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A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5–C8), and first thoracic (T1) spinal nerves, and innervate the ...
Erb's palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5–C6 nerves. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5–C8 and thoracic nerve T1.
Injury to Erb's point is commonly sustained at birth or from a fall onto the shoulder.The nerve roots normally involved are C5 and partly C6. Symptoms include paralysis of the biceps, brachialis, and coracobrachialis (through the musculocutaneous nerve); the brachioradialis (through the radial nerve); and the deltoid (through the axillary nerve).
Lower brachial plexus injuries should be distinguished from upper brachial plexus injuries, which can also result from birth trauma but give a different syndrome of weakness known as Erb's palsy. Other trauma, such as motorcycle accidents, that have similar spinal cord injuries to C8 and T1, also show the same symptoms of Klumpke's paralysis.
The three main mechanisms of a stinger include receiving direct blows, extension, and compression of the brachial plexus, with most of the brachial plexus injuries being an extension-compression mechanism. A stinger is an injury that is caused by restriction of the nerve supply to the upper extremity via the brachial plexus. The brachial plexus ...
While chronic progressive brachial monoplegia is uncommon, syringomyelia and tumors of the cervical cord or brachial plexus may be the cause. The onset of brachial plexus paralysis is usually explosive where pain is the initial feature. Pain localizes to the shoulder but may be more diffuse, or could be limited to the lower arm.
The musculocutaneous nerve is a mixed branch of the lateral cord of the brachial plexus derived from cervical spinal nerves C5-C7. It arises opposite the lower border of the pectoralis minor . [ 1 ] It provides motor innervation to the muscles of the anterior compartment of the arm : the coracobrachialis , biceps brachii , and brachialis . [ 2 ]
PMS results from the brachial plexus being compressed under the pectoralis minor [2] while TOS involves compression of the bundle above the clavicle. In most patients, the nerves are constricted resulting in neurogenic PMS, but venous compression (venous PMS) can also occur. [3] PMS and TOS often, but not always, occur together.