Complete spinal cord lesions above which one of the following levels results in long-term ventilator dependence?
A. C4
B. C5
C. C6
D. C7
E. All of the above
ANS: A
Rationale: Lesions above C4 interrupt most fibers of the phrenic nerve (C3 and C5 make small contributions to the phrenic nerve), so the diaphagm does not receive adequate signals for breathing. If C4 is intact, the diaphragm receives adequate signals for breathing.
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