What Motor Function is Consistent with C7?

  • The nerve root of C7 runs between vertebrae C6 and C7. 
  • Motor function includes:
    • full shoulder movement (rotation, adduction and abduction)
    • strong scapular stability
    • elbow extension - tricep (ability to straighten bentarm)
    • strong wrist extension 
    • moderate grasp (extensor digitorium muscle permits extension of digits, some finger flexor muscle intact)
    • trunk stability 
    • respiratory reserve remains poor 
What Sensory Function is Consistent with C7?    
  • C7 provides sensation to middle digit.
Assessment of C7 Motor Function    
Assess and document motor function using motor scale from 0-5. 


  • strong neck stability


  • 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)
  • assess adduction against examiner resistance 
  • assess ability to straighten bent elbow against resistance
  • assess ability to straighten elbow against examiner resistance
  • C7  tricep function 
  • assess ability to extend wrist 
  • assess ability to extend wrist against resistance 
  • C7 strong wrist extension
  • observe digits during extension
  • assess digit extension against resistance
  • C7 strong extenion
  • observe digits during digit flexion
  • C7 weak flexion
Assessment of C7 Sensory Function    
  • Test middle finger on one hand 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 and test light touch and then pain separately. Test sensation in middle finger bilaterally

Light touch:

use wisp of cotton or tissue

Sharp or temperture 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

Expected Outcome    
  • feeding and grooming
  • independent transfers 
  • able to sit up and roll over in bed 
  • can dress self 
  • may drive car with hand controls entilation



Barr, M, and Kiernan, J. (1993). The Human Nervous System: An Anatomical Viewpoint. Philadelphia: Lippincott. pp 84-85.

Keppler, J. (1987). Acute spinal cord injury. Critical Care Clinics. July. 3:3. pp. 638-641.

Netter, F. (1989). Atlas of Human Anatomy. New Jersey: Novartis.

Waxman, S. (1996). Correlative Neuroanatomy. 23rd Ed.  Stamford: Lange. pp 46-52, 352-355, 370.

Brenda Morgan
Clinical Nurse Specialist, CCTC
May 11, 2001. Updated: January 15, 2019