NEET PG Medical – 2015 – Question – 2

he shoulder on the same side. This causes excessive traction or even tearing of C5 and C6 roots of the plexus. It occurs in the newborn during a difficult delivery or in adults after a blow to or fall on the shoulder.
The suprascapular nerve, the nerve to the subclavius, and the musculocutaneous and axillary nerves all possess nerve fibers
derived from C5 and C6 roots and will therefore be functionless.
The following muscles will consequently be paralyzed: the supraspinatus (abductor of the shoulder) and infraspinatus (lateral rotator of the shoulder); the subclavius (depresses the clavicle); the biceps brachii (supinator of the forearm, flexor of the elbow, weak flexor of the shoulder) and the greater part of the brachialis (flexor of the elbow) and the coracobrachialis (flexes the shoulder); and the deltoid (abductor of the shoulder) and the teres minor (lateral rotator of the shoulder).
Thus, the limb will hang limply by the side, medially rotated by the unopposed sternocostal part of the pectoralis major; the forearm will be pronated because of loss of the action of the biceps.
The position of the upper limb in this condition has been likened to that of a porter or waiter hinting for a tip. In addition, there will be a that of a porter or waiter hinting for a tip. In addition, there will be a loss of sensation down the lateral side of the arm.
Treatment
The three most common treatments from Erb’s Palsy are: Nerve transfers (usually from the opposite leg), subscapularis releases and latissimus dorsi tendon transfers.