Erb's palsy or upper brachial plexus injury anatomy

This is about the anatomy of an upper brachial plexus injury, also known as Erb's palsy. Damage to the upper or superior trunk of the brachial plexus affects neurones running from the C5 and C6 roots to the axillary, suprascapular and musculocutaneous nerves in particular.
If we look at this anatomy and the muscles supplied by these nerves we can work out which muscles are likely to be weak, paralysed and/or atrophied, explaining the classical presentation of the upper limb in this injury. We will also consider what sensation in the upper limb might be affected and what movements might test for this.
If nothing else we'll have a better understanding of why we need to study the anatomy of the very complex brachial plexus.
Music by Jahzzar
Album: HiFi City Tales
Song: Bodies
/ jahzzar​​

[@rou_dhi]

You're a very talented teacher, I did not lost attention during the whole video, and that's something very few teacher can reach.. Congratulations!

[@Momcat_maggiefelinefan]

Thank you so much for a wonderful lecture! I’m a retired ER nurse, worked in a teaching hospital in Canada most of my career. My mother was a tiny woman, father was a 6 foot tall Englishman and I was 9 pounds 1 ounce. I was born in 1953. Delivered by a GP, he caused the injury from what I assume was his attempts to extract me. My parents were never told what the injury was, how it occurred, but fortunately taught Mom and my 16 year old sister a physio routine. I had zero function, but sensation didn’t seem to be affected. I spent my childhood travelling 100 k to a travelling clinic to see paediatric surgeons. I grew up in Northern Ontario, a very medically under serviced area. I had some sort of nerve repair when I was 8. I was the 5th Canadian child to have the surgery, and the third successful outcome. When I was 16 I got a new GP, a British chap, who told me I had Urb’s palsy. I suffered a right numerous spiral fracture thanks to my overenthusiastic Lab 7 years ago. They couldn’t do a surgical repair due to the size and thinness of the bone, but was told that I could use a shoulder immobilizing sling for 6 months. It didn’t heal well and now I have pain in my arm for the first time. I learned a great deal from your lecture and now, at 69, finally know what happened to me so long ago. I can’t thank you enough!

[@kintsugi2262]

omg finally ! my favorite hated topic ever !! finally, going to understand it today !!

[@Skate3League]

I’m in clinical physio internship right now, thank you for these videos they really mean a lot to us. You’re an amazing teacher ❤️

[@stewartcaldwell5299]

Thank you. I've lived with this since 1976.

[@05afnanabdullah87]

God bless you Stewart 😄👍

[@Dijas.painting16]

I have lived with it since 1988. And still suffering. Pain and feeling of handicap

[@AbhishekJain1992]

​@@Dijas.painting16 sorry for your pain and suffering, can you also share how you got it would be really helpful for me to answer some of my questions.

[@trickywoody]

Hi stewart, same with me too right arm since 1976

[@stewartcaldwell5299]

@@trickywoody We must be related ! LOL. Mine is on the left. Together we function just right.

[@wink3194]

I was never given any physio for this when I was a baby. How I wish I could turn back time and tell my parents to do everything to get me back to normal. I was able to put a name into this condition when I reviewed my baby records and saw the diagnosis “Erb’s Palsy”. I don’t know who to blame…

[@emmanuelogbemudia]

Sorry about that, is yours a total paralysis? I've Erbs palsy too from birth, i never had surgery yet I can do some basic activities and I don't have waiter's tip

[@Sparshderick9]

Fantastic explanation As initial 15 degrees of abduction is carried out by supraspinatus and it is also impaired due to injury in the suprascapular nerve so abduction will doesn't occur at all 👌🔥

[@brunoneves5106]

@Sam Webster Thank you so much for this video. I got a motorcycle accident at 95/02/04 , Humerus fracture and a brachial plexus injury in c3-4, c5-6 and c6-8. Got surgery but only recovered my hand, c6-8 i think. Now i know this because of this amazing video. Keep on the Good Work and Thank you so much one more time. Keep driving my 🛵, because help me a lot to recover my hand and some arm and shoulder strength 🙌🏼💪🏼✌🏼😎

