A patient with a spinal cord injury arrives in the emergency department. The nurse assesses motor and sensory function and finds the patient without sensation or movement in all four extremities. The injury is most likely in what area?
a. Above C4
b. C4–C8
c. T8–T11
d. L1–L4
ANS: B
Cervical cord injuries can affect all four extremities, causing paralysis and paresthesias, impaired respiration, and loss of bowel and bladder control. If the injury is at C3 or above, the injury is usually fatal because muscles used for breathing are paralyzed. An injury at the fourth or fifth cervical vertebrae affects breathing and may necessitate some type of ventilatory support. Thoracic and lumbar injuries affect the legs, bowel, and bladder.
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