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Brachial plexus injury
From WikEM
Contents
Background
- Injuries can be penetrating, compression, or closed traction:
- Supraclavicular (roots and trunks)
- Infraclavicular (cords and terminal nerves)
Anatomy[1]
- Roots:
- C4
- C5
- C6
- C7
- T1
- Trunks:
- Upper
- Middle
- Lower
- Cords:
- Lateral
- Posterior
- Medial
- Terminal Nerves:
- Musculocutaneous
- Median
- Axillary
- Radial
- Ulnar
Clinical Features
- Arm pain (constant, burning)
- C5 injury:
- weakness of deltoid and infraspinatus causes adducted, internally rotated shoulder
- C6 injury:
- weakness of biceps causes elbow extension
- C7 injury:
- weakness of extensor muscles causes wrist and digit flexion
Differential Diagnosis
Evaluation
- Clinically evaluate for concurrent phrenic nerve injury and diaphragmatic paresis
- MRI
- CT myelography
- EMG
- Surgical exploration
Management
- Early neurosurgical consultation
- PT / OT
Disposition
See Also
External Links
References
- ↑ Tintinalli. Emergency Medicine. 7th Edition, 2011.