SCI stuff Slide 2 Motor Points Slide 3 Dermatomes and Peripheral
Nerve Distributions Slide 4 Convert your thinking from peripheral
nerves to spinal cord segments: Slide 5 Case #3: Damage to C8 @
Exit Slide 6 C6 Neurological Level N-G T-0 x x x x F-P Key Muscles:
C5: Deltoid, Biceps C6: ECRL, ECRB C7: Triceps C8-T1: FDP,
intrinsics Slide 7 Slide 8 MMT to determine neurological level: If
you test a muscle innervated by C5&6 and it tests 3/5, this
"Fair" strength grade is telling you the muscle is not fully
innervated. If you test another muscle innervated by C6 only or
C6&7 and it is 0/5, the picture becomes clearer that C5 is
connected, C6 and higher numbers (lower levels of the cord) are
not. Further MMT of muscles with C5, C6, C7 innervations confirms
the finding, as does sensory testing using the dermatome map. Slide
9 MMT to determine neurological level: Functioning C5 and
non-functioning C6 were responsible for the first muscle strength
@3/5; non functioning C6 and lower levels are responsible for 0/5
strength in muscles innervated by the lower spinal cord segments.
Everything innervated by segments C5 and above (segments located
anatomically higher in the cord) should test 5/5. Slide 10
Neurological level continued... Look on your charts and see why you
think the following muscles comprise the short list of Key Muscles:
short list: Scapular elevation GH flexion, abduction; elbow
flexion, forearm supination Wrist extension elbow extension Thumb
IP flexion (FPL), thumb abd., lumb./interosseus function C4
C5C6C7C8,T1 Slide 11 Slide 12 Slide 13 Refer to your grids and test
the instructor... MMT of: Scapular elevation Shoulder flexion
Shoulder abduction Elbow flexion & forearm supination Elbow
extension Wrist extension Muscles & Levels: Traps, lev scap
(C4) Ant. Delts, pec major (C5) Middle delts (C5) Biceps (C5)
Triceps (C7) ECRL & B (C6) Slide 14 Refer to your grids and
test the instructor... MMT of: Scapular elevation Shoulder flexion
Shoulder abduction Elbow flexion & forearm supination Elbow
extension Wrist extension Muscles & Levels: Traps, lev scap
(C4) Ant. Delts, pec major (C5) Middle delts (C5) Biceps (C5)
Triceps (C7) ECRL & B (C6) Slide 15 Links for functioning w/o
triceps (without active elbow extension): Skip: Elbow extension
hand free in space reachingElbow extension Skip: Active elbow
extension against gravityActive elbow extension Skip: MMT of
triceps = proofMMT Slide 16 Tenodesis: Requires: Active wrist
extension (via C6 innervated ECRL & B) Full wrist extension and
flexion range of motion Full MCP, PIP, DIP flexion (for grasp) and
enough extension for release Short FDP and FPL* *Try model with and
without shortening the FDP Slide 17 Links for Tenodesis: Tenodesis
grasp and SCI: A good video: https://www.youtube.com/watch?v=0YrD
Rvm-saU.https://www.youtube.com/watch?v=0YrD Rvm-saU Also see Skip:
Grasp of telephone receiver_tenodesisGrasp Skip: ROM to maintain
joint motion and allow/facilitate FDP/FPL shortening
(contracture)ROM Slide 18 Slide 19
