National Physical Therapy Examination (NPTE) Practice Exam

A patient with spinal cord injury at T4 might experience difficulties with what function?

1. Leg movement

2. Upper body strength

3. Respiratory control

4. Gait functionality

The correct answer is: Respiratory control

A spinal cord injury at the T4 level can significantly impact various bodily functions due to the role that specific segments of the spinal cord play in controlling different areas of the body. In this case, respiratory control is affected because the T4 vertebra is located in the thoracic region, which is responsible for innervating certain muscles involved in respiration. In particular, while the diaphragm is primarily controlled by the cervical nerves (C3-C5), the intercostal muscles, which assist with breathing, are innervated by thoracic nerves. An injury at T4 can lead to weakened intercostal muscle function, which can result in compromised respiratory mechanics. Patients may experience difficulty with deep breathing and cough effectiveness, leading to respiratory complications. Although leg movement, upper body strength, and gait functionality could also be affected, they are less directly impacted when compared to respiratory control. The extent of these issues depends significantly on the specifics of the injury and the segment(s) that may still retain some motor function. Thus, the primary concern regarding respiratory control is valid in the context of a T4 spinal cord injury.