COTA exam
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| Dx involving upper motor neuron lesions | SCI, MS, Parkinsonism, CVA, TBI |
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| Dx involving lower motor neuron lesions | MD, Polio, Myasthenia gravis, Peripheral nerve injuries |
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| C1-C3 | Respiratory-vent dependent. Unable to clear secretions. Total A- bowel & bladder | Total A w/ mobility, eating, dressing, bathing, needs 24hr care, TA to I for communication dep on tech/set up | sternocleidomastoid, levator scapulae, Upper traps, diaphragm | neck flex/ext/rotate; chew, swallow, talk, sip, puff, some scapular elevation
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| C4 | Function: breathe independently, shoulder girdle elevation | 24 hr attendant care including homemaking | Trapezius (upper, mid,low) diaphragm, cervical & paraspinal muscles | respiration, scapula elevation, neck movements
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| C5 | Elbow flexion. Can be independent in feeding & grooming. OT: prevent contractors due to unopposed biceps. Assistive tech key | Personal care 10 hours/day. Homecare 6 hrs/day | deltoid, biceps brachialis, brachioradialis, rhomboids, s. anterior, teres maj, | Elbow flexions & supination, shoulder abduct, flex, ext, H abduc, H adduct, Int/ext rotation, scapular protraction/retraction
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| C6 | W/assistive devices can achieve functional independence, but not common. Trnsfr w/sliding board | Personal care 6 hrs/day. Homecare 4 hrs/day | Ext carpi radialis longus & brevis, serratus anterior, pronator teres, coracobrach, pec maj, lat dorsi | Wrist extension, tenodesis possible.
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| C7 | Elbow extension. Highest level of injury allowing for independent living w/adaptations. Bowel/bladder program key. More difficult for women | I in ADLs, Txf, bed mob, ManW/C, bowel/bladder - Indep | Triceps, pec maj, lat dorsi, flex digitorum superfic, ext digitorum FCR, ECU, EP longus & brevis, Ab pollic longus | elbow ext, ulnar/wrist ext & flex, finger flex/ext, thumb ext/flex/abdu, full strength shoulder movement
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| C8,T1 | Finger flexion - helps with independence with hand grasp/release | Indep in ADL w/ txf & bed mob | All UE muscles fully innervated | full control of UE, fine coordination and grasp
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sherryama
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