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GeriatricHydralisk t1_jd8a7y1 wrote

"C3,4,5 keeps the diaphragm alive"

The phrenic nerve, which controls the diaphragm, originates pretty high up, into the neck. Nerves are named for the number of vertebrae they emerge between and the region. So in this case, these would be the 3rd through 5th cervical (neck) nerves.


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BladeDoc t1_jdamq2e wrote

Can’t tell that one without the other.

S 2,3,4 keeps your pecker off the floor.


GeriatricHydralisk t1_jdapuke wrote

Nice, I never heard that one. Dirtiest one I heard was the famous cranial nerves one.


CocksuckOfDouchebag t1_jdbj4pz wrote

Yeah, I'm a smart person who knows that one too. Would you type it out here though, for all the schmucks who've never heard it?


Minus-Celsius t1_jdct9w1 wrote

There are 12 cranial nerves (basically nerves that come directly out of the brain, not through the spinal cord).

Some of them receive signals only ("somatosensory", S). Some of them send signals only (motor, M) and some do both (B).

Some Say Marry Money But My Brother Says Big Boobs Matter More

There's also the wrist bones one, "Some Lovers Try Positions That They Can't Handle" but I don't remember what they all stand for anymore, haha.


duckpearl t1_jder7cr wrote

I thought you were going to lead with

Ooh, ooh, ooh, to touch and feel virginal girls' vaginas and hymen


Alfred_The_Sartan t1_jd8humr wrote

So correct me if I’m wrong, but during old Timey, hangings, when a neck was broken, it’s not really the same as instantly killing someone. Just that their diaphragm no longer works and they still choke to death, right?


lostPackets35 t1_jd8yoip wrote

"it depends" on the length of the drop (if any) placement of the knot , etc...

Done well, the insult to the cns from having the neck broken should hopefully cause near immediate unconsciousness

Failing that, compression of the arteries supplying blood to the brain should do it within 10 seconds or so.

The cause of death is still usually strangulation though. So there can well be a lot of suffering if any of the above don't lead to rapid loss of consciousness.


johnsadventure t1_jd8s7e0 wrote

Hanging is supposed to snap the neck well enough to cause immediate and total paralysis, meaning that all body functions stop (heart, lungs, breathing).

Without blood flow and oxygen brain death happens soon after, but I have read brain activity can continue up to 5 minutes after supporting body functions stop.

With that information, assuming the hanged does not lose consciousness they will feel immense pain and panic as their brain suffocates. If their eyes are open they can watch the world while unable move or communicate for their last few minutes of life.


PowerStacheOfTheYear t1_jd90uqn wrote

The heart is actually not reliant on the brain, as it has its own internal pacemaker. Signals from the nervous system can speed it up or slow it down in response to various factors, but without any signal it will just continue to beat on its own at a very steady rhythm and rate. Around 60 bpm if I remember correctly.

As far as surviving after the drop, I have to wonder what that yank of the rope does to your brainstem. If the pull on the spinal cord causes significant tearing and damage in the brainstem, your entire brain would essentially just "turn off". The brainstem is responsible for regulating your brain activity as a whole. Without the activating signals it sends out, the rest of your brain basically shuts down.


Jfrog1 t1_jd9kz6i wrote

um, no, the brain does control the heart, not sure who told you that, but they lied to you.


garlicgoon3322 t1_jd9nzu2 wrote

The heart creates it's own electrical pulses.

The heart will still beat when disconnected from the body.

You are speaking confidently about something you don't thoroughly understand


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GroinShotz t1_jd9uj6s wrote

As long as it was fed oxygen... Yes. I think that's where you're being confused... The brain does play a role in the heart pumping... by keeping the other organs supplying the heart with what it needs.

It's why people that are "brain dead" can be kept "alive" for a while, with a machine that breathes for them. The brains not sending the signals to the lungs to get oxygen in the blood stream to supply the heart with the energy it needs to beat.


Brrdock t1_jd9vuiz wrote

You don't? Why?

