<s>[INST] If some one has his spinal cord at the C4 level, which of the following signs would you expect to observe after the spinal shock had resolved? Question options: Increased patellar and Achilles tendon reflexes. Spastic paralysis of the upper limbs and lower limbs. Normal somatic sensation of the facium, neck and trunk. You would expect to observe both a) and b). [/INST] Hello dear, Is it that you were asked this in some entrance examination, and it is not related to your health issue? Anyway, I shall answer it. Both a) and b) are true in this case. But not the c. Injury of the spinal cord at C4 level may spare sensations of face and neck as the sensory tracts giving nerves which innervates the dermatomes of face and neck are usually above the level of C4,so these areas usually spared in injury at this level. But the trunk dermatomes innervation are from the spinal segments which are well below this level and injury at this level obviously will transect these tracts and thus will cause sensory loss in trunk region in addition to lower limbs. I hope it helped. </s>