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Cervical spinal nerve 4, also called C4, is a spinal nerve of the cervical segment. It originates from the spinal cord above the 4th cervical vertebra (C4). It contributes nerve fibers to the phrenic nerve , the motor nerve to the thoracoabdominal diaphragm .
Injuries to the cervical spine are common at the level of the second cervical vertebrae, but neurological injury is uncommon. C4 and C5 are the areas that see the highest amount of cervical spine trauma. [8]
A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. [1] [2] These are grouped into the corresponding cervical, thoracic, lumbar, sacral and coccygeal regions of the spine. [1]
They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral (m. scalenus, m. levator scapulae, m. splenius cervicis) from lateral side. There is anastomosis with accessory nerve, hypoglossal nerve and sympathetic trunk. It is located in the neck, deep to the sternocleidomastoid muscle. [5]
Cervical spine disorders are illnesses that affect the cervical spine, which is made up of the upper first seven vertebrae, encasing and shielding the spinal cord. This fragment of the spine starts from the region above the shoulder blades and ends by supporting and connecting the skull .
Pain arising from structures supplied by the phrenic nerve is often "referred" to other somatic regions served by spinal nerves C3-C5. For example, a subphrenic abscess beneath the right diaphragm might cause a patient to feel pain in the right shoulder. Irritation of the phrenic nerve (or the tissues it supplies) leads to the hiccup reflex.
In a radiculopathy, the problem occurs at or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm.
Sensation, including pain and the sense of joint position (proprioception), travel via the ventral rami of the third (C3) and fourth (C4) cervical spinal nerves. [5] Since it is a muscle of the upper limb, the trapezius is not innervated by dorsal rami, despite being placed superficially in the back.
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