[@collinsesohwode9230]

Thanks for this video. Looking forward to my first dissection next week. Your videos are wonderful

[@exploidur]

Sensational! Thank you, Mr. Webster

[@tanvibanjan1975]

You are an amazing teacher! Bless KZbin for making it possible to learn from you:) Much love from India

[@Moali-ys8vy]

one of the best teachers that i ever found on media, allot of thanks

[@isabellacorrea8007]

Occupational Therapy student here and I just want to thank you for all your videos! Such a great and talented teacher :-)

[@Tee5]

I dunno why but I can actually pay attention to you!! And I have poor concentration!!! Your videos are sooo useful thank you so much Sir you're a lifesaver ❤

[@zeynopovski00]

Same here! I was surprised for the same thing.

[@michaelogudamen2937]

You are a very good teacher. Thank you for this video. It was helpful.

[@anosikeprecious3365]

You're doing great job sir! Your videos are very helpful.

[@illanaisme]

Absolutely brillant! Now I understand, my EMG on why my elbow flexion is weak and numbness on my radial forearm. It was from a PICC line as I didn't have any trama, falls, broken arm etc.

[@moizzazahid3766]

HOW EVERYTHING YOU SAY IS SO INTERLINKED IS ADORABLE

[@jw9609]

Thank you Sam, what a fabulous video, you have just described exactly what I have due to Parsonage Turner Syndrome. My axillary and supraspinatus nerves aren't firing and have been in this state for approx 6 months now. I can't abduct my arm nor lift above head. My supraspinatus and infraspinatus muscles are gone and have been replaced with fat according to the MRI scans. Having another MRI this week of the brachial plexus to see why nerves not improving after such a long duration. Orthopaedic surgeon said he can't do anything so is now in the hands of neurology. Interesting to hear you mention nerve grafts?

[@myishalorraine]

I suffer from a break you’ll plexus injury that occurred during delivery. It came from the forceps applying to much pressure to my shoulders. I am 35 and I still have no use of my right arm. I suffer from severe neuropathy. Thanks for this video

[@rachkate76]

So sorry to hear this. ☹️

[@Dijas.painting16]

Sorry, so am I but my left arm 😭

[@zeynopovski00]

Hey! Same here! From delivery, right arm, and 35 years. The issue is not fun, but similarities and common challenges feels like sisterhood :) oh and your profile name is so me, I'd have chosen this name really😅 i feel you. With love 🙋🏾‍♀️

[@myishalorraine]

@ Zey No definitely makes life a little challenging and as if that’s not enough I lost my vision five years ago. Through it all I keep my faith strong and my spirits high. I have two wonderful kids who keeps me going

[@pokeballs8763]

Also injured at birth! ::low five:: 🙌 Both arms are effected for me and my diaphragm was also injured somehow..🤔

[@pratikshyarijal1913]

Thank you isn't enough to describe how much you have helped us. Your teaching style and sense of humor is impeccable. Thank you sir once again. We students are indebted to you. ❤️ Love from Nepal 🇳🇵

[@cheskybaba4864]

I have Eb's palsy from birth with perhaps a less pronounced severity. Your tutorial was spot on. It is simply amazing at how the the body is wired.

[@Momcat_maggiefelinefan]

I have a fairly severe brachial plexus injury from birth. My mother was a tiny woman, but my father was a big 6 foot Englishman. I was a big baby, 9 pounds, 1 ounce. The family doctor who delivered me … born in 1953 … apparently twisted and over-stretched my neck and I was thus left with no use of my right arm until I had some sort of surgery when I was 8. Back then when a child was injured by the physician, their parents weren’t told what had occurred. I didn’t even know what my injury was called until I was 16 and got a British family doctor. He said I had Urb’s palsy, and was lucky that I had a successful outcome. (I was the 5th Canadian child to have the surgery which saved my life as I know it). I had a 25 year nursing career, most of it in Canada’s largest teaching hospital. I’ve lost a lot of function in the affected arm since my Lab took me out when we were playing “soccer” and I ended up with a spiral fracture of my upper arm. Sucks to be me, but I’m a tough chick and continue to persevere!

