• The nerve root of C6 runs between vertebrae C5 and C6. 
• Motor function includes:
• strong bicep muscles (strong elbow flexion)
• weak wrist extension 
• tenodesis (ability to passively flex fingers with wrist extension)
• shoulder rotation, adduction and abduction 

• C6 sensation:
• includes thumb side of lower forearm
• thumb (radial nerve)
• first finger (median nerve)

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)
• assesss adduction against examiner resistance

• have patient flex or bend elbow 
• evaluate the ability to bend the elbow while examiner holds forearm to create resistance
• C6 provides strong bicep

• assess ability to extend wrist
• assess ability to extend wrist against resistance

• observe digits during wrist extension; passive digit flexion occurs with C6 during wrist extension
• assess ability to move thumb

• Test one side, 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; assess sensation to thumb side of forearm, thumb and first finger
• Sharp touch:
• use safety pin (do not use needle), or cap of pen; assess sensation to thumb side of forearm, thumb and first finger

 

• feeding and grooming 
• able to use assisted devices to grasp objects
• can roll over and maneuver in bed 
• may drive car with hand controls 
• may be able to transfer ventilation