Question 2c

A  24-year-old   male   mountain  bike   rider  crashes   into   a   tree,  resulting  in   a   severe hyperextension neck injury, and  fractured lower left ribs. He now presents to hospital  with shock and a painful distending  abdomen.

After another 24 hours it is apparent that he has a complete spinal cord lesion at C4. What signs of this lesion are likely to be present?

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College Answer

Tone may well still be decreased (though with time this will increase, with posturing developing in an  upper  motor  neurone  distribution).     Anal  tone  would  be  lax  with  a  complete  lesion. Quadriparesis would be expected, with no movement below deltoid.  Respiratory muscles may be significantly compromised.   Reflexes may still be absent, though with time will increase.   The plantar reflex should be upgoing.  A sensory level is expected between C2 to C6, and to all modalities (eg. touch, pain, temperature, JPS and vibration).


This question  is identical to Question 14 from the second paper of 2005.