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Neurological Cervical and Thoracic Cord Syndromes

  1. The diaphragm is innervated by two phrenic nerves that originate as branches of the cervical plexus in neck. This motor nerve to diaphragm arise from the anterior rami of cervical nerves C3, C4, C5, with major a contribution coming from C4.
  2. So transection of spinal cord at C7 level is not going to stop respiration but due to involvement of thoracic intercostal muscles and abdominal muscles, there will be some weakness of respiratory effort. (i.e. limited respiratory effort)
  3. Deep tendon reflexes above the level of complete spinal cord injury (i.e. biceps & brachioradialis) will be spared; at the level of injury (triceps) will be absent and below the level of injury (quadriceps & tendoachilles) will be exaggerated.
  4. Superficial reflexes above the level of injury are spared and at the level of injury and below the level of injury are absent.
Root Value Superficial cutaneous reflex
T9 - T12 Abdominal
L1- L2 Cremasteric
S1 Babininski/ Plantar
S2, S3, S4, S5 Anal wink
S2, S3, S4 Bulbocavernous
 
Root Value Deep tendon reflex
C5-C6
C5-C6
C7-C8
Biceps branchii
Brachioradialis
Triceps
L3-L4
S1-L5
Quadriceps/Patellar
Achilles/Ankle




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