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