Common Problems of the Brachial Plexus

Question 1

Outline a long thoracic nerve injury

Answer 1

innervates serratus anterior = hold scapular against chest wall

damage = winged scapula

make pt push against wall to visualise

Question 2

Outline a musculocutaneous nerve injury

Answer 2

cause = upper brachial plexus injury, axilla wound

paralysis of biceps

sensory loss of lateral forearm

Question 3

Outline an axillary nerve injury

Answer 3

runs posterior to humeral head

cause = shoulder dislocation, fracture surgical neck

sensory loss regimental badge

Question 4

Outline Erbs palsy

Answer 4

angle between arm and neck forcibly widens

upper trunk injury

presentation = waiters tip (musculotaneous, axillary damage)

Question 5

Outline a median nerve injury

Answer 5

cause = supracondylar fracture (elbow), wrist laceration

hand of benediction

loss of sensation lateral 3.5 digits

Question 6

Outline ulnar nerve injury

Answer 6

causes = medial epicondyle fracture, wrist damage, lower brachial plexus injury

presentation = ulnar claw hand - ulnar paradox

sensory loss medial 1.5 digits

Question 7

Outline Klumpkes palsy

Answer 7

angle betwen arm and chest wall forcibly widens

lower trunk injury

presentation = claw hand

Question 8

Outline radial nerve injury

Answer 8

runs in radial groove along humerus

cause = fracture of shaft

presentation = wrist drop (paralysis of extensor compartment)

sensory loss anatomical snuffbox