UT C6 C7 C8 T1 MT LT LC MC PC C5 Brachial plexus injuries Radiculopathy affects myotomes amp dermatomes Upper lesions of the brachial plexus Traction injuries affecting the upper roots C5 amp C6 ID: 920456
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Slide1
Nerve injuries of the upper limb
Slide2Slide3UT
C6
C7
C8
T1
MT
LT
LC
MC
PC
C5
Brachial plexus injuries= Radiculopathy (affects myotomes & dermatomes)
Slide4Upper lesions of the brachial plexus
Traction injuries
affecting the upper roots (C5 & C6)
Erb-Duchenne
palsy
- In Infants (Congenital)
In adults
(Acquired)
Slide5Affected nerves
Paralyzed
Result
Suprascapular (C5, C6)
Supraspinatus
Infraspinatus
-No Shoulder Abduction
-No Shoulder Lat. rotation
Axillary (C5, C6)
Deltoid
Teres minor
-Weak all shoulder movements except adduction
-No Shoulder Lat. rotation
Affected nerves
Paralyzed
Result
Long thoracic (C5, C6, C7)
- Most of Serratus ant.
- Winging of scapula
Musculocutaneous (C5,C6,C7)
- Arm elbow flexors
- Greatly weakened elbow flexion
Radial branch to supinator C5
- Supinator
- Forearm pronated
Wrist flexors (C6 myotome)
- Wrist flexion
-Weak wrist flexion
Slide6Affect
the C8 & T1 root distributed to the small muscles of the hand
Lower lesions of the brachial plexus (
Klumpke’s
Palsy)
Slide7Thoracic outlet syndrome (C8, T1)
Slide8Affected nerves
Paralyzed
Result
Median
- Wrist pronators
- Wrist flexors
- Thenar mm.
- Forearm supinated
- Wrist extended
- Thumb paralyzed
Ulnar
- Small muscles of the hand
- Fingers flexed &
clawd
Slide9Long thoracic nerve
injury: Winged scapula
Slide10Axillary nerve injury
CAN
CAN’T
Passive
30
O
Slide11Radial
nerve
Slide12Forearm injury: Supinator syndrome-Finger drop: (ECRL still functions)
Radial n.
Slide13Arm injury: Wrist drop (No fist)
Radial n.
Slide14Axilla injury: Elbow
flexed+Wrist
drop
Radial n.
Slide15Radial n. injury summary
Slide16Median nerve (C5-T1)
distribution
Slide17Sites of injury
Slide18Carpal tunnel syndrome
Median n.
Slide19Carpal tunnel syndrome
Median n.
Slide20Distal injury (CTS):
Extend fingers
Median claw
Median n.
Slide21Recurrent branch damage
Median n.
Slide22Proximal/Pronator syndrome
Make a fist
Benediction sign
Median n.
Slide23Median nerve injury summary
Slide24Ulnar nerve (C7-T1)
distribution
Slide25Ulnar nerve: sites of injury
Slide26Ulnar distal injury
Ulnar n.
Slide27Ulnar claw
Ulnar n.
Slide28Ulnar proximal injury
Ulnar n.
Slide29Ulnar nerve injury summary
Slide30Ulnar Paradox