brachial plexus question

[arkroyal]

If your shoulder become really depressed, what part of brachial plexus would be injured? (this is from the 3rd nbme)

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[cyclohexanol]

If your shoulder become really depressed, what part of brachial plexus would be injured? (this is from the 3rd nbme)

The uppermost root gets stretched (C5)

 

[Knicks]

What exactly do you mean by "become really depressed"?

 

[cyclohexanol]

What exactly do you mean by "become really depressed"?

As in shoulder dystocia in macrosomic birth... "severely" depressed by compression on the pubic rami during labor.

 

[Instatewaiter]

I figured they were talking about erb-duchene (C5, C6- ie waiter's tip)

Note that a dislocation of the shoulder can cause axillary nerve problems too- which causes inability/weakness in shoulder adduction.

So to distinguish between the 2 you have to have some the clinical s/s.

 

[GynGuy1983]

I figured they were talking about erb-duchene (C5, C6- ie waiter's tip)

Note that a dislocation of the shoulder can cause axillary nerve problems too- which causes inability/weakness in shoulder adduction.

So to distinguish between the 2 you have to have some the clinical s/s.

I agree. I don't really know what he means by depressed, since the deltoid could also become depressed in the case of axillary nerve paralysis.

I wonder if he meant winging of the scapula?

 

[cyclohexanol]

I agree. I don't really know what he means by depressed, since the deltoid could also become depressed in the case of axillary nerve paralysis.

I wonder if he meant winging of the scapula?

If you took NBME form 3, you would have seen the exact question. It isn't winging of the scapula. Think shoulder dystocia. The shoulder joint itself is being forced inferiorly relative to the neck due to traction forces involved in passing a huge fetus through a small opening (and having the shoulder get stuck on pubic rami) during birth. This causes strain on the uppermost brachial plexus ventral rami (C5).