[@cheskybaba4864]

@@Momcat_maggiefelinefan It doesn't suck to be you. You sound like a beautifully wonderful person., whose done the best with the short comings you've been dealt. Like you, I too was a big baby that should not have been delivered vaginally. But as you say, the Dr's and hospitals never took responsibility or told our parents what the circumstances were. They let them assume it was a birth defect to avoid any litigation. I believed it was just so until I was in my early thirties and read the hospital report on my arm - the day my first born child arrived. I had wondered if they kept my records after all those years and they did in the archives. I cried reading it.

[@Momcat_maggiefelinefan]

@@cheskybaba4864 Thanks for sharing. I realize just how fortunate I am. When my son was born, the first thing I asked before the gender, was “Can my baby move its arms?”. The doc’s answer was almost as good as a healthy, normal child.

[@useridcn]

Does it still bother you or influence your daily life? My baby is suffering from it now. We are doing PT and she has improved a lot. The doctor said she can get full recovery... But I'm just not sure if they just say it so we don't use the hospital...

[@lwij5417]

Thank you, these are an absolute treasure!!

[@ZahidKhan-le6tb]

Thanks 🙏 I don’t know how someone can dislike these videos

[@ashelodd4973]

i have erbs palsy from birth the way he described. thank you for this video i found it very interesting to learn about my condition, interestingly though i have different symptomes because of tendon implant and muscle moving surgeries.

[@ifrahabdi8780]

please Ihave baby boy Erps pasly place can help me

[@mozhgannabi4187]

Very useful information. My brother in an car accident lost the ability and the mobility of C nerves

[@fatimasuleman1980]

Thank you very much. This was a very clear explanation.

[@arunojyakumari5139]

Appreciate your videos they’ve helped me so much Could you also make embryology videos please

[@frankenstein4391]

This helped a lot, doctors never told me this

[@TachyTutorials]

Great video!

[@hannahjoy2199]

Thank you sir that was a wonderful lecture

[@trickywoody]

Thank you for this great video, everything is spot on with my condition except i cannot straighten my elbow and my wrist is not affected.

[@clydesdale5512]

This is very informative, A lot of this Is how I feel with my arm, from a fall from a truck.

[@aungkhant3482]

thank you for your explanation. It works well

[@Dr._Mahmoud_Qasem]

Thanks a lot Doc.

[@halcyonechase1025]

Excellent teaching skills ❤

[@simon-rl6wd]

informative video. i have erbs after severing c5 to t1 in 1991. i got bicep movement from a c5 graft but this caused my arm to pull into the chest. i guess due to the effects of erbs. i also had a trapezius transfer for abduction but this too seemed to contribute to the forward rolling of the upper arm. the remedial measure was to externally rotate the lower arm just above the elbow. i now have hand to mouth movement. for me, the worse attribute of the injury is the chronic pain. interestingly. the covid jabs intensified the pain. over time, the horner symptoms became much less noticable.

[@dickensaluha6487]

Thanks. Very useful

[@madi-kp6po]

Hi Sam! I just wanted to leave a comment about your amazing explanation of things. I am a fellow teacher (woo-hoo!) but I am also someone who has a birth-induced brachial plexus injury. I wasn't able to move my right arm / shoulder / neck for the first 5 months of my life. And one night, it miracuously began gaining function. I had surgery when I was 10 and a brace to correct my wrist as an infant. My movement is pretty significantly impacted and my body holds a certain way. Up until now, I've only been asked what it is and told people "It's a nerve damage thing so my arm's all messed up"... I never realized I hadn't learned fully for myself what I was dealing with. My jaw dropped with your video! I am absolutely amazed. You explained everything so well and I feel like I can understand what happened to my body much better now, and why it still has its limitations. Thank you so much for making this video! Fantastic job.

