Brachial plexus (clinical)

Question 1

Which nerve roots are damaged in Erb’s Palsy?

Answer 1

C5 and C6 upper root/trunk damage

Question 2

What can cause Erb’s palsy?

Answer 2

Forced separation of neck from shoulder
Stab wound/laceration to the neck
CBL case: fall off bike OR during birth (forceps injury)

Question 3

What will the patient present with in Erb’s palsy?

Answer 3

Waiter’s tip appearance

Limb is medially rotate, pronated and hangs limp

Question 4

What nerve roots are damaged in Klumpke’s palsy?

Answer 4

C8 and T1 lower root damage/compression

Question 5

A patient has come in to AandE, they have fallen off from the top of a tree and tried to grab onto something to stop falling (upper limb traction) and hence have a traction injury. What type of palsy do you suspect?

Answer 5

Klumpke’s palsy - C8 and T1 root damage
Can also be caused due to cancer at lung apex
Also can be compressed via cervical rib

Question 6

What physical signs will you notice in a patient with Klumpke’s palsy?

Answer 6

The resting position of the hand will be like a claw

‘Claw hand deformity’