SPINAL CORD FUNCTIONING AT C5

• The nerve root of C5 runs between vertebrae C4 and C5. 
• Motor function includes:
  • movement of the deltoid (abduction of arm - movement of the arm at shoulder away from midline)
• • weak bicep muscles (able to flex forearm at elbow) 
  • lattissmus and pectoralis function is not present at C5 

• C5 sensation includes bicep area (C4 provides sensation to shoulder)

Bicep:

• have patient flex or bend elbow 
• evaluate the ability to bend the elbow while examiner holds forearm to create resistance
• C5 DOES NOT allow straightening of the elbow

• evaluate ability to abduct shoulder (move arm away from body)
• C5 DOES NOT provide adduction of shoulder (movement towards body)
• Latissmus and pectoralis function is not present at C5

• Test bicep on one side 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

Light touch:

• use wisp of cotton or tissue; touch bicep on either side and assess sensation

Sharp or temperature 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
• assess bicep sensation on either side

• ability to feed self with assisted devices (C5 does not provide any hand movements)
• ability to operate modified wheel chairs for short distances