Brachial plexus injuries

Question 1

Upper brachial plexus injury

What causes it?

What are the symptoms?

Answer 1

• excessive increase in angle between neck and shoulder (trauma, birth of baby if shoulders impacted in pelvis)
• Parasthesia at affected dermatome and paralysis at affected myotome

Question 2

Erb’s palsy

What is it?

What causes it?

What is the presentation?

Answer 2

• Upper brachial plexus root injury resulting in a waiter’s tip position
• Excessive traction applied to baby’s neck during birth with its shoulders impacted in pelvis
• medial rotation of limb, adducted arm, extended elbow

Question 3

Lower brachial plexus injury

What causes it?

When will this occur during birth?

What is ther term called?

What is symptom and presentation?

Answer 3

• hyperextension & hyperabduction of arm
• arm delivered first and traction applied to arm to deliver rest of body
• Klumpke’s palsy
• Claw Hand - hyperextension of all metacarpophalangeal joints, flexion of interphalangeal joints, abduction of thumb, wasting of interossei