I'm sure you can go on liveleak to find some decapitation video, but from seeing a cow get slaughtered by decapitation myself, the heart definitely keeps pumping blood for a good while


Jfrog1 t1_jdaconl wrote

You don't understand the concept of a sodium potassium pump in cellular biology?


Tiny_Rat t1_jdadkhz wrote

What does that have to do with the heart requiring brain activity to function?


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PowerStacheOfTheYear t1_jd9mtxu wrote

The nervous system can control the heart, but the heart isn't dependent on input from the nervous system to beat. Without any input from the nervous system, the heart will continue to beat on its own, it will just lose the vast majority of its ability to adjust based on the body's needs.


Jfrog1 t1_jd9nyo6 wrote

the heart is controlled by the autonomic nervous system, which is a subset of the hypothalamus and medulla oblongata, ie (brain). This is not really a debate, your completely wrong, and I am 100 percent right.


PowerStacheOfTheYear t1_jd9q2zj wrote

Okay, I will be sure to reach out to my medical school and let them know that modern medicine completely misunderstands the function of cardiac pacemaker cells and the sinoatrial node. They should also check on all the people walking with dysautonomia. I'm sure they will be surprised that their hearts actually haven't been beating this whole time.


Jfrog1 t1_jd9qfr9 wrote

what do you think controls the AV node, the SA node, and the Bundle of hiss?? the heart controls itself, or its impulses come from the ANS, which is a sub branch of the CNS, which is the brain and the spinal cord.


Astralwinks t1_jdafvjt wrote

Are you suggesting something afib is actually neurological in origin?

Call JAMA, The Lancet, NEJM! They have to know!


Minus-Celsius t1_jdcs256 wrote

Wait you googled SA node and you still think you're not wrong?

Damn, dude.

The brain controls the SA node, but the SA node can function without the brain. There's also a ventricular pacemaker. There's backups to the backups. The heart is an important organ.


tonypconway t1_jd9sumq wrote

You're confidently incorrect. I'm only vaguely familiar with this topic as my dad had heart surgery last year, and I have a tetraplegic friend who has explained some of it to me. But it only took about five minutes of fudging about on Wikipedia to find a detailed explanation of how the heart generates its own impulses:

The brain and other systems can influence the rate, but they aren't the primary driver. This is why people get arrhythmia - different systems sending contradictory signals.


IthinkIllthink t1_jd9p9r3 wrote

The heart has “pacemaker cells” that make it beat/contract without any nerve input. Look up pacemaker cells.

The ANS speeds up or slows down the heart rate.


Jfrog1 t1_jd9q4za wrote

if you put a bullet through the medulla oblongata/brain stem, the heart stops, this is simple stuff, does it happen immediately, no, as electrical impulses are still working, but your concept that the heart controls itself is so basic and unfounded, I am amazed you made it through high school biology


IthinkIllthink t1_jd9qty1 wrote

Perhaps that’s from the trauma of the gun shot.

Look at a video of the transport or removal of a human heart for a heart transplant. It is beating without any nerve input.


ilikeyourjacket t1_jdcqxv8 wrote

You’re right the ANS can influence heart rate but the heart itself has an intrinsic rate. The SA node has an intrinsic rate between 60-100bpm. The AV nice has an intrinsic rate of about 40-60bpm. The ventricles have an intrinsic rate of about 30bpm. That’s why in complete heart block often the heart rate is about 30bpm as that’s the default rate of the ventricles when signals from the SA or AV node are blocked.


Clearchus76 t1_jd8zhxt wrote

I still feel like the guillotine is the optimal method behind a huge cocktail of morphine and insulin


BlueTreskjegg t1_jd9siho wrote

The most painless and save method would be a mask or gas chamber with pure nitrogen atmosphere.


imissapostrophes t1_jd996uy wrote

Sorry for my ignorance: Why insulin?


Nimelennar t1_jd9b5lv wrote

Your brain needs sugar to function.

An overdose of insulin drops your blood sugar enough that you lose consciousness.

