Brachial Plexus Injury

Brachial plexus

This is a group of nerves originated from the cervical spinal nerves and supplied to the upper extremity.

This network of nerves originated from spinal cord and through the cervicoaxillary canal in the neck, over the first rib and into the armpit.

The brachial plexus is divided into five roots, three trunks, six divisions (three anterior, three posterior).


Roots-

  • The five roots are the five anterior primary rami of the spinal nerves.
  • The brachial plexus emerges at the root level C5, C6, C7, C8, T1.
These roots combines to form the trunk which further supplies as the group of nerves to the group of muscles.


Trunks-
  • C5 and C6 emerges as the upper trunk.
  • C7 is a single trunk or middle trunk.
  • C8 and T1 emerges as the lower trunk.

Divisions-
  • Each trunk split into the two to form six divisions.
  • Anterior divisions of the upper, middle, and lower trunk.
  • Posterior division of the upper, middle, and the lower trunks.

Cords-
  • These six divisions combines to form the cords of larger fiber bundles.
  • Posterior cord- three posterior divisions of the trunks (C5, C8 , T1).
  • Lateral cord- anterior division of the upper and the middle trunk (C5, C7).
  • Medial cord- anterior division of the lower trunk (C8, T1).


Brachial Plexus Injury

Brachial plexus neuropathy or trauma may causes severe symptoms in the upper extremity.
This can cause pain in the shoulder or arms.



Causes of brachial plexus injury

  • Brachial plexus injury may causes at the time of birth or after the birth in sports injuries or any other kind of neuropathy.
  • Breech presentation during delivery.
  • Birth trauma.
  • Stretching of shoulder muscles.
  • Any kind of tumor in the shoulder or armpit level.
  • Inflammatory neuropathy in diabetes mellitus, or any other neuropathy.


Symptoms of Brachial plexus injury

  • Numbness- Brachial plexus injury can causes the numbness in the shoulder, arm, hand.
  • Abnormal sensations- burning or tingling sensation.
  • Weakness- motor disability where muscles power decreases.
  • Muscle wasting or atrophy


Diagnosis of Brachial plexus injury

  • Blood test
  • Chest X-ray
  • Electromyogram
  • MRI of the head, shoulder, neck
  • Nerve biopsy
  • Nerve conduction velocity.


Treatment of brachial plexus injury

  • Medications- anticonvulsants, antidepressants, pain killers, anti-inflammatory drugs.
  • Exercises to be given for the strengthening of the muscles.
  • Occupational therapy.
  • Surgery in case of neuropathy or cut.
  • Splint can be used in recovery period.

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