BRACHIAL PLEXUS LESIONS-CHART 1

Nerve ( Segment) Motor Deficit(s) Sensory Deficits

Long Thoracic Winged Scapula- Serratus None
(C 5,6,7) Anterior
Suprascapular Hard to start shoulder None
(C 5,6 ) abduction - Supraspinatus
Axillary (C 5,6 ) Difficult abducting arm to Lateral side of
horizontal - Deltoid arm below point
Loss of shoulder roundness - of shoulder
Deltoid

Musculocutaneous Very weak flexion of elbow Lateral forearm

C 5,6,(7) joint- Biceps & Brachialis
Weak supination of radioulnar
joint -Biceps

Radial (C 5 - T1) Drop Wrist - Extensor carpi Posterior lateral

radialis longus & brevis, Ext. &arm; dorsum
carpi ulnaris of hand
Difficulty making a fist -
synergy between wrist
extensors and finger flexors

Median C 5 - T1) Pronation of radioulnar joints- Radial portion of

at Elbow Pronator teres & quadratus palm; palmar
Weak wrist flexion - Fl. carpi surface & tips of
radialis radial 31/2 digits
Weakened opposition of
thumb - thenar muscles
“Ape Hand”- thumb hyper
extended and adducted -
thenar muscles
“Papal Hand” Loss of flexion
of I.P. joints of thumb &
fingers 1 & 2 - Fl. pollices
longus ; Fl. digit.
superficialis, Fl. digit
profundus

Median (C 5 - T1) Weakened opposition of Palmar surface

at Wrist thumb - thenar muscles & tips of radial
“Ape Hand”- thumb hyper 31/2 digits
 extended and adducted -
thenar muscles

Ulnar (C 8, T1) at “Clawing” of fingers 3 & 4- Ulnar and dorsal

Elbow M.P. joints hyper extended; aspect of palm
P.I.P. Flexed - Interossei & and of ulnar 1
Lumbricals 1/2 digits
Loss of abduction &
adduction of M.P joints of
fingers -Interossei
Thumb - abducted and
extended - adductor pollices
Loss of flexion of D.I.P. joints
of fingers 4 & 5 - Fl. digit
profund.

Ulnar (C 8, T1) at “Clawing” of fingers 3 & 4- Ulnar and dorsal

Wrist M.P. joints hyper extended; aspect of palm
P.I.P. Flexed - Interossei & and of ulnar 1
Lumbricals 1/2 digits
Loss of abduction &
adduction of M.P joints of
fingers - Interossei
Thumb - abducted and
extended - adductor pollices

UPPER AND LOWER ROOT LESIONS- CHART 2

Motor
Lesion Sensory Deficits Nerves
Deficits
Erb’s Loss of Posterior and lateral Axillary,
Palsy (C abduction, aspect of arm - Suprascapular,
5,6 ) flexion and axillary n. Upper and Lower
rotation at subscapular
shoulder ;
Weak
shoulder
extension -
deltoid,
rotator cuff
Very weak Radial side of Musculocutaneous ;
elbow flexion Forearm- Radial N. brs. to
and supination musculocutaneous supinator &
of radioulnar n. Thumb and 1st brachioradialis
 joint - biceps finger - superficial muscles
brachii & br. of radial; digital
brachialis brs. - Median n.
Susceptible to Suprascapular,
shoulder Upper and Lower
dislocation - subscapular
loss of rotator
cuff muscles
“Waiters
Tip”position
Klumke’s Loss of Ulnar side of Thenar branch of
Palsy (C8, opposition of forearm , hand & & Median nerve
T1 ) thumb ulnar 1 1/2 & digits
-Thenar - ulnar and medial
muscles antebrachial
cutaneous
Loss of Ulnar nerve
adduction of
thumb -
Adductor
pollices
Loss of Deep branch of
following Ulnar & Median
finger
movements:
abduction and
adduction of
M.P. joints ;
flexion at M.P.
& extension
of I.P.joints.
Lumbricals &
interossei
Very weak Ulnar and Median
flexion of
P.I.P.& D.I.P.
joints Fl.
Digit. Super.
& Profund.