Tag Archives: SCI

Spinal Cord Injury – ASIA Scale

 

 

c

d

Key sensory points:

  • C2 At least one cm lateral to the occipital protuberance at the base of the skull. Alternately, it can be located at least 3 cm behind the ear.
  • C3 In the supraclavicular fossa, at the midclavicular line.
  • C4 Over the acromioclavicular joint.
  • C5 On the lateral (radial) side of the antecubital fossa just proximal to the elbow (see image below).
  • C6 On the dorsal surface of the proximal phalanx of the thumb.
  • C7 On the dorsal surface of the proximal phalanx of the middle finger.
  • C8 On the dorsal surface of the proximal phalanx of the little finger.
  • T1 On the medial (ulnar) side of the antecubital fossa, just proximal to the medial epicondyle of the humerus.
  • T2 At the apex of the axilla. T2 T1 C5 International Standards for the Classification of Spinal Cord Injury Key Sensory Points June 2008
  • T3 At the midclavicular line and the third intercostal space, found by palpating the anterior chest to locate the third rib and the corresponding third intercostal space below it.
  • T4 At the midclavicular line and the fourth intercostal space, located at the level of the nipples.
  • T5 At the midclavicular line and the fifth intercostal space, located midway between the level of the nipples and the level of the xiphisternum.
  • T6 At the midclavicular line, located at the level of the xiphisternum.
  • T7 At the midclavicular line, one quarter the distance between the level of the xiphisternum and the level of the umbilicus.
  • T8 At the midclavicular line, one half the distance between the level of the xiphisternum and the level of the umbilicus.
  • T9 At the midclavicular line, three quarters of the distance between the level of the xiphisternum and the level of the umbilicus.
  • T10 At the midclavicular line, located at the level of the umbilicus.
  • T11 At the midclavicular line, midway between the level of the umbilicus and the inguinal ligament.
  • T12 At the midclavicular line, over the midpoint of the inguinal ligament.
  • L1 Midway between the key sensory points for T12 and L2.
  • L2 On the anterior-medial thigh, at the midpoint drawn on an imaginary line connecting the midpoint of the inguinal ligament and the medial femoral condyle.
  • L3 At the medial femoral condyle above the knee.
  • L4 Over the medial malleolus.
  • L5 On the dorsum of the foot at the third metatarsal phalangeal joint.
  • T12 L1 L2 L3 L4 L5 International Standards for the Classification of Spinal Cord Injury Key Sensory Points June 2008
  • S1 On the lateral aspect of the calcaneus.
  • S2 At the midpoint of the popliteal fossa.
  • S3 Over the ischial tuberosity or infragluteal fold (depending on the patient their skin can move up, down or laterally over the ischii).
  • S4/5 In the perianal area, less than one cm. lateral to the mucocutaneous junction.

 

a.JPG

b

e

 

f

 

ASIA WORKSHEET <pdf>

Auto_Stan_Worksheet <pdf>

 

Reference:

“ASIA Learning Center”. Asia-spinalinjury.org. N.p., 2017. Web. 23 Mar. 2017.

Advertisements

Spinal Cord Injury SCI Scales

Capture.JPG

Asia impairment scale (modified from Frankel)

  • A=Complete. No sensory or motor function is preserved in the sacral segments S4-S5
  • B=Incomplete. Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5.
  • C=Incomplete. Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade less than 3.
  • D=Incomplete. Motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade greater than or equal to 3.
  • E=Normal. Sensory and motor function is normal.

Capture1.JPG

 

Capture3.JPG

 

Key Sensory Points in SCI evaluation:

  • 0 = absent
  • 1 = impaired (partial or altered appreciation, including hyperaesthesia)
  • 2 = normal
  • NT = not testable

The testing for pin sensation is usually performed with a disposable safety pin; light touch is tested with cotton. In testing for pin appreciation, the inability to distinguish between dull and sharp sensation is graded as 0

  • C2=Occipital protuberance
  • C3=Supraclavicular fossa
  • C4=Top of the acromioclavicular joint
  • C5=Lateral side of the antecubital fossa
  • C6=Thumb
  • C7=Middle finger
  • C8=Little finger
  • T1=Medial (ulnar) side of the antecubital fossa
  • T2=Apex of the axilla
  • T3=Third intercostal space (IS)*
  • T4=Fourth IS (nipple line)*
  • T5=Fifth IS (midway between T4 and T6)*
  • T6=Sixth IS (level of xiphisternum)*
  • T7=Seventh IS (midway between T6 and T8)*
  • T8=Eighth IS (midway between T6 and T10)*
  • T9=Ninth IS (midway between T8 and T10)*
  • T10=Tenth IS (umbilicus)*
  • T11=Eleventh IS (Midway between T10 and T12)*
  • T12=Inguinal ligament at mid-point
  • L1=Half the distance between T12 and L2
  • L2=Mid-anterior thigh
  • L3=Medial femoral condyle
  • L4=Medial malleolus
  • L5=Dorsum of the foot at the third metatarsal phalangeal joint
  • S1=Lateral heel
  • S2=Popliteal fossa in the mid-line
  • S3=Ischial tuberosity
  • S4-5 = Perianal area (taken as one level)

*Asterisks indicate that the point is at the mid-clavicular line

Capture4.JPG

 

Motor Points in SCI Evaluation:

  • C5 = Elbow flexors (biceps, brachialis)
  • C6 = Wrist extensors (extensor carpi radialis longus and brevis)
  • C7 = Elbow extensors (triceps)
  • C8 = Finger flexors (flexor digitorum profundus) to the middle finger
  • T1 = Small finger abductors (abductor digiti minimi)
  • L2 = Hip flexors (iliopsoas)
  • L3 = Knee extensors (quadriceps)
  • L4 = Ankle dorsiflexors (tibialis anterior)
  • L5 = Long toe extensors (extensor hallucis longus)
  • S1 = Ankle plantarflexors (gastrocnemius, soleus)

 

Reference:

Jr, Frederick M Maynard et al. “International Standards For Neurological And Functional Classification Of Spinal Cord Injury”. Spinal Cord 35.5 (1997): 266-274. [pdf]

Asia’s Neurologic Classification of Spinal Cord Injury

Capture

 

REFERENCE:

Scientific American. January 2016. Traumatic Brain and Spinal Cord Injuries – Neurology.  Mohit Datta, MD, Geoffrey S.F. Ling, MD, PhD, FAAN.  Uniformed Services University of the Health Sciences, Bethesda, MD