The exact nature of impairment depends on the cause of the paralysis, the extent of the paralysis, and where the paralysis begins. [Here is a diagram of the spinal column](https://s3.amazonaws.com/reeve-assets-production/BrainSpinalCordlabld.jpg) with the vertebrae labeled with the functions of the spinal nerves that emerge from them. Someone with an injury at or above the C4 vertebrae is going to have breathing problems and will probably require some form of mechanical ventilation, as the C4 vertebra enervates the diaphragm. While the brain does regulate the heart to some degree, the heart beats on its own. You know this already because people with transplanted hearts are still alive! The heart will beat on a sort of “default” setting, although a person will probably have some amount of cardiac dysfunction.
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