NERVESOFUPPERLIMBANDTHEIRINJURIES.docVIP

NERVES OF UPPER LIMB AND THEIR INJURIES LEARNING OBJECTIVES Revise the course and branches of nerves of upper limbs Understand Injuries associated with these nerves Know causes and motor and sensory loss associated with nerve injuries of upper limb Know deformities associated with these nerves BRACHIAL PLEXUS Present in neck and axilla Formed by ventral primary rami of C5-T1 ROOTS C5+C6=UPPERTRUNK C7----( MIDDLE TRUNK C8+T1 = LOWER TRUNK All trunk divides into anterior and posterior DIVISIONS Anterior divisions of upper and middle trunk unite to form LATERAL CORD Anterior division of middle trunk continues as MEDIAL CORD Posterior divisions of all 3 trunk form POSTERIOR CORD BRANCHES FROM ROOTS TRUNKS ROOTS: Dorsal scapular nerve C5, Long thoracic nerve C5,6,7 UPPER TRUNK C5 C6 Suprascapular nerve , Nerve to subclavius BRANCHES FROM LATERAL CORD Lateral pectoral nerve Musculocutaneous nerve Lateral root of median BRANCHES FROM MEDIAL CORD Medial pectoral nerve Medial cutaneous nerve of arm and forearm Ulnar nerve Medial root of median BRANCHES FROM POSTERIOR CORD Upper and lower subscapular nerves Thoracodorsal Axillary nerve Radial nerve BRACHIAL PLEXUS INJURIES Upper lesions of brachial plexus Erb duchenne palsy Lower lesions of brachial plexus Klumpke palsy UPPER LESION OF BRACHIAL PLEXUS Traction or even tearing of C5 and C6 root Cause: Excessive displacement of head to opposite side and depression of shoulder on same side In infants during a difficult delivery In adults following a fall on or a blow to the shoulder Nerves involved: Supra scapular nerve, Nerve to Subclavius Musculocutaneous nerve ,Axillary nerve MUSCLES AND FUNCTIONS LOST Lateral rotation of arm: Teres minor Infraspinatus Abduction of shoulder Supraspinatus Deltoid Flexion of shoulder: corobrachialis Biceps brachii Flexion of elbow: Brachialis Biceps brachii Supination of forearm Biceps brachii ERB’S PALSY