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6 out of 8

Which of the following signs is not suggestive of a cervical spinal cord injury: (AIIMS Nov 2010)

A Lower limb Flaccidity

B Increased rectal sphincter tone

C Diaphragmatic breathing

D Priapism

Ans. A

Lower limb Flaccidity

Cervical cord injury

1). UMN Features below the site of lesion

a. Lower limbs will show signs of UMN lesions and not LMN lesions

b. Wasting and fasciculations are signs of LMN lesion and are not seen in the lower limbs in a patient with cervical injury

2). LMN features at site of lesion

a. Upper limbs may show signs of LMN lesion at the site of transaction

b. Wasting and fasciculations are signs of LMN lesion and may be seen in the upper limbs in patient with cervical cord injury

3). Horner’s syndrome

Horner’s syndrome may be seen in cervical cord lesions

Cervical Cord Injury

Findings that indicate a cervical cord injury (in an unconscious patient)

1). Flaccid Paralysis with Areflexia (Spinal shock)

2). Flaccid Rectal sphincter or decreased tone of the rectal sphincter

3). Hypotension with bradycardia (Neurogenic shock)

4). Diaphragmatic Breathing

5). Priapism (Autonomic transection)

6. Ability to flex but not extend the elbow

7). Response on eliciting painful stimuli above the clavicle but not below the clavicle

Cervical spinal cord injury is associated with a decreased rectal sphincter tone (and not an increased rectal sphincter tone)

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