Full NBCOT COTA Exam Prep
Questions and Answers.
Function of C1, C2, C3 -
\Sternocleidomastoid, cervical paraspinal, neck accessories
Neck flexion, extension, rotation
Facial and neck muscles innervated by cranial nerve
Chew, swallow, talk, blow
Inability to clear secretions
Patterns of weakness: total paralysis of trunk, UE's, LE's; dependent on ventilator.
Intervention for C1, C2, C3 -
\Mobility
Sip and puff electronically controlled reclining w/c
Communication
High-tech computer - mouthstick
Telephone - automatic dialer, headset
Recreation
Games, art, reading,
Vocational
Environmental controls
Attendant education.
Mechanical transfers, 24-hour care
Function of C4 -
\Diaphragm, upper trapezius, cervical paraspinal muscles
Scapular elevation, respiration
Neck flexion, extension, rotation, scapular elevation, inspiration
May be able to breathe without a ventilator
Treatment
-Same as for C1-3
-Tilt table
-Hydraulic standing table
,Paralysis of trunk, UE, LE, inability to cough, endurance and respiratory reserve low
secondary to paralysis of intercostal.
Function of C5 -
\Biceps, brachialis, brachioradialis, supinator, infraspinatus, deltoids, rhomboids,
serratus anterior (partially innervated)
Elbow flexion and supination, shoulder external rotation, shoulder flexion and abduction
to 80-90°
Gravity provides shoulder adduction, pronation, internal rotation
Absence of elbow extension, pronation, all wrist and hand movement, total paralysis of
trunk and LEs.
Intervention for C5 -
\Can self-feed using equipment (scoop dish, universal cuff, swivel utensils)
Splint: ratchet wrist-hand orthosis (WHO), long opponens
Mobile Arm Supports; suspension slings. Elbow control electric bed
Transfers using board with total assist
Some can propel manual w/c using handrim modifications
Function of C6 -
\Pectoralis minor = some shoulder horiz adduction
serratus anterior = reach forward
latissimus dorsi = shoulder adduction, internal rotation & extension; more respiratory
reserve
supinator = supination
radial wrist extensors = wrist extension, tenodesis grasp
Extensor carpi radialis lognus and brevis
Scapular protractor, some hor adduction, forearm supination, radial wrist extension
Absence of wrist flexion, elbow extension, hand movement, total paralysis of trunk and
LEs
Intervention for C6 -
\Independent self-feeding: interlacing grip, rocker knife
Splint; dynamic wrist driven WHO for strong palmer pinch
Independent in dressing using button hook, zipper pulls
,Independent UB bathing, assisted LB. Can use hand-held shower, bath mitt, padded
shower bench
Assist to independent transfers with board
Assit to indep. hygiene and grooming
B & B: Uses bowel routine, inserts suppositories with adaptive device. May be indep.
with toilet transfers. Self-cath, drain urine from leg bag.
Mobility: Independent driving van from w/c using hand controls, indep. bed mobility (roll,
sit up), indep. w/c propelling.
Independent pressure relief
Independent light homemaking
Can hold and use pencil with wrist driven WHO
Some w/c sport participation
Function of C7 -
\Triceps = elbow extension
Extrinsic finger extensors = active finger extension
Pronator quadratus = pronation
Flexor carpi radialis = wrist flexion
Paralysis of trunk and lower extremities, limited grasp and dexterity secondary to partial
intrinsic muscles of the hand.
Intervention of C7 -
\Feeding and dressing: Independent with ease and use of equipment
Bathing, grooming, B & B: As C6 but easier
Bed mobility: Fully independent
Depression transfers and push ups for pressure relief
Wheels standard chair easily
Uses adapted car. Assisted with w/c.
Communication without adapted equipment
, Recreation: Games without adaptation
Function of C8-T1 -
\Intrinsics including thumb
Ulnar wrist flexors and extensors
Extrinsic finger and thumb flexors
Extrinsic thumb extensors
= Full upper extremity control including fine coordination and strong grasp
Intervention for C8-T1 -
\Uses minimal adapted equipment
Independent in feeding, dressing, bathing, bowel and bladder care, skin inspection,
locomotion
Travel by accessible public transportation
Independent light housekeeping
Vocation and avocation: Independent depending upon type of mobility.
Function of T6 -
\Top half of intercostals = increased endurance due to larger respiratory reserve
Long muscles of the back = pectoral girdle stabilized for heavy lifting
Better trunk control
Intervention for T6 -
\Independent in all self-care
Can ambulate with GREAT difficulty
Standing aid
Work: Can work with tools and do fairly heavy lifting from a sedentary position
Active w/c sports
Independent with weekly housekeeping
Function of T12 -
Questions and Answers.
