Spinal Cord Injuries – Understanding Sensory and Motor Deficits
From the symptoms reported, Johnny’s inability to perceive the location of the touch on his calf or on his foot and being able to move his arms and differentiate touch on his elbow or wrist is evidence of damage to the lower part of the spinal cord. In particular, this speaks of a spinal lesion in the lumbar segments that control the somatosensory and motor functions of the lower extremities.
Lumbars (L1-L5) is the section responsible for handling sensations and motor control of lower limbs. If Johnny cannot tell the difference between a touch on his calf and a touch on his foot, then it means that the sensory pathways in this part of the body, especially the lumbar region, have been affected. This kind of injury usually interferes with the ability to perceive position and touch, which may lead to confusion when identifying the exact point of touch.
Follow-up Question
Quadriplegia (also known as tetraplegia)
Location of Damage: Cervical spinal cord (C1-C8).
Deficiencies
This kind of injury entails the loss of mobility in all the limbs and the trunk of the body, partly or completely. According to the level of cervical injury, paralysis can be complete or incomplete, mild or severe (Lalwani et al., 2020). These injuries, particularly the high cervical ones (C1-C4), often result in respiratory dysfunction and necessitate ventilatory support. C5 to C8 injuries usually enable the patient to have some form of mobility or at least function of the arms and hands, but not full control.
Paraplegia
Location of Damage: Thoracic (T1-T12) or lumbar (L1-L5) regions of the spinal cord.
Deficiencies
Consequently, one is unable to feel or move down the body, including the legs. Thoracic injuries more likely affect the trunk and the legs while leaving the arms and hands exempt (Bennett et al., 2020). Lumbar injuries affect the lower limbs and may cause the inability to control bowel movements or urination while retaining basic limb mobility of the upper extremities.
Hemiplegia
Typically, it results from brain injury (e.g., stroke) rather than spinal cord damage. When spinal cord injury causes similar symptoms, it is due to a unilateral lesion affecting one side of the body.
Deficiencies
Hemiplegia results in paralysis on one side of the body. This condition often arises from damage to the brain’s hemisphere opposite the affected side. For example, damage to the left hemisphere of the brain results in right-sided hemiplegia.
References
Bennett, J., M Das, J., & Emmady, P. D. (2020, May 11). Spinal cord injuries. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560721/
Lalwani, R., Kotgirwar, S., & Athavale, S. A. (2020). Changing medical education scenario: A wakeup call for reforms in Anatomy Act. BMC Medical Ethics, 21(1). https://doi.org/10.1186/s12910-020-00507-0
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Question 
Initial Post Instructions
Johnny was involved in a car accident on his way home from work. In the ER, his nervous system is assessed. Johnny is not certain if the doctor is touching his calf or his foot. Johnny does have the ability to move his upper extremities and knows the difference when someone touches his elbow or wrist. What part of the spinal cord has been affected by the accident?
Spinal Cord Injuries – Understanding Sensory and Motor Deficits
Follow-up question: what is the difference in location of damage between quadriplegia, paraplegia, and hemiplegia? Where would you expect a patient to have deficiencies with each of those injuries?