SCI基本概念与功能评估的国际标准.ppt

非关健肌 节段 肌肉 C5 肩屈曲、伸展、外展、内收、内外旋，前臂旋后 C6 前臂旋前，腕屈曲 C7 近端指间关节屈曲、伸展，拇指屈曲、伸展，外展（flexion, extension and abduction in plane of thumb) C8 掌指关节屈曲，拇指对指、拇指垂直掌面内收和外展( opposition, adduction and abduction perpendicular to palm) T1 Abduction of little finger L2 内收肌 L3 髋外旋 L4 伸髋、髋外展、髋内旋 屈膝 踝足内翻和外翻 脚趾：跖趾关节和趾间关节伸展 L5 踇趾、脚趾：近端趾间关节和远端趾间关节屈曲和外展 S1 踇趾外展 非关健肌的作用 区分B和C 腱反射与脊髓节段相应的反射弧 C5 ： 肱二头肌反射 C6 ： 旋后肌反射 C7 ： 三头肌反射 L3 ： 股四头肌反射 S1 ： 腓肠肌反射 S2～4： 球－肛门反射 ASIA and ISCoS Frankel Classification grading system Grade A: Complete neurological injury - no motor or sensory function clinically detected below the level of the injury. Grade B: Preserved sensation only - no motor function clinically detected below the level of the injury; sensory function remains below the level of the injurybut may include only partial function (sacral sparing qualifies as preserved sensation). Grade C: Preserved motor non-functional - some motor function observed below the level of the injury, but is of no practical use to the patient. Grade D: Preserved motor function - useful motor function below the level of the injury; patient can move lower limbs and walk with or without aid, but does not have a normal gait or strength in all motor groups. Grade E: Normal motor - no clinically detected abnormality in motor or sensory function with normal sphincter function; abnormal reflexes and subjective sensory abnormalities may be present.? Frankel分级 ASIA Impairment Scale (AIS) A = Complete. No sensory or motor function is preserved in the sacral segments S4-S5. B = Sensory Incomplete. Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5 (light touch, pin prick at S4-S5 or deep anal pressure (DAP), AND no motor function is preserved more than three levels below the motor level on either side of the body. C = Motor Incomplete. Motor function is preserved below the neurological level**, and more than half of key muscle functions below the single neurologica