Spinal Cord Injury

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Author:
xdiabx
ID:
200796
Filename:
Spinal Cord Injury
Updated:
2013-02-15 14:47:07
Tags:
SCI
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Description:
SCI
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  1. C1, C2, C3 clinical picture
    • Muscles: all facial and neck muscles intact
    • Respirator Dependent
    • Total dependence with t/f, bed mob, NO ambulation, NO u/e or trunk control
    • Mobility: electric wheelchair with mouth controls (huff/puff devices)
  2. C4 clinical picture
    • Muscles: diaphragm & trapezius muscles
    • Patient is totat dependent w/ t/f, bed mob, NO amb, NO u/e but some trunk control
    • Mobility: electric w/c w/ mouth controls (huff/puff device)
  3. C5 clinical picture
    • Muscles: biceps, brachialis, brachioradialis, deltoid, infraspinatus, rhomboids, supinator-forearm. Generally, no internal rotation, elbow extension or wrist movement
    • No ambulation, some u/e function, trunk binder for support and for cough assistance
    • Mobility: manual or electrical w/c. Start t/f with sliding board or AD
  4. C6 clinical picture
    • Muscles: ECR, infraspinatus, latissimus dorsi, pectoralis major (clavicular portion), pronator teres, serratus anterior, teres major
    • Mobility: no amb, manual w/c, independent with t/f and bed mob w/ AD. Patient may need trunk binder for support in dynamic sitting positions and for coughing assistance
    • Demonstrates a positive tenodesis effect (wrist extension/finger flexion)
  5. C7 clinical picture
    • Muscles: triceps, elbow extensors, wrist flexors, finger extensors
    • Mobility: independent t/f and bed mob, manual w/c. May not need trunk binder, independent manual cough. No amb
  6. C8/T1 clinical picture
    • Muscles: full upper extremity innervation including fine coordination and grasp
    • Mobility: Independent with bed mobility and t/f. Manual w/c for assistance. No amb
  7. T4-T6 clinical picture
    • Muscles: erector spinae (most of them), all intercostals
    • Mobility: initiate physiological standing with standing table and bracing with HKAFO/KAFO. Improved trunk control, w/c for accessible living environment, able to perform wheelie's with curb negotiation
  8. T9-T12 clinical picture
    • Muscles: lower abdominals,all intercostals
    • Mobility: good trunk support, household amb, KAFs with crutches or walker. W/c on an "as needed" basis for energy conservation
    • Independent with t/f & bed mob
  9. L2, L3 & L4 clinical pic
    • Muscles: gacilis, ilipsoas, quadratus lumborum, rectus femoris, sartorious
    • Mobility: Functional amb w/ crutches, bracing with KAFO and AFO w/c as needed 
  10. L4 & L5 clinical pic
    • Muscles: quads, tib anterior, post tibialis, some hamstrings, erector spinae, completed extensor digitorum
    • Mobility: strong knee extensors, functional amb w/ crutches/cane, AFO's as needed. W/c for energy conservation. I t/f & bed mob
  11. SI- clinical pic
    • Muscles: ankle pf are partially innervated
    • Mobility: functional amb, AFO's as needed & crutches/cane. W/c for energy conservation
  12. How to reduce tone
    • Baclofen- causes drowsiness 
    • stretching program
    • gently rocking
    • hooklying position with pressure through knees
  13. Goals for paraplegia
    • -Mod I with w/c propulsion on tile for community distances, ramps, door management, pop wheelie
    • -Mod I with self ROm LE (sitting, leaning against wall
    • -Recognize signs and symptoms of risks
    • -Performs w/c to mat lateral scoot w/ sliding board mod I or sit pivot mod I
    • -Car t/f min PA w/ legs
    • -Mat mobility min PA
  14. Goals for Quadraplegia
    • Above plus resp education (monitor tidal vol), how to cough without abdominals (quad cough), diaphragmatic breathing
    • For C6--sliding board t/f with mod PA
  15. Asia Scale
    • A complete transection
    • B sensation, no motor
    • C sensation, spotty motor
    • D sensation & motor

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