SPINAL CORD FUNCTIONING AT C7

• The nerve root of C7 runs between vertebrae C6 and C7. 
• Motor function includes:
  • full shoulder movement (rotation, adduction and abduction)
  • strong scapular stability
  • elbow extension - tricep (ability to straighten bentarm)
  • strong wrist extension 
  • moderate grasp (extensor digitorium muscle permits extension of digits, some finger flexor muscle intact)
  • trunk stability 
  • respiratory reserve remains poor 

• C7 provides sensation to middle digit.

Neck: 

• strong neck stability

Shoulder: 

• assess ability to rotate shoulder
• assess ability to abduct arm at shoulder (away from body)
• assess abduction against examiner resistance 
• assess ability to adduct arm at shoulder (toward body)
• assess adduction against examiner resistance 

• assess ability to straighten bent elbow against resistance
• assess ability to straighten elbow against examiner resistance
• C7  tricep function 

• assess ability to extend wrist 
• assess ability to extend wrist against resistance 
• C7 strong wrist extension

• observe digits during extension
• assess digit extension against resistance
• C7 strong extenion
• observe digits during digit flexion
• C7 weak flexion

• Test middle finger on one hand for sensation, then test same spot on opposite side
• Always apply the same amount of pressure to each side
• Ask patient to compare sensation on side A to side B

• Conceal test from the patient and test light touch and then pain separately. Test sensation in middle finger bilaterally

Light touch:

use wisp of cotton or tissue

Sharp or temperture touch:

use safety pin or blunt end needle

pain is a better assessment than temperature for this pathway because patients need to be able to articulate that they can distinguish hot or cold; this is unreliable among intubated patients

• feeding and grooming
• independent transfers 
• able to sit up and roll over in bed 
• can dress self 
• may drive car with hand controls entilation