brachial plexus question

Discussion in 'Step I' started by arkroyal, Jun 15, 2008.

  1. arkroyal

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

    cyclohexanol No, no. Doggie afuera.
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    The uppermost root gets stretched (C5)
     
  3. Knicks

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    What exactly do you mean by "become really depressed"?
     
  4. cyclohexanol

    cyclohexanol No, no. Doggie afuera.
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    As in shoulder dystocia in macrosomic birth... "severely" depressed by compression on the pubic rami during labor.
     
    #4 cyclohexanol, Jun 15, 2008
    Last edited: Jun 15, 2008
  5. Instatewaiter

    Instatewaiter But... there's a troponin
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    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.
     
  6. GynGuy1983

    GynGuy1983 C&A Psychiatry Fellow
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    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?
     
  7. cyclohexanol

    cyclohexanol No, no. Doggie afuera.
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    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).
     

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