ASIA Impairment scale.

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Presentation transcript:

ASIA Impairment scale

Tetraplegia ( 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 segment Incomplete lesion: either sensory or motor function is present; sacral sparing

Motor 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 level Key muscles C5 Elbow flexors L2 Hip flexors C6 Wrist extensors L3 Knee extensors C7 Elbow extensors L4 Ankle dorsiflexors C8 Finger flexors L5 Long toe extensors T1 Finger abductors S1 Ankle plantar flexors

Muscle power 0=total paralysis 1=palpable or visible contraction 2=active movement, gravity eliminated 3=active movement, against gravity 4=active movement, against some resistance 5=active movement, against full resistance

Sensory level Sensory level:左右兩側28 dermatome 之 key sensory point。 a. 測pin-prick與light-touch sensation。 b. 0=absent 1=impaired 2=normal Sensory 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 C2 Occipital protuberance C3 Supraclavicular fossa C4 Top of the acromioclavicular joint C5 Lateral side of the antecubial fossa C6 Thumb C7 Middle finger C8 Little finger T1 Medial(ulnar)side of the antecubiatl fossa T2 Apex of the axilla T3 Third intercostal space T4 Fourth intercostal space (nipple line) T5 Fifth intercostal space (midway between T4 and T6)  

T6 –T9 intercostal space T10 Tenth intercostal space(umbilicous) T11 Eleventh intercostal space 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 phalan-geal joint S1 Lateral heel S2 Popliteal fossa in the midline S3 lschial tuberosity S4-S5 Perianal area

ASIA Impairment Scale A=Complete: No motor or sensory function is preserved in the sacral segments S4-S5 B=Incomplete:Sensory but not motor functions preserved below the neurological level C=Incomplete:Motor function is preserved below the neurological level, and the majority of key muscles < 3 D=Incomplete: Motor function is preserved below the neurological level, and the majority of key muscles below the neurological level >= 3 E=Normal:Motor and sensory function is normal