Paramedic National Registry Practice

A patient with paralysis from the waist down has a spinal injury at which level?

1. L1

2. L3

3. L5

4. S1

The correct answer is: L3

In the context of spinal injuries and resulting paralysis, a patient experiencing paralysis from the waist down indicates that the injury affects the lower parts of the spinal cord. Specifically, paralysis from the waist down is typically associated with an injury at the lumbar level. The lumbar spine consists of five vertebrae (L1 to L5), with each level controlling different muscle groups and providing sensory innervation to the legs. An injury at L3 means that the injury occurs enough above the region controlling the lower limbs, leading to loss of function in the legs and potentially affecting bladder and bowel control. While the injury at the other levels mentioned can also produce various effects, L1 and L5 would typically yield different presentations of impairment; for example, an L1 injury may cause paraplegia with preserved hip flexor strength, whereas L5 injuries may still allow some mobility in the foot, thereby not resulting in complete paralysis from the waist down. S1 is below the level that would typically be responsible for the major motor function loss in the legs. Thus, an injury at the L3 level directly correlates with the described condition.