[@Momcat_maggiefelinefan]

I too have a severe birth related brachial plexus palsy. I had sensation but no function in my right arm which, luckily, was repairable by the time I was 8. Due to the injury I spent my first 8 years with a useless limb. I attended a Crippled Children’s travelling clinic (born and grew up un Northern Ontario, Canada, very medically under serviced even now) until I was 8. They did some kind of nerve repair in a Toronto hospital and I spent 2 months in an enormous cast, from my upper torso to my hips, and once it was off, began extensive therapy via Mom. Thanks to her perseverance I had fair outcome and had a very fulfilling career as an ER nurse.

[@Momcat_maggiefelinefan]

I too have a severe birth related brachial plexus palsy. I had sensation but no function in my right arm which, luckily, was repairable by the time I was 8. Due to the injury I spent my first 8 years with a useless limb. I attended a Crippled Children’s travelling clinic (born and grew up un Northern Ontario, Canada, very medically under serviced even now) until I was 8. They did some kind of nerve repair in a Toronto hospital and I spent 2 months in an enormous cast, from my upper torso to my hips, and once it was off, began extensive therapy via Mom. Thanks to her perseverance I had fair outcome and had a very fulfilling career as an ER nurse.

[@jeanniegeiser9676]

I had Brachial Plexus in 2000. Horrific nerve pain down my arm. The nerves were all dying and I had a swinging limb. 2 and a half years physical therapy and surgery on my wrist of a tendon transfer, which was the second one ever and it worked. I praise God for helping me get through this. That was 23 years ago, and my neck is starting to hurt again and causing me lightheadedness and nausea. PLEASE HELP ME OUT HERE!

[@hbhossam]

Thank you so much , God bless you

[@zephra1675]

I’m an Erb’s Palsey baby from birth, but given the circumstances I got lucky with a minor case. My parents recorded my birth (both medical so didn’t think it weird) so when I was born the signal I had the brachio-plexus injury was that my arm was completely limp. I was a ‘turtling’ baby, but injury came primarily from the the forceps used on my head pulling too long; could have had my head pop off with the 20ish second duration, but result (luckily?) was the shoulder getting pulled. Biggest problem was the injury wasn’t treated or acknowledged (documented) by the staff at delivery. Certainly led to problems when my parents first seeked out physical therapy/evaluation for the injury, and baby me apparently circumvented therapy a bit much compensating with my left which wasn’t helping either. Thankfully my mom tried her hypothesis of using electro stimulation on specific muscle insertions around the damaged areas (mine is in my right arm with a bicep contracture) for muscle therapy and stimulation since she couldn’t find scientific articles on the topic proving her inference (it was 2003, so electrostimualtion was in a lull after 1960s sports use until mid 2010s had it implemented again) As an adult I may have some posture problems relating to it with winging scapula, but got lucky regaining most of my range young so the surgery option never had to be considered seriously. Visually speaking I think the only tell now would be my pretty much lack of a forearm muscle, also still have a bicep contracture so hair tying can be cramp inducing but range besides hyper extension is relatively there. Appreciate the extra information from the vid, having medical parents gives a more informed view but this helps contextualize as well

[@David-bi6lt]

😒will y'all believe when I tell y'all that I have a brachial plexus injury by sleeping with to many pillows...I thought it was entrapment but the stretching and gliding made it worse...now I know why ‼️🙏Thank You

[@Yashvant5569]

Good explanation sir

[@shivangdave870]

Thanks alot... that was helpful..

