BRACHIAL PLEXUS LESIONS-CHART 1 Nerve ( Segment) Motor Deficit(s) Long Thoracic (C 5,6,7) Suprascapular (C 5,6 ) axillary (C 5,6) Winged Scapulaserratus Anterior Hard to start shoulder abduction - Supraspinatus Difficult abducting arm to horizontal - Deltoid Musculocutaneous Very weak flexion of elbow C 5,6,(7)
BRACHIAL PLEXUS LESIONS-CHART 1 Nerve ( Segment) Motor Deficit(s) Long Thoracic (C 5,6,7) Suprascapular (C 5,6 ) axillary (C 5,6) Winged Scapulaserratus Anterior Hard to start shoulder abduction - Supraspinatus Difficult abducting arm to horizontal - Deltoid Musculocutaneous Very weak flexion of elbow C 5,6,(7)
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BRACHIAL PLEXUS LESIONS-CHART 1 Nerve ( Segment) Motor Deficit(s) Long Thoracic (C 5,6,7) Suprascapular (C 5,6 ) axillary (C 5,6) Winged Scapulaserratus Anterior Hard to start shoulder abduction - Supraspinatus Difficult abducting arm to horizontal - Deltoid Musculocutaneous Very weak flexion of elbow C 5,6,(7)
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Nerve ( Segment) Motor Deficit(s) Sensory Deficits
Long Thoracic Winged Scapula- Serratus None (C 5,6,7) Anterior Suprascapular Hard to start shoulder None (C 5,6 ) abduction - Supraspinatus Axillary (C 5,6 ) Difficult abducting arm to Lateral side of horizontal - Deltoid arm below point Loss of shoulder roundness - of shoulder Deltoid
Musculocutaneous Very weak flexion of elbow Lateral forearm
C 5,6,(7) joint- Biceps & Brachialis Weak supination of radioulnar joint -Biceps
radialis longus & brevis, Ext. &arm; dorsum carpi ulnaris of hand Difficulty making a fist - synergy between wrist extensors and finger flexors
Median C 5 - T1) Pronation of radioulnar joints- Radial portion of
at Elbow Pronator teres & quadratus palm; palmar Weak wrist flexion - Fl. carpi surface & tips of radialis radial 31/2 digits Weakened opposition of thumb - thenar muscles “Ape Hand”- thumb hyper extended and adducted - thenar muscles “Papal Hand” Loss of flexion of I.P. joints of thumb & fingers 1 & 2 - Fl. pollices longus ; Fl. digit. superficialis, Fl. digit profundus
Median (C 5 - T1) Weakened opposition of Palmar surface
at Wrist thumb - thenar muscles & tips of radial “Ape Hand”- thumb hyper 31/2 digits extended and adducted - thenar muscles
Ulnar (C 8, T1) at “Clawing” of fingers 3 & 4- Ulnar and dorsal
Elbow M.P. joints hyper extended; aspect of palm P.I.P. Flexed - Interossei & and of ulnar 1 Lumbricals 1/2 digits Loss of abduction & adduction of M.P joints of fingers -Interossei Thumb - abducted and extended - adductor pollices Loss of flexion of D.I.P. joints of fingers 4 & 5 - Fl. digit profund.
Ulnar (C 8, T1) at “Clawing” of fingers 3 & 4- Ulnar and dorsal
Wrist M.P. joints hyper extended; aspect of palm P.I.P. Flexed - Interossei & and of ulnar 1 Lumbricals 1/2 digits Loss of abduction & adduction of M.P joints of fingers - Interossei Thumb - abducted and extended - adductor pollices
UPPER AND LOWER ROOT LESIONS- CHART 2
Motor Lesion Sensory Deficits Nerves Deficits Erb’s Loss of Posterior and lateral Axillary, Palsy (C abduction, aspect of arm - Suprascapular, 5,6 ) flexion and axillary n. Upper and Lower rotation at subscapular shoulder ; Weak shoulder extension - deltoid, rotator cuff Very weak Radial side of Musculocutaneous ; elbow flexion Forearm- Radial N. brs. to and supination musculocutaneous supinator & of radioulnar n. Thumb and 1st brachioradialis joint - biceps finger - superficial muscles brachii & br. of radial; digital brachialis brs. - Median n. Susceptible to Suprascapular, shoulder Upper and Lower dislocation - subscapular loss of rotator cuff muscles “Waiters Tip”position Klumke’s Loss of Ulnar side of Thenar branch of Palsy (C8, opposition of forearm , hand & & Median nerve T1 ) thumb ulnar 1 1/2 & digits -Thenar - ulnar and medial muscles antebrachial cutaneous Loss of Ulnar nerve adduction of thumb - Adductor pollices Loss of Deep branch of following Ulnar & Median finger movements: abduction and adduction of M.P. joints ; flexion at M.P. & extension of I.P.joints. Lumbricals & interossei Very weak Ulnar and Median flexion of P.I.P.& D.I.P. joints Fl. Digit. Super. & Profund.