Neurology · MU Sofia

38. Diseases of the cervical and brachial roots and cervical and brachial plexus

Covers damage to the cervical and brachial nerve roots, cervical plexus, and brachial plexus. It begins with root lesions and their causes, then the pain, sensory, motor and reflex features, with a table of reflex changes by root and a list of myotomes. It then describes cervical plexus lesions with phrenic nerve involvement, and closes with upper trunk, lower trunk and total brachial plexus lesions, including the waiter's tip position and claw hand.

Inside: 1 section · 2 labelled pictures · 1 table · 16 flashcards · 2 min

Topic 38 of 88 in the MU Sofia syllabus for Neurology (Medicine, Year 4). The free AceMed note covers it in 1 section, about 223 words (2 min of reading), with 16 flashcards.

In this note

  1. Disease of the cervical and brancial roots and cervical and brachial plexus

Disease of the cervical and brancial roots and cervical and brachial plexus

1. Cervical & Brachial Root Lesions (Radiculopathy)

Definition: Damage to a spinal nerve root (C5–T1) causing segmental motor, sensory, and reflex deficits.

Causes: Intervertebral disc herniation. Cervical spondylosis. Trauma. Tumors. Inflammation (radiculitis)

Clinical Features (Root Syndrome):

1.Pain: Severe radicular pain. Radiates along dermatome. Worsens with coughing, sneezing, movement

2.Sensory Loss: Dermatomal pattern.Numbness, paresthesia

3.Motor Deficit: Weakness in myotomal distribution. Muscle atrophy (if chronic)

4.Reflex Changes

Cervical Root Key Myotomes

C5: Shoulder abduction. C6: Elbow flexion, wrist extension

C7: Elbow extension. C8: Finger flexion

T1: Finger abduction

2. Cervical Plexus Lesions (C1–C4)

Main Nerve: Phrenic nerve (C3–C5)

Clinical Features: Diaphragmatic paralysis (unilateral/bilateral). Dyspnea, especially when lying down. Reduced cough strength. Hiccup (sometimes)

3. Brachial Plexus Lesions (C5–T1)

Anatomy Overview

Divided into: Roots → Trunks → Divisions → Cords → Branches

A. Upper Trunk Lesion (Erb-Duchenne Palsy)

Roots: C5–C6

Cause: Birth injury. Fall on shoulder. Excessive neck separation.

Muscles affected: Deltoid. Biceps. Supraspinatus. Infraspinatus

Clinical Position: “Waiter’s tip position”. Arm adducted. Internally rotated. Extended and pronated

Loss: Shoulder abduction. Elbow flexion

B. Lower Trunk Lesion (Klumpke Palsy)

Roots: C8–T1

Cause: Sudden upward pull on arm. Thoracic outlet syndrome

Muscles affected: Intrinsic hand muscles

Clinical Features: “Claw hand”. Weak finger movements. Loss of grip. Sensory loss medial forearm/hand

C. Total Brachial Plexus Lesion

Features: Complete paralysis of upper limb. Complete sensory loss. Flaccid limb. Severe atrophy

Read the full note free

The whole note is free with an AceMed account, with its 16 flashcards. Premium adds flashcard recall, highlights and Ask AI.

Start freeAlready a member? Open the note