FN: Brachial Plexus Injuries

Question 1

Anatomy spinal levels

Answer 1

C5-T1

Question 2

Roots leave vertebral column between

Answer 2

Scalenus anterior and medius

Question 3

Divisions occur under

Answer 3

the clavicle, medial to coracoid process

Question 4

Plexus relation to blood vessels

Answer 4

Intimate relationship with subclavian and brachial arteries.

Median Nerve is formed anterior to brachial artery

Question 5

Causes of injury

Answer 5

Direct e.g. shoulder girdle fracture, penetrating or iatrogenic injury

Indirect e.g. avulsion or traction injuries

Question 6

Leffert Classification

Answer 6

1. Open
2. Closed: supraclavicular, infraclavicular
3. Radiation induced
4. Obstetric
   - upper
   - lower
   - mixed

Question 7

Erb’s Palsy

Answer 7

High (C5/C6)

• abductors and external rotators paralysed
• waiters tip position
• Loss of sensation in C5/6 dermatomes

Question 8

Klumpke’s Paralysis

Answer 8

Low (C8/T1)

• paralysis of small hand muscles
• Claw hand
• Loss of sensation in C8/T1 dermatomes (ulnar damage)