brachial plexus

Question 1

when a fall forces the shoulder down and the head to the opposite side, what injury can result?

Answer 1

upper-trunk palsy (erb-duchenne)

Question 2

when the angle btw the arm and the chest wall forcibly widens, what injury can result?

Answer 2

lower-trunk palsy (arm and shoulder forced upward, increasing angle btw arm and chest)

Question 3

what are the physical manifestations of lower brachial plexus injury?

Answer 3

typically maintain shoulder and elbow strength, but will lose hand function

• over time, will cause fingers to contract into claw position, so pt won’t be able to perform fine motor tasks
• also typically have numbness in at least the ring and small fingers

Question 4

classic erb duchenne palsy manifestation

Answer 4

waiter tip - combination lesions of axillary, suprascapular, msc nn w loss of shoulder mm and anterior arm

Question 5

what are the hallmarks of the waiter’s tip hand that describes Erb’s palsy?

Answer 5

adducted shoulder 
medially rotated arm 
extended elbow
wrist flexed
loss of sensation in the lateral aspect of the upper limb