SCI Levels

Question 1

C1-C4 SCI

Answer 1

• High cervical
• Ventilator please! Don’t forget your generator!
• Total A for personal and domestic care
• Movement: limited head and neck movement; tetraplegia
• Nervous system: sympathetic nervous system compromised; possible autonomic dysreflexia; no bowel or bladder control
• Mobility: electric wheelchair with sip and puff, chin, head or breath control
• Power tilt WC!
• Hospital bed

Question 2

How often should pressure reliefs be done?

Answer 2

Every 30 mins!

Question 3

What movement does a C1-C4 patient have?

Answer 3

Head and neck flexion, extension, and rotation

Question 4

C5 SCI

Answer 4

• C5: think of pooh!
• Universal cuffs please! Cuz you got NO wrist or hand movement!
• Low stamina, but breathing with diaphragm
• Complete A for personal and domestic care
• Movement: full head and neck; ability to raise arms and flex elbows (no extension)
• Nervous system: sympathetic nervous system compromised; possible autonomic dysreflexia; no bowel or bladder control
• Mobility: electric WC with hand controls
• Hospital bed

Question 5

What adaptive equipment is appropriate for a client with a C5 SCI?

Answer 5

• Mobile arm support
• Long opponens splint (for a pen, or paintbrush e.g.)
• Wrist cock up (for support)
• Universal cuff

Question 6

C6 SCI

Answer 6

• C6: You got tenodesis grasp! Snow white!
• Transitions from fancy hospital bed to standard bed
• Medical management: low stamina, but breathing with diaphragm; moderate A for personal care; complete A for domestic care
• Movement: full head and neck; ability to raise arms and flex elbows (no extension); some wrist extension
• Nervous system: little bowel or bladder control
• Mobility: electric WC with hand controls; manual WC for short distances; may drive a vehicle with hand controls
• Own skin inspections!

Question 7

What movement does SCI level C6 now have?

Answer 7

-Elbow flexion (innervation to biceps)

Question 8

At what SCI levels can the pt use a manual WC for short distances and may drive a vehicle with hand controls?

Answer 8

SCI C6-C8

Question 9

What adaptive equipment can a SCI C6 pt now use?

Answer 9

Wrist-driven flexor hinge (Tenodesis splint!)

Question 10

SCI C7

Answer 10

• C7: Arial!
• Push up and lift, bitch, cuz you got those triceps!
• Full shoulder strength
• Elbow extension
• Medical management: low stamina, but breathing with diaphragm; limited assistance for personal care; partial assistance for heavy-duty domestic care
• Movement: full head and neck; ability to raise arms and flex and extend elbows; wrist flexion and extension; partial finger movement
• Nervous system: little bowel or bladder control
• Mobility: independent transfers; electric WC with hand controls, manual WC for short distances; may drive with hand controls

Question 11

At what SCI level is a patient primarily independent in personal care, but still requires partial assistance for heavy-duty domestic care?

Answer 11

SCI level C8

Question 12

At what level can SCI pt do own depression transfers?

Answer 12

SCI C7-now have elbow extension and full shoulder strength

Question 13

At what SCI level is a pt independent in transfers?

Answer 13

C7–now have elbow extension and full shoulder strength

Question 14

At what SCI level can a pt have an electric hospital bed OR a standard bed?

Answer 14

SCI C6

Question 15

SCI C 8

Answer 15

• C8: 8th grade graduation
• Moving on up towards greater independence!
• Key functional outcome: Finger flexion/extension/ abduction
• Electrical hospital OR standard bed
• Movement: full head and neck; ability to raise arms and flex and extend elbows; wrist flexion and extension; partial finger movement
• Nervous system: little bowel or bladder control
• Mobility: independent transfers; electric wheelchair with hand controls; manual WC for short distances; may drive with hand controls

Question 16

What movements do a SCI C 7 pt have?

Answer 16

Full head and neck; ability to raise arms and flex and extend elbows; wrist flexion and extension; partial finger movement

Question 17

SCI T1-T5

Answer 17

• Medical management: respiration capacity and endurance may be compromised; independent in personal care
• Movement: normal UE ROM and strength
• Nervous system: little bowel or bladder control
• Mobility: independent transfers; manual WC; may drive with hand controls

Question 18

At what SCI level is a pt independent in personal care (still requires partial assistance for heavy-duty domestic care)?

Answer 18

SCI T1-T5

Question 19

At what SCI level does a pt have normal UE ROM and strength?

Answer 19

SCI T1 and lower

Question 20

SCI T6-T12

Answer 20

• Medical management: respiration capacity and endurance may be compromised; independent in personal care; partial assistance for heavy-duty domestic care
• Movement: normal UE ROM and strength
• Nervous system: little bowel or bladder control
• Mobility: independent transfers, may use manual WC or may stand in standing frame or walk with braces; may drive with hand controls

Question 21

At What SCI level can a pt use a manual WC full time?

Answer 21

T1-T5

Question 22

At what SCI level may a pt use a manual WC OR stand in standing frame or walk with braces?

Answer 22

SCI level T6-T12

At L1-L5, pt probably will not stand in standing frame. They will either use a manual SC or walk with braces

Question 23

SCI L1-L5

Answer 23

• Medical management: normal respiratory system; independent in personal care; partial assistance for heavy-duty domestic care
• Movement: normal UE ROM and strength; partial paralysis in hips and legs
• Nervous system: little bowel or bladder control
• Mobility: independent transfers; may use manual wheelchair or may walk with braces; may drive with hand controls

Question 24

At what SCI level may a pt use a WC OR walk with braces?

Answer 24

SCI L1-L5.

-At T6-T12, pt may use a WC, stand in standing frame or walk with braces

Question 25

SCI S1-S5

Answer 25

- Medical management: independent in personal care; partial assistance for heavy duty domestic care - Movement: normal UE ROM and strength; some loss of function in hips and legs - Nervous system: little bowel or bladder control - Mobility: independent transfers; likely able to walk with assistance or aids, though slowly and with difficulty; may drive with hand controls and load WC into car independently

Question 26

At what SCI level does a pt have partial paralysis in hips and legs?

Answer 26

SCI L1-L5. | -At S1-S5 you have some loss of function in hips and legs

Question 27

What what SCI level does a pt have some loss of function in hips and legs ?

Answer 27

SCI S1-S5 | -At SCI L1-L5, pt has partial paralysis in hips and legs

Question 28

At what SCI level is a pt likely able to walk with assistance or aids, though slowly and with difficulty?

Answer 28

SCI S1-S5 | Can also load WC into car independently