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.
