome
Injury to the lumbosacral nerve roots within the neural canal resulting in nonreflexive bladder, bowel and lower limbs.
Mm and movement at C1, C2 and C3
Max A x 2 paralysis of - arms body and legsMuscles Innervated sip and puff ventilator required secretion assistance
Sternocleidomastoid
Cervical paraspinal
Neck accessory
Movement
Neck flexion
Neck extension
Neck rotation
goals: communication and w/c mobility
Mm and movement at C4
Max A Have : head and neck weak : shoulder sip and puff secretion assistance
Muscles Innervated Upper/Lower trapezius Diaphragm Cervical paraspinal muscles Levator scapulae
Movement Neck flexion Neck extension Neck rotation Scapular elevation Inspiration
goal: feeding independence
Mm and movement at C5
May assist with dressing Full head and neck movement good shoulder movement ELBOW FLEXION hand control w/c secretion assistance
Muscles Innervated Deltoid Biceps Brachialis Brachioradialis Rhomboids Serratus anterior Teres minor/major
Movement Shoulder flexion Shoulder abduction Shoulder extension Elbow flexion Supination Scapular adduction & abduction
goals: independence with eating, drinking, face washing, tooth brushing, face shaving, and hair care, after assistance in setting up specialized equipment.
Maybe - driving
Mm and movement at C6
WRIST EXTENSION passive key grip (tenodesis) hand control/manual w/c variable bed to chair A self-feeding secretion assistance UE dressing Writing
Muscles Innervated Pectoralis Supinator Extensor carpi radialis longus and brevis Latissimus dorsi
Movement Scapular protraction Horizontal adduction (some) Forearm supination Radial wrist extension
goals: functional goals include greater ease and independence in feeding, bathing, grooming, personal hygiene and dressing. Some individuals may also independently perform bladder and bowel management, ight housekeeping duties, transfer, do pressure reliefs, turn in bed, and drive using adaptive equipment.
Mm and movement at C7 & C8
Wrist Flexion and partial finger flexion independent transfer : bed to chair , chair to car drive with AE secretion assistance B & B independent Ind. UE dressing and bathing simple meal prep
Muscles Innervated Sternal pectoralis Triceps Pronator quadratus Extensor carpi ulnaris Flexor carpi radialis Flexor digitorum profundus and superficialis Extensor communis Pronator/flexor/extensor/abductor pollicus
Movement Elbow extension Ulnar wrist extension Wrist flexion Finger flexion & extension Thumb flexion, extension, & abduction
goals: wheelchair, greater ease in performing household work and transferring, ability to do wheelchair pushups for pressure reliefs, and the need for fewer adaptive aids in independent daily living.
Mm and movement at T1-T4
Full UB use manual w/c transfers feeding I in personal care NORMAL communication
Muscles Innervated
Intrinsics of hand including thumb
Internal and external intercostals
Erector spinae
Movement
Upper extremity
Limited trunk stability
Increasing lung capacity
C8-T1 -Functional goals include living independently without assistive devices in feeding, bathing, grooming, oral and facial hygiene, dressing, transferring, bladder management and bowel management.
T2-T6 - increasing the use of ribs and chest muscles, or trunk control.
T10-L1
Muscles Innervated
Fully intact intercostals
External obliques
Rectus abdominus
Movement
Trunk stability
For injury levels between T7 and T12, there is the added motor function of increased abdominal control. Functional goals for individuals within the six levels of injury may include improving cough effectiveness and increasing ability to perform unsupported seated activities
