Brachial plexus lesions

Question 1

Erb’s Palsy: injury

Answer 1

Traction or tear of upper trunk: C5-C6 roots

Question 2

Erb’s Palsy: causes infants

Answer 2

Lateral traction neck during delivery

Question 3

Erb’s Palsy: causes adults

Answer 3

Trauma leading to neck traction (e.g. falling on head/shoulder in motorcycle accident)

Question 4

Erb’s Palsy: muscle deficit

Answer 4

Deltoid, supraspinates, infraspinatus, biceps brachii

Question 5

Erb’s Palsy: presentation

Answer 5

Arm hangs by side, medially rotated, arm extended and pronated (waiter’s tip)

Question 6

Klumpke palsy: injury

Answer 6

Traction or tear of lower trunk: C8-T1 roots

Question 7

Klumpke palsy: causes children

Answer 7

Upward force arm during delivery

Question 8

Klumpke palsy: causes adults

Answer 8

Trauma (e.g. grabbing tree branch to break a fall)

Question 9

Klumpke palsy: muscle deficit

Answer 9

Intrinsic hand muscles

Question 10

Klumpke palsy: presentation

Answer 10

Claw hand

Question 11

Thoracic outlet syndrome: injury

Answer 11

Compression lower trunk (C8-T1) and subclavian vessels, most commonly within scalene triangle

Question 12

Thoracic outlet syndrome: causes

Answer 12

Cervical first rib, Pancoast tumor

Question 13

Thoracic outlet syndrom: muscle deficit

Answer 13

Intrinsic hand muscles

Question 14

Thoracic outlet syndrome: functional deficit

Answer 14

Atrophy of intrinsic hand muscle
Ischemia, pain and edema due to vascular compression

Question 15

Winged scapula: injury

Answer 15

Lesion of long thoracic nerve: roots C5-C7

Question 16

Winged scapula: causes

Answer 16

Axillary node dissection after mastectomy
Stab wounds

Question 17

Winged scapula: muscle deficit

Answer 17

Serratus anterior

Question 18

Winged scapula: functional deficit

Answer 18

Inability to anchor scapula to thoracic cage: cannot abduct arm above horizontal position