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SCI Levels of Function
Exam 1
97
Medical
Graduate
02/27/2012

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Cards

Term
At these levels of function the pt can basically only move the face and neck.
Definition
C1-3
Term
At these levels, the pt will be vent. dependent, they can talk, but have little to no head control
Definition
C1-3
Term
Name 4 available movements of a C1-3 SCI
Definition
Talking
Mastication
Sipping
Blowing
Term
What types of transfer are most appropriate for C1-3 SCI
Definition
Hoyer with head support
2 man lift
Term
What equipment or assistance is needed for ADL's with C1-3 SCI?
Definition
Total dependence. Ventilator dep. Full time attendant required
Term
What type of equipment is needed to activate light switches, page turners, call buttons, etc. for SCI C1-3
Definition
EADL (Electronic Aid to Daily Living)
Term
How will a C1-3 SCI perform locomotion?
Definition
Power w/c (power reclining back or tilt in space), portable vent, sip-n-puff control system or tongue control system or other high tech devices
Term
How will a C1-3 SCI ambulate?
Definition
Standing frame/standing power w/c with head, trunk, and LE support
Term
How does a C1-3 SCI bathe?
Definition
Dependent with reclining shower (with head support) / commode w/c
-Shower must be at least 6x6
Term
Can a C1-3 SCI drive?
Definition
Not yet, coming soon
Most will require a full size van lift
Term
Can a C1-3 SCI work?
Definition
Possible with attendant care
-Computer/phone
Term
With this level of function, the pt now has their diaphragm and trapezius muscles
Definition
C4
Term
Name 2 available movements for C4 SCI
Definition
Respiration
Scapular Elevation
Term
Can a C4 SCI breath without a vent?
Definition
Yes
Term
At this level, many pts will be ventilated at first, but not permanently. Temporary trachs are common or even an iron lung
Definition
C4
Term
How can a C4 SCI do independent pressure relief?
Definition
Tilt w/c using sip-n-puff
Term
This level of SCI has full head control and shoulder shrug but no arms
Definition
C4
Term
What assistance is needed for C4 SCI to perform ADLs
Definition
Full time attendant required
Term
What type of equipment is needed for C4 SCI for self-feeding
Definition
Limited. Mobile arm support, adapted eating equipment
Term
How can a C4 SCI type or use a computer?
Definition
Head or mouth stick, sip-n-puff controls or voice activated
Term
How can a C4 SCI turn on and off light switches?
Definition
EADLs
Term
How does locomotion occur in a C4 SCI?
Definition
Power w/c, power recline or tilt system, sip-n-puff, tongue or head control
Term
How can a C4 SCI ambulate?
Definition
Standing frame w/c for weight bearing with trunk support
Term
Can C4 SCI drive?
Definition
Not yet, coming soon
Term
What types of transfers are appropriate for C4 SCI?
Definition
Hoyer, airplane, 2 man lift, seated pivot
Term
How does C4 SCI bathe?
Definition
Dependent; attendant needed; reclining shower chair/tilt chair
Term
Can a C4 SCI work?
Definition
Yes with some attendant care; needs flexible hours
Term
With a C5 SCI, what muscles become available?
Definition
-Biceps
-Brachialis
-Brachioradialis
-Deltoid
-Infraspinatus
-Rhomboids
-Supinator
Term
What movements are available for C5 SCI?
Definition
-Elbow flexion and supination
-Shoulder ER
-Shoulder abduction to 90
-Limited shoulder flexion
(little anterior movement)
Term
How does C5 SCI perform ADLs?
Definition
-able to do all activities of C4 but with greater skill and less equipment
-can learn to groom in front (face) but not back of head
-Assistance required in set up / some attendance required
Term
Can C5 SCI perform self-feeding?
Definition
With adaptive equipment
Term
What equipment would be needed for C5 SCI to type or use computer?
Definition
Hand splints, mobile supports and slings, voice activated
Term
How does C5 SCI perform UE dressing and self-care?
