<prompt> Klumpkes paralysis involvedC5, 6C6, 7C7, 8C8, T1  <response>: C8, T1 53-BDC-l 4thERBS PARALYSISKLUMPKES PARALYSISSite of Injury - The region of the upper trunk of the brachial plexus is called Erbs point, six nerves meet here. Injury to the upper trunk causes Erbs paralysis.Lower trunk of brachial plexusCause of injury - Undue seperation of the head from the shoulder, which is commonly encountered in i birth injury ii fall on the shoulder iii during anaesthesiaUndue abduction of the arm, as in clutching something with the hands after a fall from a height or sometimes in birth injuryNerve root involved - Mainly C5 and partly C6Mainly T1 and partly C8Muscle paralysed - Mainly biceps, deltoid, brachialis, and brachioradialis. Partly supraspinatus, infraspinatus and supinatorDeformity - position of the limbArm: Hangs by the side: It is adducted and medially rotated.Forearm: Extended and pronatedThe deformity is known as policemans tip or porter s tip hand1. Intrinsic muscles of the hand Tl2. Ulnar flexors of the wrist and fingers C8Claw hand due to the unopposed action of the longflexors and extensors of the fingers.Hyperextension at the MCP joint and flexion at the IP jointDisability: The following movements are lost1. Abduction and lateral rotation of the arm shoulder2. Flexion and supination of the forearm3. Biceps and supinator of the forearm4. Sensation are lost over a small area over the lower part of the deltoid1. Claw hand2. Cutaneous anaesthesia and analgesia in a narrow zone along the ulnar border of the forearm and hand3. Homers syndrome This is because of injury to sympathetic fibres to the head and neck that leave the spinal cord through nerve T14. Vasomotor changes5. Trophic changes 