The American Way #3: A Medical Review

May 19th, 2006

Filed under: Comics, Medicine

The American Way #3 “Book Three: Let the Word Go Forth”
John Ridley, writer
Georgen Jeanty, penciler

In the middle of the issue, the super hero Secret Agent confronts a murderer at the site of his crime. The killer is holding a young boy hostage, but that doesn’t slow down the Secret Agent: he fires a bullet that ricochets around the room before clipping the murderer in his back.

Narration by Secret Agent: I crease the guy easy. Hit him right in the T7 vertebra. He’ll be a quadriplegic for the rest of his sorry life.

Just one problem there, Secret Agent: a spinal cord injury at T7 leads to paraplegia, not quadriplegia.

The spinal column is made up of 5 sets of vertebrae. The cervical vertebrae (C1-C7) are in the neck, the thoracic vertebrae (T1-T12) are in the upper back, the lumbar vertebrae (L1-L5) are in the lower back, followed by the 5 sacral vertebrae (which in most people are fused together), and finally the coccyx (or tailbone).

Spinal Cord InjuryThe spinal column protects the spinal cord. As the cord moves down from the brain, a pair of spinal nerves split off at the level of each vertebra. These nerves innervate different parts of the body depending on which level they are from. For instance, the C2 – C5 nerves innervate the neck and the back of the head. C5 also supplies some of the nerves to the hand and arm, as do C6, C7, C8, and T1. The thoracic nerves innervate the chest and abdomen. The lumbar nerves innervate the lower back and along with the first two sacral nerves (S1 and S2), supply nerves to the legs.

When a spinal cord injury occurs, it wipes out everything below the injury, but does not affect nerves that split off higher than the injury. A T7 injury would lead to paralysis of the legs and lower trunk and loss of feeling below the rib cage, but it would not cause quadriplegia.

*There are seven cervical vertebrae but eight cervical spinal nerves. Why? Because that’s how they were named. Just one of those wonderful bits of knowledge you learn in medical school.

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5 Responses to “ The American Way #3: A Medical Review ”

  1. Chris
    May 20th, 2006 at 12:39 am

    Okay, Scott. Seriously, I want you to come clean.

    Do you or do you not use this fantastic knowledge to fight crime?

  2. David Oakes
    May 20th, 2006 at 1:10 am

    Isn’t it eight cervical nerves with seven cervical vertebrae filling the spaces inbetween? Or do you actually have two nerves branching out at the same place? (Or I guess a cervical nerve coming out at a thoracic vertebra.)

    Heck, I was impressed enough he used a term even associated with the spine to even notice the quite common conflation of quad- and parapalegic.

    (OK, I lie. I was too ashamed of the blatent Midnighter rip-off that I quickly skipped forward to the less obvious Southern Knights rip-offs…)

  3. Scott
    May 20th, 2006 at 7:52 am
    Official Comment

    Chris,
    I like to take more of the Oracle approach — sit back and let other do my dirty work.

    David,
    You’re right. C1 comes out above the C1 vertebra and C2 beneath. C3 is beneath the C2 vertebra, and so on until C8 coms out beneath the C7 vertebra. After that it makes more sense, with the nerve comin gout beneath its vertebra (i.e. the T3 nerve comes out under the T3 vertebra).

  4. David Oakes
    May 20th, 2006 at 8:31 pm

    The Green, the Green…

    “comin gout”

    It’s an obvious typo, but since it’s a medical blog, I actually had to stop and think if there were different types of gout.

    “the T3 nerve”

    And since it is a comic book blog, I of course got all these wrong ideas how medical databases make you a more efficient killer. (Oracle…)

  5. Greg Morrow
    May 22nd, 2006 at 3:35 pm

    It seems likely that Secret Agent (or, rather, writer John Ridley) meant C7, which would indeed lead to quadriplegia.

    Pet peeve: People who pronounce it “parapalegic” or “quadripalegic”. What, the “pl” gives you problems aplenty? Probably say “nucular”, too. I like “Joan of Arcadia” except every time they referred to the older brother’s condition….

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