Advanced Patient Assessment Practice Exam

Injury to the cervical spine roots C3 to C5 is associated with which of the following abnormalities?

1. Paralysis of the diaphragm

2. Doll's-eye maneuver

3. Babinski sign

4. Absence of deep tendon reflexes

The correct answer is: Paralysis of the diaphragm

Injury to the cervical spine roots C3 to C5 is associated with paralysis of the diaphragm because these nerve roots give rise to the phrenic nerve, which is responsible for controlling the diaphragm muscle. The diaphragm is the primary muscle involved in respiration, and any damage to the C3 to C5 spinal roots can lead to significant respiratory complications, including difficulty breathing or respiratory failure due to paralysis of this muscle. The other options, while they may relate to various neurological or autonomic functions, do not specifically result from injuries at these cervical spine levels. The Doll's-eye maneuver assesses brainstem function and cranial nerve pathways rather than isolated cervical spine injuries. The Babinski sign is a reflex that indicates upper motor neuron lesions and is more relevant to the corticospinal tract rather than localized cervical root injuries. Absence of deep tendon reflexes can occur due to lower motor neuron damage or peripheral nerve injury, which is also not directly associated with C3 to C5 root damage. Thus, the association of cervical spine injuries at C3 to C5 with diaphragm paralysis is clear and clinically significant.