Transcript Brachial Plexus

Brachial Plexus
Dr. Sama-ul-Haque
Objectives
 Know the formation (root value) of brachial
plexus.
 Understand the relations of brachial plexus.
 Know the divisions, cords and branches of the
brachial plexus.
 Understand the mechanism of injury to the
brachial plexus and enlist the clinical features.
Spinal Nerve
Location of Brachial plexus
Relations of Brachial plexus
Relations of Brachial plexus
Brachial Plexus
Relation with Axillary Artery
Postfixed Brachial Plexus
Brachial Plexus Injuries
• In Infants:
During Difficult Delivery:
Brachial Plexus Injuries
• In Adults:
• Sports most commonly associated:
Football, baseball, basketball,
volleyball, wrestling, and
gymnastics.
• Nerve injuries can result from:
Blunt force trauma, poor posture or
chronic repetitive stress.
Brachial Plexus Injuries
• Patients generally present with
pain and/or muscle weakness.
• Some patients may experience
muscle atrophy.
Brachial Plexus Injuries
Result:
 Anesthesia
 Paralysis
1. Complete
2. Incomplete
Erb- Duchenne palsy
Injury to Superior part of Plexus.
Occurrence:
Due to excessive increase in the angle
between neck and the shoulder.
Roots Involved:
 C5 and C6
Muscles Involved:
 Shoulder
 Arm
Vacuum Extractor delivery
Forceps delivery
Falling on
Shoulder
Excessive Stretching
Direct Blow
Erb- Duchenne palsy
Clinical Appearance:
Motor Loss:
 Adducted Shoulder
 Medially Rotated Arm
 Extended Elbow
Sensory Loss:
 Lateral aspect of Upper Limb
klumpke paralysis or Palsy
Injury to Inferior part of Plexus.
Occurrence:
Excessive abduction of arm.
Less common then Injury to Superior part of
Plexus.
Roots Involved:
 C8 and T1
klumpke paralysis or Palsy
Clinical Appearance:
Motor Loss:
 Small muscles of Hand
Sensory Loss:
 Medial aspect of Upper Limb
Person grasping something to prevent a fall
Baby’s upper limb is pulled excessively during
delivery
Claw Hand
Claw
Hand
Cervical
Rib
Involves
Inferior part
of Plexus
What is
Waiter’s tip or
Porter’s tip
position?
Thank You