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BrachPlexus Injuries
Brachial Plexus Injuries
| Nerve | Type of injury | Symptom or sign | muscle damage |
|---|---|---|---|
| Axillary nerve | fracture of surgical head of humerus or Dislocation of shoulder joint | Abduction of arm to horizontal position is compromised | Paralysis of deltoid muscle |
| Axillary nerve | fracture of the surgical head of the humerus or dislocation ot the shoulder joint | weakened lateral rotation of the arm; deltoid paralysis | teres minor muscle |
| Axillary nerve | fracture of the surgical head of the humerus or dislocation ot the shoulder joint | "Patch sign"- loss of sensation on lateral side of upper arm | (blank) |
| Long thorasic nerve | stab wound or removal of lymph nodes during a mastectomy | Abduction of the arm past the horizontal position is impaired, and pt can't use arm to PUSH | serratus anterior muscle |
| Long thorasic nerve | stab wound or removal of lymph nodes during a mastectomy | "winged scapula" | serratus anterior muscle |
| Musculocutaneous nerve (upper trunk - C5-C6) | Violent stretch between head and shoulder | "waiter's tip", arm is medially rotated and pronated; Erb Duchenne | biceps brachii brachialis |
| Suprascapular nerve (upper trunk - C5-C6) | Violent stretch between head and shoulder | "waiter's tip", arm is medially rotated and pronated; Erb Duchenne | Infraspinatus muscle |
| Axillary nerve (upper trunk - C5-C6) | Violent stretch between head and shoulder | "waiter's tip", arm is medially rotated and pronated; Erb Duchenne | Teres minor muscle |
| Median nerve (lower trunk - C8-T1) | Sudden pull upward on arm | "claw and", loss of function of the hand and wrist; Klumpke's | Muscles of the hand and wrist |
| Ulnar nerve (lower trunk - C8-T1) | Sudden pull upward on arm | "claw and", loss of function of the hand and wrist; Klumpke's | Muscles of the hand and wrist |
| (posterior Cord- C5-T1) | (blank) | Wrist drop | (blank) |
| Radial nerve (Posterior cord -C5-T1) | Fractur of the humerus at the midshaft or badly fitted crutches | "Saturday night palsy", Can't extend wrist and digits and no supination. | paralysis of mms in extensor compartment of the forearm |
| Radial nerve (Posterior cord -C5-T1) | Fractur of the humerus at the midshaft or badly fitted crutches | sensory loss at posterior arm, posterior forearm, and lateral aspect of the dorsum of the arm "snuff box". | (blank) |
| Radial nerve (Posterior cord -C5-T1) | Fractur of the humerus at the midshaft or badly fitted crutches | "wrist drop" | paralysis of mms in extensor compartment of the forearm |
| Median nerve injury at elbow or axilla(Median cord- C5-T1) | Suracondylar fracture of the humerus | lost thumb movement | paralysis of abductor pollicis brevis, opponens pollicis and flexor pollicis brevis |
| Median nerve injury at elbow or axilla(Median cord- C5-T1) | Suracondylar fracture of the humerus | weakened flexion of the wrist, lost pronation and flexion of digits | mms in flexor compartment |
| Median nerve injury at elbow or axilla(Median cord- C5-T1) | Suracondylar fracture of the humerus | "Pope's blessing" or "ape's sign", flattening of thenar eminence | mms in flexor compartment |
| Median nerve injury at elbow or axilla(Median cord- C5-T1) | Suracondylar fracture of the humerus | sensory loss on the palmer and dorsal aspects of the index, middle and half of the ring fingers and the palmer aspect of the thumb | (blank) |
| Median nerve injury at the wrist (Median cord- C5-T1) | Slashing of the wrist or Carpal tunnel syndrome | Normal flexion of wrist and digits, and normal pronation | No paralysis of mms of flexor compartment |
| Median nerve injury at the wrist (Median cord- C5-T1) | Slashing of the wrist or Carpal tunnel syndrome | lost thumb movement | paralysis of abductor pollicis brevis, opponens pollicis and flexor pollicis brevis |
| Median nerve injury at the wrist (Median cord- C5-T1) | Slashing of the wrist or Carpal tunnel syndrome | "Pope's blessing" or "ape's sign", flattening of thenar eminence | (blank) |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | Deviation of the hand to the radial side, at the wrist joint | paralysis of flexor carpi ulnaris mm |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | "claw hand", lost flesion of the ring and little finger at the DIP joint | paralysis of the medial part of flexor digitorum profundus mm |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | lost flexion of ring and little finger at the MCP joint | paralysis of the lumbricles 3 and 4 |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | lost abduction and adduction of the fingers | paralysis of the palmer and dorsal interosseous mm |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | adduction of the thumb is lost | paralysis of the adductor pollicis mm |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | lost abduction, flexion and opposition of the little finger | paralysis of adductor pollicis mm |
| Ulnar nerve injury at the elbow or axilla (median cord C8-T1) | fracture of the medial epicondyle of the humerus | sensory loss on the palmer and dorsal aspects of the little finger and half of the ring finger | (blank) |
| Ulnar nerve injury at the wrist (median cord C8-T1) | Slashing the wrists | No wrist deviation toward ulnar side and NO problems with felxion of of ring and little finger at DIP joint | No paralysis of flexor carpi ulnaris or medial part of the flexor digitorum profundus mm |
| Ulnar nerve injury at the wrist (median cord C8-T1) | Slashing the wrists | lost flexion of ring and little finger at the MCP joint, with hyperextension at joint b/c extensor mm are intact | paralysis of the lumbricles 3 and 4 |
| Ulnar nerve injury at the wrist (median cord C8-T1) | Slashing the wrists | adduction of the thumb is lost | paralysis of the adductor pollicis mm |
| Ulnar nerve injury at wrist (median cord C8-T1) | Slashing of the wrists | adduction of the thum is lost | paralysis of adductor pollicis mm |
| Ulnar nerve injury at wrist (median cord C8-T1) | Slashing of the wrists | abduction and adduction of fingers is lost | palmer and dorsal interosseous mms |
| Ulnar nerve injury at wrist (median cord C8-T1) | Slashing of the wrists | abduction, flextion, and opposition of the little finger are lost | abductor digiti minimi, flexor digiti minimi and opponens digitiminimi mms |
| Ulnar nerve injury at wrist (median cord C8-T1) | Slashing of the wrists | palmer and dorsal aspects of the little finger and half the ring finger | (blank) |
| Ulnar nerve injury at wrist (median cord C8-T1) | Slashing of the wrists | "claw hand", yet not as severe as with lesion at the elbow | (blank) |
| Musculocutaneous nerve (lateral cord- C5-C7) | (blank) | Difficulty flexing elbow, and variable sensory loss | Paralysis of coracobrachialis, biceps and brachialis mm ( biceps reflex) |
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