Definition
UE dressing is very limited and assistance is needed. Self care is very limited and will need adaptive equipment
Term
How does C5 perform pressure relief?
Definition
Lean forward or side-to-side; typically tilt chair
Term
How does C5 SCI perform locomotion?
Definition
-Can push w/c around house but this will cause scapular winging and its not efficient
-Manual w/c with hand rim projections (not functional)
-Power w/c with joystick (efficient)
Term
How can C5 SCI ambulate?
Definition
Standing frame w/c for weight bearing with trunk support or standing wheelchair
Term
What transfers are appropriate for C5 SCI?
Definition
Airplane, seated pivot, hoyer
Term
Can a C5 SCI drive?
Definition
-Yes, van with hand controls.
-Part-time attendant required
-Uses very small steering wheel very close to the body
Term
Can C5 SCI play sports?
Definition
-Murder ball, rugby, or swimming with flotation aids
-Limited participation
Term
What 3 things in a manual w/c would C5 SCI need?
Definition
Custom
Light-weight
High Back
Term
What type of employment is appropriate for C5?
Definition
-Can type well; may use voice activation
-Very possible with desk job or limited outdoor activity/requirements
Term
How does C5 SCI bathe?
Definition
Independent in the front upper areas; shower with chair tilt; needs LE and back assistance
Term
What muscles become available to C6 SCI?
Definition
-Infraspinatus
-Latissimus Dorsi
-Pectoralis Major (clavicular portion)
-Pronator Teres
-Serratus Anterior
-Teres Minor
Term
What is the 1st level where independent living is possible?
Definition
C6
Term
What movements are availble with C6 SCI?
Definition
-Shoulder ER & IR
-Shoulder flexion, ext, adduction
-Scapular abduction and upward rotation
-Forearm pronation
-Wrist extension (TENODESIS GRIP)
Term
At what SCI does mat mobility start at?
Definition
C6
Term
What does C6 need to perform ADLs?
Definition
Some assistance to be independent
Term
How can a C6 SCI feed themselves?
Definition
-Universal cuff, intertwine utensils in fingers
Term
What does C6 SCI perform dressing and self-care?
Definition
-Adaptive equipment (possible to become independent)
Term
Is it possible for C6 SCI to become independent in bed-mobility?
Definition
Yes
Term
How will a C6 SCI perform locomotion?
Definition
Manual w/c (household) with friction coated hand rims or a power chair
Term
What equipment is necessary for C6 SCI to ambulate?
Definition
Standing frame/standing w/c for weight bearing; minimal trunk support or standing power or manual w/c
Term
What transfers can C6 SCI do independently?
Definition
Sliding board on level surfaces and slight unlevel
Term
What bathroom equipment is necesary for C6 SCI?
Definition
Standard shower chair
Tub bench maybe
Term
Can a C6 SCI perform their own skin inspections and pressure relief?
Definition
Yes independently by pushing on arm rest in either power or manual; do not have to have tilt system
Term
Is it possible for C6 SCI to be independent in bowel and bladder care?
Definition
Yes with adaptive devices
Term
Can a C6 SCI drive?
Definition
yes, car or van with hand controls; independent with van and may need assistance with car to load and unload w/c
Term
Can C6 SCI play sports?
Definition
Limited but yes; murderball, swimming, rugby, etc
Term
What muscles become avaible for C7 SCI?
Definition
-Extensor Policis longus and brevis
-Extrinsic finger extensors
-Flexor carpi radialis
-Triceps
Term
What movements become available for C7 SCI?
Definition
Elbow extension
Wrist flexion
Finger extension
Term
This SCI is independent with ADLs, self care (with equip), dressing, and bowel and bladder care (with equipment)
Definition
C7
Term
How will a C7 SCI perform locomotion?
Definition
Manual w/c with friction coated hand rims to help with grip and traction or a power w/c
Term
How might a C7 SCI ambulate?
Definition
Standing frame w/c for weight bearing or power standing w/c
Term
Can a C7 SCI perform independent transfers?
Definition
yes, maybe initially with a sliding board but then without
Term
What equipment does a C7 SCI need to drive?
