Adduction Of Thenar Muscle

BRACHIAL PLEXUS LESIONS-CHART 1 Nerve ( Segment) Motor Deficit(s)

Sensory Deficits

Long Thoracic (C 5,6,7)

Winged Scapula- Serratus Anterior

None

Suprascapular (C 5,6 )

Hard to start shoulder abduction - Supraspinatus

None

Axillary (C 5,6 )

Difficult abducting arm to horizontal - Deltoid

Lateral side of arm below point of shoulder

Loss of shoulder roundness Deltoid Musculocutaneous Very weak flexion of elbow C 5,6,(7) joint- Biceps & Brachialis

Lateral forearm

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) at Elbow

Pronation of radioulnar joints- Radial portion of Pronator teres & quadratus palm; palmar Weak wrist flexion - Fl. carpi surface & tips of radial 31/2 digits radialis 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 at Wrist thumb - thenar muscles “Ape Hand”- thumb hyper

Palmar surface & tips of radial 31/2 digits

extended and adducted thenar muscles Ulnar (C 8, T1) at Elbow

“Clawing” of fingers 3 & 4M.P. joints hyper extended; P.I.P. Flexed - Interossei & Lumbricals

Ulnar and dorsal aspect of palm and of ulnar 1 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 Wrist

“Clawing” of fingers 3 & 4M.P. joints hyper extended; P.I.P. Flexed - Interossei & Lumbricals

Ulnar and dorsal aspect of palm and of ulnar 1 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 Lesion Erb’s Palsy (C 5,6 )

Motor Deficits

Sensory Deficits

Nerves

Loss of abduction, flexion and rotation at shoulder ; Weak shoulder extension deltoid, rotator cuff

Posterior and lateral Axillary, aspect of arm Suprascapular, axillary n. Upper and Lower subscapular

Very weak elbow flexion and supination of radioulnar

Radial side of Forearmmusculocutaneous n. Thumb and 1st

Musculocutaneous ; Radial N. brs. to supinator & brachioradialis

joint - biceps brachii & brachialis Susceptible to shoulder dislocation loss of rotator cuff muscles

finger - superficial muscles br. of radial; digital brs. - Median n. Suprascapular, Upper and Lower subscapular

“Waiters Tip”position Klumke’s Loss of Palsy (C8, opposition of T1 ) thumb -Thenar muscles

Ulnar side of Thenar branch of forearm , hand & & Median nerve ulnar 1 1/2 & digits - ulnar and medial antebrachial cutaneous

Loss of adduction of thumb Adductor pollices

Ulnar nerve

Loss of following finger movements: abduction and adduction of M.P. joints ; flexion at M.P. & extension of I.P.joints. Lumbricals & interossei

Deep branch of Ulnar & Median

Very weak flexion of P.I.P.& D.I.P. joints Fl. Digit. Super. & Profund.

Ulnar and Median