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B.L., 17, had a compression fracture at the C5-C6 after jumping into a river from a bridge and slamming into a submerged rock. Fortunately, she was saved by a companion who had first-aid expertise and worked to limit any collateral damage. B.L. was unable to move her limbs, feel touch, or have reflexes in her limbs when she arrived at the emergency room. Describe the causes and ways in which B.L.'s ability to breathe may be hampered at any time.

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Since the patient suffered damage to the C5-C6 segments, the phrenic nerve (C3-C5) will be probably completely affected during the phase of the spinal shock, and since the diaphragm is innervated by the phrenic nerve, mechanical ventilation could be needed during this phase. Later C3-C4 segments could provide at least some motor input to the diaphragm. Intercostal nerves would all probably be lost since they originate from thoracic segments, leaving the patient without secondary respiratory musculature.

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