That's why first aiders are taught to never give a diabetic insulin, but rather to give them sugar: low blood sugar (hypoglycemia) can kill you quickly, but the negative effects of high blood sugar (hyperglycemia) only take effect over the long term.

So if their sugar is high and you guess wrong and give them more sugar, it's bad but probably not significantly so. But if their sugar is already low and you give them insulin, it's very likely you'll kill them.


jackyj888 t1_jdcf2ii wrote

Is that still taught? I would advise against it. Call 911 or a trusted family member/spouse of the effected person.

Giving insulin to someone with low blood sugar is generally worse than giving sugar to someone with high blood sugar, but you can still really do damage and even put someone into DKA if you don't know what you are doing.

Typically a glucometer is gonna be right next to the insulin or in a diabetics medical supplies. Use it and give the 911 operator the result and right it down next to the time you took the reading for the arriving ambulance.

If they are unconscious, don't try to put food or water in their mouth. They either need an IV or insulin, and both are jobs for trained pros. In the event of a diabetic emergency, neither dextrose/glucose or insulin should be given without a glucometer reading.

Tldr: If you aren't a paramedic or higher, you shouldn't be administering insulin or dextrose/glucose either way.

Otherwise your post seems pretty accurate. Not trying to crap on or dismiss your post or anything, just saying that that is no longer recommended.


ilikeyourjacket t1_jdcj45q wrote

Unlikely to put someone into DKA by giving them sugar as it's the lack of insulin that precipitates DKA rather than excess of sugar. But otherwise agree, important not to give unconscious person food.


Nimelennar t1_jdcmpd5 wrote

>Is that still taught?

Unless things have changed in the past year or so, since I last took a course.

>Call 911 or a trusted family member/spouse of the effected person.

Yes, if someone is in obvious enough distress that you're concerned about either hyperglycemia or hypoglycemia, you're going to want to get help to them. I should have mentioned that.

>Typically a glucometer is gonna be right next to the insulin or in a diabetics medical supplies.

Sure, but as a first aider, you're not typically trained to use it. I mean, it's not rocket science, but (IANAL, just someone who has taken a lot of first aid courses) Good Samaritan laws only tend to protect you within the scope of your training, and for anything you do outside of that training (like taking even a tiny blood sample), you can be held liable for if things go wrong.

Of course, if the 911 operator instructs you to, that's fine (at that point, you're acting under their authority, rather than your own as a first aider), but it's not something I'd recommend taking initiative on.

>If they are unconscious, don't try to put food or water in their mouth.

I was taught this is the only exception to that rule; a small amount of sugary gel (e.g. honey or icing), deposited in the cheek.


ilikeyourjacket t1_jdcp1bw wrote

Hmmm I think I would be wary putting something in the mouth of someone who is completely unconscious as they have a high risk of aspirating because they lose their protective airway reflexes.

But by all means if someone has reduced consciousness but they’re still able to swallow then we essentially use exactly that in the hospital context: a sugary gel as first line treatment of hypoglycaemia.


Nimelennar t1_jdctp7t wrote

I think that's the rationale behind putting it in the cheek (i.e. between the teeth and the lips), and of using a gel instead of a less viscous liquid like a juice: to minimize the risk of aspirating it.

At least one first aid instructor I've had has suggested running the gel into the flesh of the lips and gums, which should reduce that risk even further, but I don't think that was ever a formal part of the training.


jackyj888 t1_jddjksx wrote

You are correct. It is absolutely against common medical teaching and 99% of prehospital protocols to put glucose paste or anything else in the mouth of an unconcious diabetic. Altered LOC, sure, but not unconcious.

I'm sure you also know as a nurse that it would be absolutely a bad idea to start administration of sugar or insulin prior to obtaining blood glucose.


jackyj888 t1_jddj23y wrote

>Sure, but as a first aider, you're not typically trained to use it. I mean, it's not rocket science, but (IANAL, just someone who has taken a lot of first aid courses) Good Samaritan laws only tend to protect you within the scope of your training, and for anything you do outside of that training (like taking even a tiny blood sample), you can be held liable for if things go wrong.