Function of C1, C2, C3 -
\Sternocleidomastoid, cervical paraspinal, neck accessories
Neck flexion, extension, rotation
Facial and neck muscles innervated by cranial nerve
Chew, swallow, talk, blow
Inability to clear secretions
Patterns of weakness: total paralysis of trunk, UE's, LE's; dependent on ventilator.
Intervention for C1, C2, C3 -
\Mobility
Sip and puff electronically controlled reclining w/c
Communication
High-tech computer - mouthstick
Telephone - automatic dialer, headset
Recreation
Games, art, reading,
Vocational
Environmental controls
Attendant education.
Mechanical transfers, 24-hour care
Function of C4 -
\Diaphragm, upper trapezius, cervical paraspinal muscles
Scapular elevation, respiration
Neck flexion, extension, rotation, scapular elevation, inspiration
May be able to breathe without a ventilator
Treatment
-Same as for C1-3
-Tilt table
-Hydraulic standing table
,Paralysis of trunk, UE, LE, inability to cough, endurance and respiratory reserve low
secondary to paralysis of intercostal.
Function of C5 -
\Biceps, brachialis, brachioradialis, supinator, infraspinatus, deltoids, rhomboids,
serratus anterior (partially innervated)
Elbow flexion and supination, shoulder external rotation, shoulder flexion and abduction
to 80-90°
Gravity provides shoulder adduction, pronation, internal rotation
Absence of elbow extension, pronation, all wrist and hand movement, total paralysis of
trunk and LEs.
Intervention for C5 -
\Can self-feed using equipment (scoop dish, universal cuff, swivel utensils)
Splint: ratchet wrist-hand orthosis (WHO), long opponens
Mobile Arm Supports; suspension slings. Elbow control electric bed
Transfers using board with total assist
Some can propel manual w/c using handrim modifications
Function of C6 -
\Pectoralis minor = some shoulder horiz adduction
serratus anterior = reach forward
latissimus dorsi = shoulder adduction, internal rotation & extension; more respiratory
reserve
supinator = supination
radial wrist extensors = wrist extension, tenodesis grasp
Extensor carpi radialis lognus and brevis
Scapular protractor, some hor adduction, forearm supination, radial wrist extension
Absence of wrist flexion, elbow extension, hand movement, total paralysis of trunk and
LEs
Intervention for C6 -
\Independent self-feeding: interlacing grip, rocker knife
Splint; dynamic wrist driven WHO for strong palmer pinch
Independent in dressing using button hook, zipper pulls
,Independent UB bathing, assisted LB. Can use hand-held shower, bath mitt, padded
shower bench
Assist to independent transfers with board
Assit to indep. hygiene and grooming
B & B: Uses bowel routine, inserts suppositories with adaptive device. May be indep.
with toilet transfers. Self-cath, drain urine from leg bag.
Mobility: Independent driving van from w/c using hand controls, indep. bed mobility (roll,
sit up), indep. w/c propelling.
Independent pressure relief
Independent light homemaking
Can hold and use pencil with wrist driven WHO
Some w/c sport participation
Function of C7 -
\Triceps = elbow extension
Extrinsic finger extensors = active finger extension
Pronator quadratus = pronation
Flexor carpi radialis = wrist flexion
Paralysis of trunk and lower extremities, limited grasp and dexterity secondary to partial
intrinsic muscles of the hand.
Intervention of C7 -
\Feeding and dressing: Independent with ease and use of equipment
Bathing, grooming, B & B: As C6 but easier
Bed mobility: Fully independent
Depression transfers and push ups for pressure relief
Wheels standard chair easily
Uses adapted car. Assisted with w/c.
Communication without adapted equipment
, Recreation: Games without adaptation
Function of C8-T1 -
\Intrinsics including thumb
Ulnar wrist flexors and extensors
Extrinsic finger and thumb flexors
Extrinsic thumb extensors
= Full upper extremity control including fine coordination and strong grasp
Intervention for C8-T1 -
\Uses minimal adapted equipment
Independent in feeding, dressing, bathing, bowel and bladder care, skin inspection,
locomotion
Travel by accessible public transportation
Independent light housekeeping
Vocation and avocation: Independent depending upon type of mobility.
Function of T6 -
\Top half of intercostals = increased endurance due to larger respiratory reserve
Long muscles of the back = pectoral girdle stabilized for heavy lifting
Better trunk control
Intervention for T6 -
\Independent in all self-care
Can ambulate with GREAT difficulty
Standing aid
Work: Can work with tools and do fairly heavy lifting from a sedentary position
Active w/c sports
Independent with weekly housekeeping
Function of T12 -
