Erb-Duchenne palsy

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Erb-Duchenne palsy

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Erb-Duchenne palsy, is named after the neurologists Wilhelm Erb and Duchenne de Boulogne who first described it.

In this disorder, there’s paralysis to the muscles of the shoulder and the upper arm, and it happens when the nerves that innervate these muscles are damaged.

People with this disorder have their arm stuck in a position that looks like a waiter discreetly trying to get a tip, so it’s also called waiter’s tip deformity.

Okay, so the nervous system has two parts: the central nervous system, which consists of the brain, brainstem, and spinal cord, and the peripheral nervous system, which includes all of the nerves that fan out from the central nervous system.

Broadly speaking, the nervous system is split into an afferent and an efferent division.

The afferent division brings sensory information from sensory receptors in the peripheral nervous system to the central nervous system, and the efferent division sends motor information from the central nervous system to organs like skeletal muscles, which causes them to contract.

Now, part of the peripheral nervous system are spinal nerves, which branch off the spinal cord.

There are 31 pairs of spinal nerves, which are grouped into eight pairs of cervical nerves, twelve pairs of thoracic nerves, five pairs of lumbar nerves, five pairs of sacral nerves, and one pair of coccygeal nerves.

The brachial plexus is a network of spinal nerves that innervate the shoulder, arm, and hand, by supplying afferent or sensory nerve fibers from the skin, as well as efferent or motor nerve fibers to the muscles.

In terms of anatomy, the brachial plexus is divided into five roots, which come from the last four cervical nerves; C5, C6, C7, and C8, as well as the first thoracic nerve or T1.

The five roots will then combine to form three trunks: C5 and C6 merge to form the superior or upper trunk, C7 remains as the middle trunk, and C8 and T1 merge to form the inferior or lower trunk.

These trunks then form six divisions, which will regroup with each other to form three cords.

These cords give multiple branches.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Fractured clavicle and Erb's palsy unrelated to birth trauma" American Journal of Obstetrics and Gynecology (1997)
  6. "The Military Brace Syndrome" The Journal of Bone & Joint Surgery (1969)
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