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NEET-PG-2015-Question-Paper-With-Solutions
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1. Upper limb deformity in Erb's palsy?a) Adduction and lateral rotation of arm
b) Adduction and medial rotation of arm
c) Abduction and lateral rotation of arm
d) Abduction and medial rotation of arm
Correct Answer - B
Deformity in Erb's palsy (position of the limb):
Arm: Hanges by the side; it is adducted & medially rotated
Forearm: Extended and pronated
The deformity is known as ‘policeman’s tip hand' or ‘porter’s tip
hand’
,2. Nerve roots involved in Erb's palsy:
a) C5, C6
b) C6, C7
c) C7,C8,T1
d) C5,C6,C7,C8,T1
Correct Answer - A
Erb-Duchenne Palsy
Upper lesions of the brachial plexus are injuries resulting from
excessive displacement of the head to the opposite side and
depression of the shoulder on the same side. This causes excessive
traction or even tearing of C5 and C6 roots of the plexus. It occurs in
the newborn during a difficult delivery or in adults after a blow to or
fall on the shoulder.
The suprascapular nerve, the nerve to the subclavius, and the
musculocutaneous and axillary nerves all possess nerve fibers
derived from C5 and C6 roots and will therefore be functionless.
The following muscles will consequently be paralyzed: the
supraspinatus (abductor of the shoulder) and infraspinatus (lateral
rotator of the shoulder); the subclavius (depresses the clavicle); the
biceps brachii (supinator of the forearm, flexor of the elbow, weak
flexor of the shoulder) and the greater part of the brachialis (flexor of
the elbow) and the coracobrachialis (flexes the shoulder); and the
deltoid (abductor of the shoulder) and the teres minor (lateral rotator
of the shoulder).
Thus, the limb will hang limply by the side, medially rotated by the
unopposed sternocostal part of the pectoralis major; the forearm will
be pronated because of loss of the action of the biceps.
The position of the upper limb in this condition has been likened to
that of a porter or waiter hinting for a tip. In addition, there will be a
,that of a porter or waiter hinting for a tip. In addition, there will be a
loss of sensation down the lateral side of the arm.
Treatment
The three most common treatments from Erb's Palsy are: Nerve
transfers (usually from the opposite leg), subscapularis releases and
latissimus dorsi tendon transfers.
, 3. Root value of thoracodorsal nerve ?
a) C5,C6,C7
b) C8,T1
c) C6,C7,C8
d) Ti T2
Correct Answer - C
Ans. is 'c' i.e., C6C7C8
Branches of brachial plexus
Branches of brachial plexus arises from different anatomical
segments : -
1. Branches of the roots
Nerve to serratus anterior (long thoracic nerve) (C5, C6, C7).
Nerve to rhomboideus (dorsal scapular nerve) (C5).
2. Branches of the trunks
These arise only from the upper trunk which gives two branches. I.
Suprascapular nerve (C5, C6)
Nerve to subclavius (C5, C6)
3. Branches of the cords
1. Branches of lateral cord
Lateral pectoral (C5-C7)
Musculocutaneous (C5-C7)
Lateral root of median (C5-C7)
2. Branches of medial cord
Medial pectoral (C8, T1)
Medial cutaneous nerve of arm (C8, TO
Medial cutaneous nerve of forearm (C8, Ti).
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