Neurological Disorders Q 71

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After falling 20’, a 36-year-old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect?

  

     A. Quadriplegia with gross arm movement and diaphragmatic breathing.

     B. Quadriplegia and loss of respiratory function.

     C. Paraplegia with intercostal muscle loss.

     D. Loss of bowel and bladder control.

    

    

Correct Answer: A. Quadriplegia with gross arm movement and diaphragmatic breathing

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A client with a spinal cord injury at levels C5 to C6 has quadriplegia with gross arm movement and diaphragmatic breathing. Cervical spine injuries, although uncommon, can result in significant and long-term disability. The cervical spine encompasses seven vertebrae and serves as a protection to the spinal cord. C5 to C7 are responsible for deep tendon reflexes of the biceps, brachioradialis, and triceps respectively. C5 controls shoulder abduction with the aid of C4 and elbow flexion with the aid of C6. C6 to C7 are responsible for elbow extension, wrist extension, and flexion.

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Option B: Injury levels C1 to C4 leads to quadriplegia with total loss of respiratory function. C1 to C3 are responsible for movements of the head, the dermatome of C2 is responsible for sensation to the dorsal aspect of the head, and C3 is responsible for sensation to the lateral aspects of the face and posterior portion of the head. C3 to C4 contribute to breathing by controlling the muscles of the diaphragm.

Option C: Paraplegia with intercostal muscle loss occurs with injuries at T1 to L2. This term refers to impairment or loss of motor and/or sensory function in the thoracic, lumbar or sacral (but not cervical) segments of the spinal cord, secondary to damage of neural elements within the spinal canal. With paraplegia, arm functioning is spared but the trunk, legs and pelvic organs may be involved depending on the level of injury.

Option D: Injuries below L2 cause paraplegia and loss of bowel and bladder control. A spinal cord injury may interrupt communication between the nerves in the spinal cord that control bladder and bowel function and the brain, causing incontinence. This results in bladder or bowel dysfunction that is termed “neurogenic bladder” or “neurogenic bowel.”

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