Brachial Plexus and Nerve Lesions Flashcards
What does Randy Travis Drinks Cold Beer mean?
Roots Trunks Divisions Cords Branches
Spinal levels in upper trunk
C5-C6
Spinal levels in Middle Trunk
C7
Spinal levels in Lower Trunk
C8-T1
Spinal levels in posterior cord
C5-T1
Spinal levels in musculocutaneous nerve
C5-C7
Spinal levels in Median nerve
C5-T1
Spinal levels in Ulnar nerve
C8-T1
What nerves branch off the posterior cord?
axillary and radial
Injury to upper trunk.
Erb palsy (waiter’s tip)
Injury to lower trunk
Klumpke palsy (claw hand)
Injury to posterior cord
Wrist drop
Injury to Axillary nerve
Deltoid paralysis
Injury to Radial nerve
“Saturday night palsy” (wrist drop)
Injury to Musculocutaneous Nerve
Problems flexing elbow
Damage to median nerve
“Pope’s blessing” (decreased thumb function)
Damage to Ulnar nerve
Claw hand
Damage to long thoracic nerve
winged scapula
What causes “waiter’s tip” in Erb palsy?
Deficits in:
- Deltoid/supraspinatus (so arm is ADDucted)
- Infraspinatus (so arm is MEDIALY rotated)
- Biceps brachii (arm extended and pronated)
What injuries cause Klumpke palsy?
- Infants (upward force on arm during delivery)
- Adults (grabbing tree branch while falling)
What causes the claw hand in Klumpke palsy?
deficits in intrinsic hand muscles (no lumbricles, so MCPs are extended and DIPs/PIPs are flexed)
What injuries cause thoracic outlet syndrome?
-Pancoast tumor
What is the deficit in thoracic outlet syndrome?
compression of lower trunk and subclavian vessels (give same deficits as Klumpke palsy with atrophy of intrinsic hand muscles and pain from vascular compression)
What injury leads to Winged scapula?
- Axillary node dissection after mastectomy
- Stab wounds
Why does your scapula “wing” with thoracic nerve injury?
Inability of the serratus anterior to anchor scapula to thoracic cage (and cannot abduct arm above horizontal plane)
What injuries affect the axillary nerve?
- Fractured surgical neck of humerus
- Anterior dislocation of humerus