Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Brachial plexus lesionsInjury to brachial plexus ++ 353.0 Brachial plexus lesions767.6 Injury to brachial plexus due to birth trauma953.4 Injury to brachial plexus ++ G54.0 Brachial plexus disordersP14.0 Erb's paralysis due to birth injury P14.1 Klumpke's paralysis due to birth injuryP14.3 Other brachial plexus birth injuriesS14.3XXA Injury of brachial plexus, initial encounter ++ 4F: Impaired Joint Mobility, Motor Function, Muscle Performance, Range of Motion, and Reflex Integrity Associated With Spinal Disorders5F: Impaired Peripheral Nerve Integrity and Muscle Performance Associated With Peripheral Nerve Injury +++ Description ++ Weakness in the armDiminished reflexesPain in the upper extremityMotor or sensory changes in the ulnar, radial, and median nerve distribution due to pressure fromCompressionStretchFriction +++ Essentials of Diagnosis ++ ElectromyographyPainNumbnessSensory changes in multiple peripheral nerves of the upper extremityHand clumsiness or weaknessSymptom changes with cervical spine and elbow positionsReproduction of symptoms during clinical examinationSeddon’s classificationNeurapraxia (Class 1): 1st degreeAxonotmesis (Class 2): 2nd degreeNeurotmesis (Class 3): 3rd degree nerve fiber interruption, 4th degree epineurium intact, and 5th degree complete transection of the nerve +++ General Considerations ++ Need to differentiate between more proximal and distal ulnar nerve compression, thoracic outlet syndrome (TOS), ulnar tunnel, and cervical radiculopathyNerve compression syndrome in the upper extremityWallerian degeneration occurs below the site of injuryPatients with mild electrodiagnostic findings, intermittent symptoms and no atrophy respond well to conservative management +++ Demographics ++ Falling on an outstretched arm is common causeTraction injuryIndividuals who work for sustained periods with power tools or on computersInfants, from birth trauma or head traction +++ Signs and Symptoms ++ Acute or chronic paresthesiaSensory changes: hyposensitivity of handHand clumsinessFeeling of arm heavinessHand weakness; decreased grip-power and dexterityIntrinsic muscle atrophy Erb’s palsyWaiter’s tip signCaused by excessive lateral neck flexionLoss of lateral rotator, arm flexors, and wrist extensor musculatureKlumpike’s paralysisTraction of abducted armLower brachial plexus injuryDamage to C8 and T1Loss of intrinsic muscles of the hand, wrist, and finger flexorsWartenberg’s signFroment’s sign for ulnar nerve palsyBishop’s deformityPositive elbow flexion test +++ Functional Implications ++ Night painPoor sleep habits with arm over headFeeling of arm going “dead”Limited hand function during ADLs/IADLs due to hand clumsiness and possible loss of strength +++ Possible Contributing Causes ++ Infant head traction during forceps deliveryTraction to the cervical spineTrauma pulling the arm into abductionViral infectionGanglion or space-occupying lesionRepetitive traumaSustained pressure over the thoracic outletClavicle fractureGlenohumeral dislocation ++... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.