Concerned about cervical cord injury in your trauma or MVA pt?

Sensory and Motor exam of Cervical Nerves

Root                Motor                                        Sensory

C3                   diaphragm, trapezius              lower neck

C4                   diaphragm                              clavicular area

C5                   biceps, deltoid                        below clavicle

C6                   biceps                                    thumb and lateral forearm

C7                   triceps                                    index and middle fingers

C8                   finger flexors                           little finger

T1                    hand intrinsics                        medial arm


Or to make it easy: A strong handshake indicates an intact spinal cord down to T1.


Review of incomplete cord lesions:

Central cord syndrome: elderly pts with spondylosis or congenital stenosis. Pts with episode of forced hyperextension–> vascular ischemia –>weakness greater in arms than legs.


Anterior-cord syndrome: cervical flexion injuries –> bony fragments impinge spinal canal, cord contusion or compression of anterior spinal artery. Complete motor paralysis and loss of pain and temperature distal to lesion.


Brown-Sequard: usually penetrating injury –> hemisection of spinal cord –> ipsilateral motor paralysis, loss of proprioception and vibration and contralateral loss of pain and temperature.

To simplify: Anterior cord does motor and posterior cord does proprioception, pain, vibration and temperature.