Definition
Car with hand controls; independent in loading and unloading w/c
Term
What might determine whether a C7 SCI would need a manual or power w/c?
Definition
Depends on how active, motivation, weight, other health complications, terrain, etc
Term
What muscles become available for C8-T1 SCI?
Definition
-Extrinsic finger flexors
-Flexor Carpi Ulnaris
-Flexor pollicis longus and brevis
-Intrinsic finger flexors
Term
At what level can a person be independent in all aspects; they have grip but it is still not fully functional so they still may rely on tenodesis?
Definition
C8-T1
Term
At what spinal cord level gives you full hand function?
Definition
T1
Term
At what level will you get full innervation of UE muscles?
Definition
T1
Term
What equipment might a C8-T1 perform ADLs?
Definition
Independent, may need grab bars
Term
What equipment is necessary for C8-T1 SCI locomotion?
Definition
Manual w/c with standard hand rims; independent with wheelies
Term
How might C8-T1 SCI ambulate?
Definition
Possible for exercise only, standing frame w/c for weight bearing is more realistic; may walk with bracing but for exercise purposes only
Term
How does a C8-T1 do transfers?
Definition
Independent high level skills; floor to w/c
Term
Does a C8-T1 SCI load and unload w/c independently out of car?
Definition
Yes
Term
T2-3 is most similar to what SCI level?
Definition
T1
Term
What muscles become available for T4-6 SCI?
Definition
Top half of intercostals
Long muscles of the back
(Sacrospinalis and Semispinalis)
Term
What movements become available for T4-6 SCI?
Definition
Improved trunk control
Increased respiratory reserve
(Trunk will be very hyperextended)
Term
Can a T4-6 SCI level walk?
Definition
Exercise only with bracing. More likely to use a standing frame, KAFOs, HKAFOs, or a parawalker
Term
When a T4-6 SCI is walking, besides braces what other equipment do they need?
Definition
Rolling walker (hop or swing to)
Term
How is T4-6 with transfers?
Definition
Independent in all high level transfer skills
Term
How is a T4-6 SCI with locomotion?
Definition
Independent in all advanced w/c skills
Manual w/c
Term
With a T4-6 SCI, what bathroom equipment is needed?
Definition
Tub bench or in the tub with a cushion
Term
What muscles become available for T9-12 SCI?
Definition
Lower abdominals
All intercostals
Term
What movements become available for T9-12 SCI?
Definition
Improved trunk control, still not full balance
Term
At T12, what would they use for household ambulation?
Definition
KAFOs with forarm crutches or reciprocal walker which is more functional to move and carry things
Term
What muscles become available for L1 SCI?
Definition
Quadratus Lumborum
Term
What movements become available for L1 SCI?
Definition
Pelvis elevation (hip hikers)
Term
What gait pattern is most possible for L1 SCI?
Definition
4 point gait pattern possible with crutches or reciprocal walker
Term
Is a wheelchair the primary means of locomotion for L1 SCI?
Definition
Yes. Braces provide household ambulation only
Term
What muscles become available for L2-3 SCI?
Definition
Gracilis
Iliopsoas
Quadratus Lumborum
Rectus Femoris
Sartorius
Term
What movements become available for L2-3 SCI?
Definition
Hip Flexion
Hip adduction
Knee extension
Term
How will L2-3 SCI ambulate?
Definition
KAFOs with crutches (L2, ~L3 and possible AFOs for L4 or stance control brances)
Term
What muscles become available for L4-5 SCI?
Definition
Extensor Digitorum
Low Back Muscles
Medial Hamstrings (weak)
Posterior Tibialis
Quadriceps
Tibialis Anterior
Term
What movements become available for L4-5 SCI?
Definition
Strong hip flexion
Strong knee extension
Weak knee flexion
Term
What is the first SCI level that has the potential for AFOs and community ambulation?
Definition
L4-5
Term
What equipment does L4-5 SCI use for locomotion?
Definition
Manual w/c for sports or long distances (w/c might become secondary)
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