Spine: neurological level in cervical injury: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: neurological level in cervical injury

Sample item

After a cervical spine injury, a patient has normal power in the biceps, 4/5 power in the wrist extensors and 1/5 power in the triceps, with a matching sensory level. What is the neurological level of injury?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. C6

Key muscles are C5 elbow flexors, C6 wrist extensors, C7 elbow extensors, C8 finger flexors and T1 finger abductors. The level is the lowest segment with at least grade 3 power when the segments above are normal. The wrist extensors qualify and the triceps do not, so the level is C6.

Option by option

  • A. C8

    C8 function needs finger flexor power, and the C7 muscle above it is already weak.

  • B. C6 (correct)

    Correct. C6 wrist extensors are functioning while the C7 triceps are not.

  • C. C7

    C7 function needs triceps power of at least grade 3, which is absent here.

  • D. C5

    The level would be C5 only if the wrist extensors were also below grade 3.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, C6. Key muscles are C5 elbow flexors, C6 wrist extensors, C7 elbow extensors, C8 finger flexors and T1 finger abductors.

Why is "C8" not the answer?

C8 function needs finger flexor power, and the C7 muscle above it is already weak.

Why is "C7" not the answer?

C7 function needs triceps power of at least grade 3, which is absent here.

Why is "C5" not the answer?

The level would be C5 only if the wrist extensors were also below grade 3.

What concept does this question test?

It tests Spine: neurological level in cervical injury in Orthopaedics. The level is the lowest segment with at least grade 3 power when the segments above are normal. The wrist extensors qualify and the triceps do not, so the level is C6.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: neurological level in cervical injury?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.