It's more in scope than administration of sugars or insulin to a diabetic, which is typically a medic though sometimes an EMT skill.

Ting a first aid course or being first aid certified doesn't even include a scope of practice anyways.

>Of course, if the 911 operator instructs you to, that's fine (at that point, you're acting under their authority, rather than your own as a first aider), but it's not something I'd recommend taking initiative on.

Again, you can get someone killed by administration of sugar or insulin, and administration of sugar or insulin is beyond first aiders/Emr anyways.

Unlike using insulin or sugar, using a glucometer poses 0 risk to the patient unless you somehow manage to miss the finger and poke them in the eye or something.

>I was taught this is the only exception to that rule; a small amount of sugary gel (e.g. honey or icing), deposited in the cheek.

Big no no. Absolutely do not do this and this hasn't been recommended for like over 20 years, at least in the USA. An unconcious diabetic needs a line, not stuff put in their mouth.

Source: Degree in Paramedicine, and a career working as a medic on the ambulance.


TeeDeeArt t1_jdh8wd7 wrote

> Tldr: If you aren't a paramedic or higher, you shouldn't be administering insulin or dextrose/glucose either way.

Quickly checked current Australian and uk first aid resources (red cross training), and they do still seem to recommend that first aiders do it (giving sugar/sugary foodndrink) assuming the diabetic person is still responsive. I'd maybe be a bit more careful with wording when giving medical advise or first aid training online without being very specific as to where it applies.


FindorKotor93 t1_jd9ewus wrote

If you need an efficient, relatively painless method then boltgun beats guillotine, less set up and prep and more guarantee of breaking the brain beyond functioning.


HomeAl0ne t1_jd9sx7h wrote

For efficient, painless, cheap and easy just put them in a room and fill it with nitrogen.


swordsmanluke2 t1_jda0bv3 wrote

Or combine the two for maximum efficacy! Nitrogen until loss of consciousness, then bolt gun until loss of ...appetite


FindorKotor93 t1_jde17jq wrote

That's not cheap nor easy. You need a whole room per execution, time to fill it with nitrogen and defill it to get the next person in and you have to have compressed nitrogen.


HomeAl0ne t1_jdg0m2i wrote

Fine. Put a plastic hood over their head, out a tube up inside and tie it off snuggly at the neck.


Master0fAllTrade t1_jdal8b7 wrote

"If" done correctly. I heard that if there were more than a few beheading on one day the blade would be blunted, leading to partial beheadings. Reminds me of Nearly Headless Nick


Brunurb1 t1_jdb166a wrote

nearly headless?! How can you be nearly headless?!


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phdpeabody t1_jd8ypfd wrote

That’s why when they used to do beheadings, they would pick up the decapitated head and hold it up, so it could see the crowd cheering for their death.


maybeCheri t1_jd97pkt wrote

We should take a survey or do a medical study on this question. Probably should do a full study on all forms of capital punishment.

  1. How long were you conscious before everything went dark?
  2. Did you see me? I was in the second row in the blue shirt.
  3. Did you have any lasting effects, PTSD, pain, etc. from said procedure?

mug6688 t1_jd957t6 wrote

Exactly what they said, but I would add that respiration can also be impaired if you damage the spinal nerves in your thoracic area (intercostals) especially if an injury occurs at/above T7 for the abdominal muscles.


NeoEpoch t1_jd9o674 wrote

The fact that there is a mnemonic for this is actually a bit concerning. Is it that common?


mikailatc t1_jdaboom wrote

There are mnemonics for all spinal area enervations. Cranial nerves as well. Cranial Nerve “3,4 6 make the eyes do tricks” and so forth. Its important to know what nerves do what so if a part of the body isn’t working right it helps track down the potential culprit. Lots on mnemonics in medicine in general.


BladeDoc t1_jdamnb9 wrote

S2,3,4 keeps your pecker off the floor. Sacral nerves 2-4 control erection and incontinence.


