Brachial Plexus
Dr. Sama-ul-Haque
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.
Objectives
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 InjuriesResult:
Anesthesia Paralysis
1. Complete 2. Incomplete
Erb- Duchenne palsyInjury to Superior part of Plexus.Occurrence: Due to excessive increase in the angle between neck and the shoulder.Roots Involved:
C5 and C6Muscles 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 ofPlexus. 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