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THEIR LESIONS
DR TATHEER ZAHRA
ASSISTANT PROFESSOR ANATOMY
NERVE SUPPLY OF UPPER LIMB
MOTOR
SENSORY
AUTONOMIC
DERMATOMES
(FOERSTER, 1933)
(GARRETT, 1948)
BRACHIAL PLEXUS
SURGICAL APPROACH
TYPES OF NERVE LESIONS
COMPRESSION
STRETCH
SECTION
BRACHIAL PLEXOPATHY
Can refer to involvement
of the entire plexus, or
parts of the plexus
Trunk lesion
Cord lesion
Distribution of weakness
and numbness depends
upon the part of the
plexus affected
PATTERN OF INJURY
B: BRACHIAL PLEXUS
INJURIES:
Incomplete paralysis
Complete paralysis
Erb-Duchenne palsy
Backpackers palsy
Klumpke paralysis
Affection of:
1- Most of the small muscles of the hand (T1)
2- Ulnar flexors of the flexor compartment of forearm are partially
affected (C8)
BRACHIAL PLEXUS BLOCK
INJURY TO NERVE ROOTS &
BRANCHES
INJURY TO DORSAL SCAPULAR
NERVE
LONG THORACIC NERVE INJURY
WINGING OF
SCAPULA
INJURY TO CORDS & TERMINAL
BRANCHES
THORACODORSAL NERVE
INJURY
INJURY TO AXILLARY NERVE
Anterior
Shoulder Dislocation
Dislocated Head
Normal Head
Waisting of shoulder
Winging of the Scapula
Extended
Adducted and index and
extended middle
thumb
Flat thenar
eminence
1- Week flexion
2- Loss of adduction
3- Inability to adduct thumb
4- Inability to put the hand in writing position
- Sensory loss
- Partial claw hand deformity
B - Above Wrist:
1- No Week flexion
2- No Loss of adduction
3- Inability to adduct thumb
4- Inability to put the hand in writing position
Treatment
Anti-inflammatory medications
Wrist splints
Therapeutic exercises
An inability to oppose the thumb to the little
finger can result from damage to the
________ nerve.
a) Axillary
b) Musculocutaneous
c) Radial
d) Ulnar
e) Median
Hyperextension of the proximal phalanges of
the little and ring fingers can result from
damage to the ________ nerve.
a) Ulnar
b) Axillary
c) Radial
d) Median
e) Musculocutaneous
Wrist drop can result from damage to the
________ nerve.
a) Median
b) Ulnar
c) Radial
d) Anterior interosseous
e) Axillary
REFERENCES
Cinical Anatomy By Regions, By RICHARD S.
SNELL, 8th edition