BossermanMD t1_jdaylbn wrote

There's a billion mnemonics for anatomy and other facets of medicine as rote memorization of everything would be incredibly difficult. The dirtier ones are always the most memorable.


Dalakaar t1_jd9vkjz wrote

First thing I thought of was back to my old first aid training doing chest compressions to the beat of Bee Gee's "Stayin' Alive".


DumbNBANephew t1_jd9o6cq wrote

Still doesn't answer the question completely though. Are there other nerves that are involved with breathing and somehow originate lower? Do we know for sure that an injury beyond C5/C6 would NOT affect breathing?

Or is it only nerves from C5 and above that affect breathing?


GeriatricHydralisk t1_jdae8gr wrote

As others note, lower nerves innervate the intercostals and abdominals. But the diaphragm is both necessary and sufficient for human ventilation, and is innervated exclusively by the phrenic nerves (left and right), which originate from those three levels.


Gonzo_B t1_jd8a4ur wrote

Google "spinal nerve diaphragm" and find which nerve controls the diaphragm (breathing) and where the nerve originates from the spine. I'd tell you, but it is always beneficial to practice your Google Fu and get good at it!


arlenroy t1_jd9b899 wrote

And then Google Tyson Kidd, pro wrestler who suffered a Christopher Reeve like injury. Head detached from his spine. But because years of neck bridges the muscles were significantly stronger, the muscles kept his head on until he had emergency surgery. He has full body function to this day.


Anomaly-Friend OP t1_jd8afoa wrote

You're good! This was exactly what I was looking for. I am now less worried about accidentally breaking my spine and not being able to breathe lol


ImAScientistToo t1_jd8buvj wrote

Keep in mind that a injured spinal cord can temporarily lose function higher than the injury due to inflammation.


Anomaly-Friend OP t1_jd8es1o wrote

Thank you! I am now just as worried as I was originally lol


ImAScientistToo t1_jd8g4td wrote

If it’s a stable fracture then you don’t have to be too worried about losing respiratory function.


foolishbison t1_jd9url0 wrote

Also might not be a thing you do to yourself. I received a "nerve block" for routine shoulder surgery that damaged my phrenic nerve, resulting in a loss of diaphragm function on that side. I now have two good shoulders, but only one good lung.


Tectum-to-Rectum t1_jd8urhq wrote

It takes a lot of effort to do that. The overwhelming majority of cervical fractures do not result in neurological injury. I’ve been involved with probably 2-3 high cervical injuries requiring ventilator dependence and most are old people with bad bones and a type 2 dens fracture that pinch their cords.


carrot_bunny_dildo t1_jd9wrlr wrote

It depends how you define respiratory impairment. Nerves supplying muscles of breathing come from differing areas of the spine. Notably as another person mentioned the C3, C4, C4 muscles supply the diaphragm. The diaphragm accounts for roughly 60% of your respiratory effort. Other muscle of respiration include accessory muscles of breathing such as intercostal muscles, neck muscles and upper thoracic wall muscles. A lower cervical spine injury ie. C6 would impair all of those muscle but leave the diaphragm. A person with a spinal injury but intact C6 and below has significant impairment of their breathing. An important consideration is the ability to cough, without being able to effectively cough secretions build up and recurrent lower respiratory tract infections can occur. The main muscle to support coughing are abdominal muscles supplied by thoracic nerves. Other factors include the ability to regulate our sympathetic nervous system. A paraplegic above T6 may have no sensation below T6 such that a painful stimulus will result in crazy amplification of the sympathetic nervous system below T6. This can result in this like acute pulmonary oedema from severe pulmonary hypertension. You’ll be fine cracking your back though, lol.


_irish_potato t1_jdb53xc wrote

Injury at C3 would completely impair breathing, with partial impairment down to C5. The accessory muscles that assist with breathing (not the diaphragm) like the intercostals can be affected all the way down to T12 with varying degrees of impairment.

Source: orthopedic resident who sometimes does spine surgery