Study note

Erb's paralysis and selected axillary anatomy

THE CONTEXT
The clinical problem links loss of shoulder abduction, elbow flexion and forearm supination to injury at Erb's point.

Structures involved at Erb's point

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The ventral rami of the fifth and sixth cervical segments join to form the upper trunk.
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The six structures listed at the injury site are the fifth and sixth cervical ventral rami, suprascapular nerve, nerve to subclavius, and anterior and posterior divisions of the upper trunk.
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The suprascapular nerve and nerve to subclavius arise from the upper trunk.

Motor deficits and posture

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The patient cannot abduct the shoulder, flex the elbow or supinate the forearm.
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The upper trunk divisions supply fibres to deltoid, brachialis, biceps brachii and supinator.
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The elbow is extended and the forearm is pronated in Erb's paralysis.
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The supplied answer key associates porter's tip or policeman's tip deformity with Erb's paralysis and identifies triceps brachii as the exception among the listed muscles weakened.

Additional anatomical distinctions

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The supplied answer key identifies the suprascapular nerve as the exception among the listed posterior cord branches.
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The medial root of the median nerve is the exception among the listed lateral cord branches.
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Teres minor is the exception among the listed muscles forming the posterior wall of the axilla.
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