BRACHIAL PLEXUS INJURY

 The brachial injury is formed(TERBENTUK) by the confluence of nerve roots from C5 to T1.
 The plexus, as it passes from the cervical spine between the muscles of the neck and
beneath the clavicle en route to the arm, is vulnerable(RENTAN) either a stab wound or
severe traction caused by a fall on the side of the neck or the shoulder
 An important distinction is made between preganglionic lesion and post ganglionic lesion
o Pre ganglionic : avulsion of nerve root from the spinal cord, disruption proximal to
the dorsal root ganglion; this cannot recover and operation irreparable
 Crushing or burning pain in an anasthetic hand
 Paralysis of scapular muscles or diaphragma
 Horner syndrome ( ptosis,myosis,enopthalmus, anhidrosis)
 Severe vascular injury
 Associated fractures of the cervical spine
 Spinal cord dysfunction
o Post ganglionic : rupture of a nerve root distal to the ganglion , or of a trunk or
peripheral nerve;which is surgically reparable and potentially capable of recovery

5 roots : C5,C6,C7,C8,T1
3 trunks :superior trunk, middle trunk, inferior trunk
6 division : anterior (flexor)& posterior(extensor) each trunk
3 cord : lateral, middle, posterior
level motor reflex sensory clinically
C5 deltoid biceps Lateral shoulder Shoulder abduction
Shoulder extension
Shoulder extenal rotation
Some elbow flexion
C6 biceps brachioradialis thumb Elbow flexion
Forearm pronation
Forearm supination
Some wrist extension
C7 Triceps Triceps Middle finger Diffuse loss of function in the
extremity without complete
paralysis of a spesific muscle
group
Elbow extension
 Consistently the latissimus dorsi
C8 Introssei finger - Ring & small finger Finger extensors
Finger flexors
Wrist flexors
Hand intrinsic
T1 abduction Ulnar forearm&hand Hand intrinsic