Spinal Levels—C4 ER Quiz 1

You are the intern on call for neurosurgery at a major Northeast medical centre with a great college basketball team. Your chief resident is clipping an aneurysm. You receive a phone call from an outside hospital.

Outside Doc:

Hello. I have a motorcycle accident victim in my ER now. He is hemodynamically stable and is breathing fine on his own. His problem is that he can't move his legs.

I got a pin level on him, and he stops feeling pin at around two inches above his nipple line. I looked up this in my pocket brain, and it seems that this is where the C4 dermatome is.

I have a C-spine Xray down to C5 which looks OK.

Your response:

(By the way, the aneurysm just burst and your chief resident isn't available. Your senior resident just got called to a code in the unit. You are on your own, bubbie. Start thinking.)

(for further discussion, return to spinal level and read on...)