Shoulder & Brachial Plexus LO6
6. Predict the functional loss that may result from injury to upper or lower roots, cords, and/or terminal nerves.
Injuries to the brachial plexus affect sensation and movement of the upper limb, ie, anesthesia and paralysis. Signs and symptoms depend on what part of the plexus is injured. What would be affected if the upper part of the plexus was injured (C5 & C6) – Erb-Duchenne palsy? Remember, the upper parts of the plexus supply the more proximal upper limb. Or if the lower part was injured (C8 & T1) – Klumpke paralysis? Remember, lower part of the plexus supplies the more distal portion.
Erb-Duchenne palsy - injuries to the superior parts (C5 & C6) of the brachial plexus. The upper limb typically presents with an adducted shoulder (deltoid affected), medially rotated arm (rotator cuff mm. affected), pronated forearm (biceps brachii m. affected), and extended elbow (anterior compartment of arm affected).
Klumpke’s palsy - injuries to the inferior parts (C8 & T1) of the brachial plexus. These types of injuries are less frequent than those of the superior parts of the brachial plexus. Muscles of the hands are commonly affected (claw hand).