[@user-lz8bm5vi6p]

Amazing sir

[@wajeehaabbas8438]

Thank you so much sir..you are an amazing.l have learned a lot from your videos.lots of prayers from pakisatn

[@barbarafortesgarcia1696]

Acabo de descubrir sus videos y es que tenemos una bebe en casa con esta dificultad y me recomendaron sus videos . El problema es que no se inglés. Podrás ayudarme en esto. Gracias y bendiciones.

[@circleview21]

Kindly make a detail video on dermatomes and myotomes..

[@peterjohnston4472]

Struggling with a posterior shoulder dislocation and nerve damage. i have about 50 % (rom) not exactly sure as to what all is damaged as far as nevers i did have loss of sensation around the regimental badge area constant pain and burning around shoulder blade ,shoulder iner and outer forearm motorcycle rta 2021 Constantly think about a friend who took his own life after a serious brachial plexus injury from a motorcycle accident also . Tha ks for the informative video 😊

[@vincetheworldly537]

Neat. Thanks.

[@moizvahora241]

Thank you

[@Mehraj052]

Thank you so much sir.... Can you please make video on Cerebral Palsy?

[@LittleGenius399]

God how can Samy make every topic interesting

[@zahraahussein3496]

Perfect ..

[@amreenchahal7593]

Please make video lectures on embryology

[@rebeccagutierrez1960]

The waiters tips...it was perfect timing with the "restaurant kitchens" noise.🤣

[@SocialDeviant_]

😂 turtling, love the video, GREAT job! Thank you

[@jeanniegeiser9676]

Yes, I’ve had this….physical therapy is of the utmost importance to bring you back to functioning. I had 2 1/2 years and tendon transfer at the last. I have most back,….something you NEVER want to go through.

[@santoshchoudante4140]

Thanks sir

[@intelliGENeration]

A family memeber of mine has both arms incapacitated. He lives in a remote area and with very little knowledge or funds to venture into doing anything about it. I’m trying to help him out, but don’t even know what his condition is… though with enough research I feel like it’s a rare case of dual brachial plexus injury. Can that happen and under what conditions? Are there other conditions that leads to such an outcome? Truly appreciate your input as I’m pretty un-knowledgeable towards this and just want to see how to help him.

[@pw2l697]

did someone mention earlier that you and doctor house (house,md) tv show actor look same! great content btw

[@salihahaha]

Thanks

[@dominicgartung]

Hey, just wanted to hop in and show apreciation. I have sever erbs palsy/ brachial plexus palsy in my right arm with supination and partaily uncontrollable dislocation of my shoulder with lots of scar tissue. Had two nerve graft sugeries at 3 and 5 i think. Entire childhood of therapy....

[@moizzazahid3766]

WOW MAGICAL

[@toxin_d]

can chiroproctors cause this injury?

[@jaysonmabanag1121]

Hi Doc, i have ang Branchial Plexus Injurie in left arm due to motor cycle accident.. I want help 🙏

[@anandpaswan1371]

Good

[@irinaright6917]

Thank you! Better than House m.d. TV-show :)

[@hussankhan9482]

Sar god bless you and please answer me how can we recover this injury because my baby is 2 years old and she is suffering with this injury how we recover this injury please sir tell me

[@ilsole_777]

Anyone know of a doctor or surgeon in the US that can treat or reverse palsies?? There used to be a specialist in Texas that could reverse certain palsies up to the age of 35. I haven’t been able to locate any information on him after my initial contact over 15 yrs ago. I’m not even sure if he’s still in practice. Any information will be greatly appreciated!

