Question
Hi, Im an Occupational Therapy student doign a case study on a man with a C3-4 injury. I am confused as to wether he will be able to move his arms at all? Do people with this type of injury generally have some muscle innervation of the arm?

thanking you
Sophie

Answer
Although this website frowns on us answering "homework" questions, I have the following information for your case study.

Individuals with complete high (C1-C4) tetraplegia have little or no movement of upper- and lower-extremity muscles. They have movement of the head and neck and possible shoulder elevation (shrug). Those with an injury at the C4 level have innervation of the diaphragm (the primary muscle for respiratory inspiration). They should not need long-term ventilatory assistance, though it is not uncommon to receive ventilation initially after injury.

Patients with C1-C3 injuries are likely to require long-term mechanical ventilatory support because of the loss of innervation to the diaphragm. These individuals may be candidates for FES of the phrenic nerve (or diaphragm) to reduce their need for mechanical ventilation, if their lower motor innervation to the diaphragm remains intact. Swallowing and phonation functions are preserved.

Individuals with injuries at the C1-C4 level will likely depend on others to help with almost all of their mobility and self-care functions, though they may be able to use a power wheelchair with chin or pneumatic (sip and puff) controls. If their elbow flexion and shoulder movement are suboptimal (muscle grade 2 or 3), a balanced forearm orthosis (BFO) or mobile arm support (MAS) may assist them with feeding and grooming activities. A long bottle or straw can enable and permit independence with drinking.

Thank you for your question, Sophie.  I hope that my answer was helpful.