身体左右两侧同时具有正常运动机能之最低脊髓部位【精品-ppt】

ASIA Impairment scaleTetraplegia ( quadriplegia ) : injury within the cervical region; loss of motor , sensory function, or both, in the arms, trunk, and legs, as well as loss of bladder, bowel, and sexual function to some degree. Paraplegia: injury in the thoracic, lumbar, or sacral segments; involvement of the trunk, legs, bowel, bladder, and sexual dysfunction. Neurological level: the most caudal neurological segment that retains normal sensory and motor function on both sides of the body. A muscle with a strength grade of 3 is considered to have an intact innervation if the next most rostral muscle is grade 5.Complete lesion: absence of sensory or motor function in the lowest sacral segmentIncomplete lesion: either sensory or motor function is present; sacral sparingMotor level身體左右兩側同時具有正常運動機能之最低脊髓部位，根據 10條關鍵肌 (Key muscles )之肌力而定Motor levelKey musclesC5 Elbow flexors L2 Hip flexorsC6 Wrist extensors L3 Knee extensorsC7 Elbow extensors L4 Ankle dorsiflexorsC8 Finger flexors L5 Long toe extensorsT1 Finger abductors S1 Ankle plantar flexorsMuscle power0=total paralysis1=palpable or visible contraction2=active movement, gravity eliminated3=active movement, against gravity4=active movement, against some resistance5=active movement, against full resistanceSensory levelSensory level:左右兩側 28 dermatome 之 key sensory point。a. 測 pin-prick與 light-touch sensation。b. 0=absent1=impaired2=normalSensory level之決定 :身體左右兩側同時具有正常感覺機能之最低脊髓部位。 key sensory points n C2 Occipital protuberancen C3 Supraclavicular fossan C4 Top of the acromioclavicular jointn C5 Lateral side of the antecubial fossan C6 Thumbn C7 Middle fingern C8 Little fingern T1 Medial(ulnar)side of the antecubiatl fossan T2 Apex of the axillan T3 Third intercostal spacen T4 Fourth intercostal space (nipple line)n T5 Fifth intercostal space (midway between T4 and T6) T6 T9 intercostal space T10 Tenth intercostal space(umbilicous)T11 Eleventh intercostal spaceT12 Inguinal ligament at mid-pointL1 Half the distance between T12 and L2L2 Mid-anterior thighL3 Medial femoral condyleL4 Medial malleolusL5 Dorsum of the foot at the third metatarsal phalan-geal jointS1 Lateral heelS2 Popliteal fossa in the midlineS3 lschial tuberosityS4-S5 Perianal area ASIA Impairment ScaleA=Complete: No motor or sensory function is preserved in the sacral segments S4-S5B=Incomplete:Sensory but not motor functions preserved below the neurological levelC=Incomplete:Motor function is preserved below the neurological level, and the majority of key muscles = 3E=Normal:Motor and sensory function is 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