Klumpke's paralysis results from lesion of

Ans. b (Lower brachial plexus injury). (Ref. B & L, Surgery, 22nd ed., 380)Klumpke's paralysis- Site of injuryLower trunk of brachial plexus.- Cause of injuryUndue abduction of arm, as in clutching something with the hands after a fall from height or sometimes in birth injury.- Nerve root involvedMainly T1 & party Cg- Muscles paralysed- Intrinsic muscles of the hand (T1).- Ulnar flexors of the wrist & fingers (C8)DeformityClawhand due to unopposed action of the long flexors & extensors of fingers.In a clawhand there is hyperextension at the metacarpo-phalangeal & flexion at the interphalangeal joints.- DisabilityCutaneous anesthesia & analgesia in a narrow zone along the ulnar border of forearm & hand.- Horner's syndrome-ptosis, miosis, anhydrosis, enopthalmos, & loss of ciliospinal reflex may be associated. (MH'05, AI05, Kar'05)