Brachial Plexus Injuries

Question 1

What roots are most commonly involved in a traumatic brachial plexus injury?

Answer 1

All roots (70-75%); also can have:
C5 and C6 (Erb’s Palsy); 20-25%
C8 and T1 (Klumpke’s palsy); 0.6-3.0%

Question 2

What is the most common mechanism of a traumatic brachial plexus injury?

Answer 2

High speed MVC; mostly motorcycles (85%)
caudally forced shoulder can affect upper roots
Traction of abducted shoulder can affect lower roots

Question 3

What is indicative of nerve degeneration on EMG?

Answer 3

Fibrillations

Question 4

What can testing the serratus anterior and rhomboids tell you about a C5 nerve injury?

Answer 4

If it is preganglionic (root avulsion; CNS) vs post ganglionic (PNS)

Question 5

What is the best clinical sign of effective nerve regeneration?

Answer 5

Advancing tinel sign

Question 6

The posterior cord of the brachial plexus gives rise to what nerves?

Answer 6

1) upper subscapular nerve
2) lower subscapular nerve
3) thoracodorsal nerve
4) axillary nerves
5) radial nerve