[35] Brachial Plexus Injury

Question 1

What nerve roots form the brachial plexus?

Answer 1

C5-T1

Question 2

How do the nerve roots forming the brachial plexus leave the vertebral column?

Answer 2

Between the scalenus anterior and medius

Question 3

Where do the divisions of the nerve roots forming the brachial plexus occur?

Answer 3

Under the clavicle, medial to the coracoid process

Question 4

What does the brachial plexus have an intimate relationship with?

Answer 4

Subclavian and brachial arteries

Question 5

Where is the median nerve formed?

Answer 5

Anterior to the brachial artery

Question 6

What are the categories of causes of brachial plexus injury?

Answer 6

Direct

Indirect

Question 7

Give 3 examples of direct causes of brachial plexus injury

Answer 7

Shoulder girdle fracture
Penetrating trauma
Iatrogenic injury

Question 8

Give 2 examples of indirect causes of brachial plexus injury

Answer 8

Avulsion injuries

Traction injuries

Question 9

What is the Leffert classification of brachial plexus injury?

Answer 9

1. Open
2. Closed
3. Radiation-induced
4. Obstetric

Question 10

How are closed brachial plexus injuries further classified?

Answer 10

a. Supraclavicular

b. Infraclavicular

Question 11

How are obstetric brachial plexus injuries further classified?

Answer 11

a. Upper
b. Lower
c. Mixed

Question 12

What is considered to be a high brachial plexus injury?

Answer 12

C5/6

Question 13

What does a high brachial plexus injury produce?

Answer 13

Erb’s palsy

Question 14

What happens in Erb’s palsy?

Answer 14

Abductors and external rotators are paralysed, producing Waiter’s tip position
Loss of sensation in C5/6 dermatomes

Question 15

What does a low brachial plexus injury produce?

Answer 15

Klumpke’s paralyssi

Question 16

What happens in Klumpke’s paralysis?

Answer 16

There is paralysis of the small hand muscles, producing claw hand
Loss of sensation in C8/T1 dermatomes