In a trauma patient with suspected spinal injury above C-4, which respiratory finding would you most expect?

• A. Normal Breathing
• B. Respiratory Arrest
• C. Chest Pain
• D. Bilateral Leg Weakness Only

Answer: (B)

When the injury is at or above the level of the phrenic nerve roots (C3–C5), the diaphragm’s function can be lost or severely impaired. The diaphragm is the main muscle of breathing, and disruption of its nerve supply from a high cervical injury often leaves the patient unable to initiate or sustain spontaneous breathing. That makes respiratory arrest the most likely finding in this scenario, requiring immediate airway support.

Normal breathing would be unlikely because high cervical trauma tends to disrupt respiratory drive and diaphragmatic movement. Chest pain isn’t a typical finding related to spinal injury itself in the absence of chest trauma, and bilateral leg weakness indicates spinal cord involvement but doesn’t speak to the patient’s breathing status.