Exam for Spinal Cord Injury

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- See:
        - Brachial Plexus - Neuro Exam
        - Management of Spinal Cord Injury:

- Assess for Spinal Shock & Sacral Sparing
     - bulbocavernosus
     - anal sphincter S-3
     - bladder sphincter S-2
     - FHL S-1
     - level of a spinal cord injury is determined by the most distal intact (5/5) function

- Lower Extremity:
     - sensory:
            - in acute situation, sparing of sensation to pin prick in a motor segment w/ grade 0 power indicates an 85% chance of motor recovery to at least grade 3;
                   - ref: Sparing of sensation to pin prick predicts recovery of a motor segment after injury to the spinal cord. Poyton JBJS. Vol 79-A No 6. Nov 1997. p 952.
     - reflexes: ankle and knee
     - motor:
         - FHL.....S-1
         - EHL.....L-5
         - TA.....L-4
         - Quads.....L-3
         - Psoas.....L-2

- Upper Extremity:
     - brachial plexus
     - sensory:
     - reflexes: triceps and biceps
     - motor:
         - Intrinsic.....T-1
         - FDP.....C-8
         - Triceps.....C-7
         - WF.....C-7
         - WE.....C-6
         - Biceps.....C-5
         - Deltoid.....C-5

- Cranial Nerves:

- Functional Assesment Scale: (from complete tetraplegia to normal);
    - brachioradialis absent:
    - brachioradialis intact:
    - brachioradialis and ECRL
    - brachioradialis, ECRL, and ECRB;
    - brachioradialis, ECRL, ECRB, and pronator teres;
    - brachioradialis, ECRL, ECRB, pronator teres, and FCR;
    - brachioradialis, ECRL, ECRB, pronator teres, FCR, and finger extensors;
    - brachioradialis, ECRL, ECRB, pronator teres, FCR, and finger extensors, and thumb extensors;
    - brachioradialis, ECRL, ECRB, pronator teres, FCR, and finger extensors, thumb extensors, and finger flexors;
    - only intrinsics are deficient;

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Upper limb surgery for tetraplegia: A 10-year re-review of hand function