Critical Care Trauma Centre

Question of the Week: June 2, 2000

What function would you expect to find in a
     patient with a complete cord injury where function to C4 is intact?


The nerve root of C4 runs between vertebrae C3 and C4.  Nerve function at C4 includes:

Motor Function
facial muscles, trapezius
  • head control, neck movement (paraspinal muscles, CN XI, trapezius muscle)
  • ability to breathe (diaphragm)
  • mouth control (facial muscles)
  • no upper extremity movement
Sensory Function
  • sensation for C4 across shoulders

Expected level of Function

  • use of mouth stick for typing, page turning, switch devices
  • swallowing
  • may have problems maintaining spontaneous ventilation


Barr, M, and Kiernan, J. (1993). The Human Nervous System: An Anatomical Viewpoint. Philadelphia: Lippincott. pp 84-85.

Keppler, J. (1987). Acute spinal cord injury. Critical Care Clinics. July. 3:3. pp. 638-641.

Netter, F. (1989). Atlas of Human Anatomy. New Jersey: Novartis.

Waxman, S. (1996). Correlative Neuroanatomy. 23rd Ed.  Stamford: Lange. pp 46-52, 352-355, 370.

Brenda Morgan
Clinical Educator, CCTC
June 2, 2000

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