EDWARD H. BERGOFSKY, M.D.
Acute respiratory failure is commonly observed immediately after injury to the cervical portion of the spinal cord in man. In such patients, clinical scrutiny often demonstrates normal or enhanced excursions of the abdomen with paradoxical inspiratory retraction of the rib cage. These observations are in accord with clinical evaluation, which reveals a normally moving diaphragm and a flaccid paralysis of the muscles of the trunk and extremities. As a general rule, the acute postinjury flaccid paralysis of the muscles of the rib cage and trunk passes into a state of spastic paralysis and the paradoxical motion of the rib cage
BERGOFSKY EH. Mechanism for Respiratory Insufficiency After Cervical Cord Injury: A Source of Alveolar Hypoventilation. Ann Intern Med. ;61:435–447. doi: 10.7326/0003-4819-61-3-435
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Published: Ann Intern Med. 1964;61(3):435-447.
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