Wednesday, February 12, 2014

Musculoskeletal Exam/ Erb's Palsy


The beautiful brachial plexus.  This plexus is a source of frustration trying to memorize the many branches, and great appreciation of the intricate engineering once it is dissected out.  One of the injuries to the C5 and C6 roots cause Erb's Palsy.  This leads to a medially rotated shoulder and extended arm called "waiter's tip."  It's one thing to see it in a book, but it's a totally different experience to see it in person.

During our musculoskeletal exam lesson during our introduction to clinical medicine class, one of our tasks was to palpate the clavicle to the acromioclavicular joint.  As i was palpating my partner, I noticed that his left AC joint was significantly lower than his right due to a broken clavicle as he was pulled out during birth.  This clavicle fracture impinged his nerve, leading to Erb's Palsy.  He was unable to completely flex his arm or abduct his shoulder.  His biceps muscle, the main supinators, were not working properly.  He also couldn't abduct his arm, or lift it to the side.  It was exciting to get a chance to see it in person and develop another perspective on the disorder.

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