A 42-year-old woman is admitted to the hospital with injury to the upper (superior) trunk of the brachial plexus. The diagnosis is Erb-Duchenne palsy. Which of the following conditions is expected to be present during physical examination?

Correct Answer: Inability to laterally rotate the arm
Description: Injury to the superior trunk of the brachial plexus can damage nerve fibers going to the suprascapular, axillary, and musculocutaneous nerves. Damage to the suprascapular and axillary nerves causes impaired abduction and lateral rotation of the arm. Damage to the musculocutaneous nerve causes impaired flexion of the forearm. A winged scapula would be caused by damage to the long thoracic nerve. The long thoracic nerve is formed from spinal cord levels C5, C6, and C7, so the serratus anterior muscle would be weakened from the damage to C5 and C6, but the muscle would not be completely paralyzed. The intrinsic muscles of the hand are innervated by the ulnar nerve, which would most likely remain intact. Paraesthesia in the medial aspect of the arm would be caused by damage to the medial brachial cutaneous nerve (C8-T1; inferior trunk). Loss of sensation on the dorsum of the hand would be caused by damage to either the ulnar or radial nerves (C6 to T1).
Category: Anatomy
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