Question:medium
A patient involved in a road traffic accident presents with quadriparesis, sphincter disturbance, a sensory level up to the upper border of the sternum, and a respiratory rate of 35 per minute. The likely level of lesion is:
A patient involved in a road traffic accident presents with quadriparesis, sphincter disturbance, a sensory level up to the upper border of the sternum, and a respiratory rate of 35 per minute. The likely level of lesion is:
Show Hint
Four weak limbs plus laboured breathing at 35 per minute means a lower cervical, not C1-C2, lesion.
Updated On: Jun 24, 2026
- C1-C2
- C4-C5
- T1-T2
- T3-T4
Show Solution
The Correct Option is B
Solution and Explanation
Work backwards from each clue. All four limbs are weak, so this is not a thoracic injury, which would leave the arms working; that immediately removes T1-T2 and T3-T4. Now the breathing is the deciding clue. The diaphragm runs on the phrenic nerve from C3, C4 and C5. If the cord were cut at C1-C2, the phrenic supply would be wiped out and the patient could not breathe at all, ending in apnoea, yet here the patient is breathing fast at 35 per minute. A struggling but present respiratory effort fits a lesion sitting at the C4-C5 level, where the phrenic outflow is partly hit but not totally lost. The sensory level reaching the top of the sternum fits a low cervical block, and the lost bowel and bladder control confirms a complete cord lesion well above the sacral segments. Pull it together: weak arms and legs rule cervical, partial diaphragm function rules out the very top of the cord, and the high chest sensory cutoff seals a lower cervical site.
\[\boxed{\text{C4-C5}}\]
Was this answer helpful?
0
