Brachial Plexus Injuries: Erb’s & Klumpke’s Palsy скачать в хорошем качестве

Brachial Plexus Injuries: Erb’s & Klumpke’s Palsy

Join this channel to support the channel    / @nabilebraheim   Brachial Plexus Injuries: Erb’s & Klumpke’s Palsy The spinal nerves of C5 to T1 are referred to as the roots of the brachial plexus. Erb’s Palsy and Erb’s Point Pressure over the red-marked area in the video elicits Duchenne–Erb paralysis. Injury to Erb’s point commonly occurs at birth or from a fall onto the shoulder. Erb’s palsy results from brachial plexus lesions involving the C5 and partly C6 nerve roots. Symptoms of Erb’s Palsy: Paralysis of the following muscles: Biceps, brachialis, coracobrachialis (via the musculocutaneous nerve) Brachioradialis (via the radial nerve) Deltoid (via the axillary nerve) Functional Deficits: Impaired shoulder abduction Loss of external rotation Weak elbow flexion Decreased sensation in the thumb and index finger Normal scapular control Obstetric Brachial Plexus Injuries 1. Erb’s Palsy (C5-C6 Lesion, sometimes C7) Most common birth-related neuropraxia (about 48% of cases) Best prognosis among brachial plexus birth injuries Paralysis of: Shoulder external rotation (ER) Shoulder abductors Biceps ("Waiter’s Tip" posture) Common risk factors: Large babies Shoulder dystocia Forceps delivery Breech birth Prolonged labor Recovery rate: 80%-90% of affected children achieve normal or near-normal function → Follow the recovery of the biceps. Persistent Horner’s sign (ptosis, miosis, anhidrosis) indicates a proximal preganglionic injury and suggests a poor prognosis. 2. Klumpke’s Paralysis (C8-T1, sometimes C7 involvement) Caused by forceful shoulder abduction Weakness in: Intrinsic hand muscles Long flexors and extensors of the fingers These lesions are usually preganglionic Look for associated Horner’s syndrome Sensory deficit along the medial aspect of the arm, forearm, and hand 3. Pan-Plexus Paralysis (C5-T1, Complete Injury) Flaccid arm Involves both motor and sensory loss Worst prognosis QUIZZES 1. Which spinal nerve roots form the brachial plexus? A. C1 to C5 B. C3 to C7 C. C5 to T1 ✅ D. C6 to T2 Explanation: The brachial plexus originates from the ventral rami of C5 to T1 spinal nerves. 2. What is the most common cause of Erb’s palsy? A. Direct trauma to the shoulder B. Injury at birth, especially with shoulder dystocia ✅ C. Cervical spine fractures D. Blunt force trauma to the clavicle Explanation: Erb’s palsy is commonly caused by excessive lateral traction on the neck during delivery, especially in shoulder dystocia. 3. Which muscles are affected in Erb’s palsy? A. Biceps, deltoid, brachioradialis ✅ B. Triceps, pectoralis major, rhomboids C. Flexor carpi ulnaris, lumbricals, interossei D. Trapezius, latissimus dorsi, serratus anterior Explanation: Erb’s palsy results from C5-C6 injury, affecting muscles supplied by the musculocutaneous, radial, and axillary nerves. 4. What is the characteristic arm posture seen in Erb’s palsy? A. Flexed elbow with supinated forearm B. Extended elbow with pronated forearm and wrist flexion ✅ C. Shoulder adduction with internal rotation D. Hyperextended elbow with wrist drop Explanation: Erb’s palsy presents as a "Waiter’s Tip" posture, where the shoulder is adducted and internally rotated, the elbow is extended, the forearm is pronated, and the wrist is slightly flexed. 5. Which nerve is primarily responsible for elbow flexion? A. Axillary nerve B. Musculocutaneous nerve ✅ C. Radial nerve D. Ulnar nerve Explanation: The musculocutaneous nerve innervates the biceps and brachialis, which are responsible for elbow flexion. 6. Which condition is associated with a "claw hand" deformity? A. Erb’s palsy B. Klumpke’s palsy ✅ C. Radial nerve injury D. Median nerve injury Explanation: Klumpke’s palsy (C8-T1 injury) affects the intrinsic hand muscles, leading to a claw hand deformity. 7. Which sensory distribution is affected in Klumpke’s palsy? A. Lateral arm and forearm B. Medial arm, forearm, and hand ✅ C. Posterior shoulder and upper arm D. Radial side of the hand and forearm Explanation: C8-T1 injuries affect the medial arm, forearm, and hand. 8. What additional sign may indicate a preganglionic brachial plexus injury? A. Horner’s syndrome ✅ B. Radial deviation of the wrist C. Scapular winging D. Wrist drop Explanation: Horner’s syndrome (ptosis, miosis, anhidrosis) suggests a proximal preganglionic lesion, often seen in severe brachial plexus injuries. 9. Which injury carries the worst prognosis among brachial plexus lesions? A. Erb’s palsy B. Klumpke’s palsy C. Pan-plexus paralysis ✅ D. Radial nerve compression Explanation: Pan-plexus paralysis (C5-T1 injury) results in complete motor and sensory loss, with poor recovery potential. 10. What is the primary function of the deltoid muscle? A. Shoulder abduction ✅ B. Shoulder external rotation C. Elbow extension D. Wrist supination Explanation: The axillary nerve innervates the deltoid, which is responsible for shoulder abduction