[@lizmburu6296]

I have just discovered after consulting a physiotherapist that my 4month infant suffered a erbs paralys...... Please tell me there is hope for full recovery

[@50kArchipelagos]

I've been thinking both my brachialis were injured and not seeing great results from exercise and stretching. Now it's pretty obvious it's the nerves not the muscles. Though it sounds dumb I'll say it anyway for anyone who might benefit I did a tremendous stretching on waking one morning and just opening my eyes and I felt the strongest urge to just stretch like crazy and I pulled my arms up and fists up close to my head and everything my body just tensed up as though I were stretching, strangely tensing everywhere, the pain was instant, and for 6 weeks now both of my shoulders and arms have been unable to properly lift straight out to the side I can't reach my shower head it's very weird and hurts - alot. So I suppose I'll try some black seed oil orally some other things that are " magical healing that have worked throughout the millennia for things unexpected; frankly I just don't see a therapy for a nerve anywhere. I'll search on it. Thanks so much for raising my understanding level about this.

[@Yashvant5569]

Sir... Can you please explain why Elbow bends??

[@sahmad5456]

Awsome

[@tabbyskitchenandent.2694]

Pls Dr Sam wen this occurs in a new born what do you do...?

[@JyotsnaTY]

Immaculate ♥️♥️

[@majedalghamdi5221]

I have same case what do we need to solve ?

[@aogunnaike]

My baby presently has this erbs palsy, any lasting solution to this?

[@mohammadimad5664]

if we say biceps are paralyzed, which means we can't do supination, why the forearm then is automatically pronated? can not we relax the pronators and have a normal shape?

[@okoreesther8948]

Because the muscles of the pronators are active and there is no supinator to counter their effects.

[@quoteworld3375]

Am I eligible to pursue my medical degree if I have this erbs palsy in my left hand.... I have cured it 70%...bit still can't rotate my palm straight

[@meeka3312]

My brachial plexus(neuritis) happrned after parson turner syndrome..now 9 months in i still have wrist drop onleft hand ..will I ever recover? Thank you for you video.

[@jeanniegeiser9676]

I had a tendon transfer for wrist drop. Dr Kim in Downingtown, but he’s retired. The second one ever done and it worked. The first one didn’t. Maybe check Jefferson hospital hand specialist.

[@kendallspurlock2706]

What causes the elbow to become locked in Erb's Palsy. Where the patient can flex the arm to touch their face but can not straighten the arm. Also does Erb's cause winged scapula?

[@kendallspurlock2706]

Are there treatments for patients that have had it for over 30 years that could increase fine motor functions, increase of shoulder range, and the hardest of all which is general strength to the arm.

[@retaa9282]

شرح ممتاز 🎉

[@ramonara2]

Grazie mille Mio marito dopo l'incidente in moto soffre di trauma plesso brachiale 😐 speriamo tutto vada bene, non e facile, mio marito che aveva il braccio destro come quello di Thor non poter quasi non fare più niente e una cosa molto difficile per lui. Siamo così fragili 🥺 grazie mille di tutto adesso ho capito molto bene tutto!

[@jhanroseliu3591]

cool :D

[@MrMasterman6969]

high velocity impact zone cervical spinal region

[@freetime6030]

Brachial-plexus-injurie my left hand ✋ recover ideas please 🙏🙏🙏🙏 sir

[@Dijas.painting16]

Same thing happened to me

[@violetaoana1563]

Try vojta therapy. My 2 months old baby has it also :(

[@MrMasterman6969]

gaglions chronic regional pain syndrome cheers this I suffer.

[@dailydoseofmedicinee]

👍👍

[@rachkate76]

I’m halfway through but don’t understand why the forearm has to be pronated if the injury was caused by the forearms in extension

[@SamWebster]

Biceps brachii is a powerful supinator, so no musculocutaneous nerve function, no biceps function, less supination power.

[@rachkate76]

@@SamWebster thank you.

[@ronaldmanko1686]

💯

[@ernestspartan1670]

I have a younger brother who has erds palsy at his birth. He is now 16yrs and living with that condition in a West African country like Ghana, life is really difficult for him and us his family.😢😢 I wish there was any hopeful cure to this problem.somebody please help us

[@user-yj6nb2xl3g]

I love you Sam Webster ❤️❤️❤️❤️❤️

[@AbhilashNairSpartnax]

he gives me dr house vibes