Home

Klumpke's palsy ppt

PPT - Brachial Plexus Injuries PowerPoint Presentation

Erbs palsy - SlideShar

KLUMPKE'S PARALYSIS MECHANISM OF INJURY: Pulling up of the arm above the head, so that stretch on the C8 and T1 roots 9. Clinical Presentation Pronators of the forearm Flexors of the wrist joint. 10. GLOBAL/TOTAL BPI 11. DIAGNOSING ERB'S PALSY Erb's palsy is diagnosed by a thorough physical examination and medical history V Klumpke's Palsy is a birth injury that. occurs when a baby sustains injury to the brachial plexus during birth. Palsy statistics show that there is a brachial plexus injury every five hundred to one thousand births. Klumpke's Palsy is one of several Brachial Plexus injuries. These injuries also include Brachial Plexus Palsy and Shoulder Dystocia V The nerve root involved are C7 C8 and T1 V. Klumpke's paralysis- Site of injury Cause of injury Nerve roots involved Muscles paralysed Deformity Disability CLAW HAND Erb's palsy Erb's palsy (Erb-Duchenne Palsy) is a paralysis of the arm caused by injury to the upper trunk C5- C6. signs of Erb's Palsy include loss of sensation in the arm and paralysis and atrophy of the deltoid. Erb-Duchenne palsy (waiters tip) 24. Lower Lesions of the Brachial Plexus(Klumpke Palsy) traction injuries by excessive abduction of the arm i.e. occurs if person falling from a height clutching at an object to save himself or herself. Can be caused by cervical rib. T1 is usually torn (ulnar and median nerves) 25 Klumpke's palsy is a condition, most often a birth injury, that results from damage to specific nerves of the brachial plexus. The brachial plexus nerves run from the spine, along the side of the neck, through the armpit area, and down the arm. They allow for movement and sensation in the arm, wrist, and hand

Klumpke paralysis is a neuropathy of the lower brachial plexus which may be resulted from a difficult delivery[1]. Usually, the eighth cervical and first thoracic nerves are injured either before or after they have joined to form the lower trunk. This injury can cause a stretching (neuropraxia,), tearing (called avulsion when the tear is at the spine, and rupture when it is not. Describe the lymphatic circulation of the mammary gland Describe the characteristic features of Erb-Duchenne palsy and Klumpke s paralysis Describe the arterial - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 7d93ce-MmZl Brachial Plexus Dr. Sama-ul-Haque Dr. Nivin Sharaf Waiter s tip palsy Erb's palsy is caused by damage to the brachial plexus during delivery of the neonate. - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 3d4cc7-ZGY3

Symptoms of Kumpke's Palsy. Whether a baby has minor neuroplaxia or full avulsion, Klumpke's palsy can present a number of symptoms. These include numbness, tingling, or partial loss of feeling in the hand, wrist, and/or forearm. In more severe cases, your child will experience partial or full paralysis in the lower part of their arm and hand Klumpke's palsy can give the hand a claw-like appearance. During labor, damage to the baby's brachial plexus can occur if the child is unusually large, or if there is a difficult presentation such as a breech birth. Sometimes, after the head has emerged, there can be a problem delivering the shoulder

Peripheral Nerve Injuries.ppt - Peripheral Nerve Injuries J C Munthali Anatomy of Peripheral Nerve Neuron \u2022 Cell Body \u2022 Dendrites \u2022 Axon \u2022. Birth Injuries • Upper arm lesion (Erb's palsy) • Lower arm lesion (Klumpke's palsy) Long Thoracic Nerve. Obstetric Brachial Plexopathy is injury to the brachial plexus that occurs during birth usually as a result of a stretching injury from a difficult vaginal delivery. Diagnosis is made clinically and depends on the nerve roots involved. Treatment can be observation or operative depending on the nerve roots involved, the severity of injury, and. Klumpke's Paralysis Due To Injury To C7,c8 Nerve Roots. -phrenic Nerve PPT. Presentation Summary : Klumpke's paralysis due to injury to C7,C8 nerve roots. -phrenic nerve palsy leading to paralysis of the hemidiaphragm -thoracic spinal cord injury will cause

Klumpke's paralysis - Scrib

Klumpke's palsy, or Klumpke's paralysis, is a form of brachial plexus palsy - a paralysis of the arm due to an injury of the network of spinal nerves that originates in the back of the neck, extends through the shoulder and armpit and gives rise to nerves in the arm. Klumpke's palsy is also sometimes referred to as Dejerine-Klumpke palsy Klumpke's paralysis is a variety of partial palsy of the lower roots of the brachial plexus. The brachial plexus is a network of spinal nerves that originates in the back of the neck, extends through the axilla (armpit), and gives rise to nerves to the upper limb

Klumpke's Palsy involves C8, T1; total OBPP affects all levels of the Brachial plexus, C5-T1. predict recovery in infants with brachial plexus birth palsy. It is designed to predict outcome, and to differentiate between good and poor recovery groups. If the score is less than 3.5 at 3 months of age, poor recovery i Klumpke's palsy is the term given to isolated lower brachial plexus injury involving the eighth cervical and first thoracic roots (C8,T1) resulting in loss of digital flexion and hand intrinsic function. The palsy may also be associated with Horner syndrome (ptosis,. Erb\u2019s Duchenne Palsy.pptx - Erb\u2019s Duchenne Palsy Klumpke Paralysis Aashitosh Mahato Erb\u2019s Duchenne Palsy Erb\u2019s Point Erb\u2019s Point Brachia Paralysis of the arm due to an injury to the brachial plexus. Upper (C5, C6): Erb's palsy lower (c8, t1): Klumpke's paralysis. Avulsion of nerve roots, usually from high speed injuries with other injuries and LOC. Pseudomeningocele, denervation of neck muscles are common - horner's sign (ptosis, miosis, anhydrosis

medical ppt online.blogspot.com contains lecture notes in most fields of medicine. § Brachial plexus injury (Erb's/Klumpke's palsy) § Asphyxia/cord compression Management § Goal: safely deliver infant before asphyxia and/or cortical injury § 7 minutes!! شَلَلُ كلومبكه (بالإنجليزية:Klumpke's palsy) أو (بالإنجليزية:Klumpke paralysis)، هو شَلل عَصبي يَحدث في الجُزء السُفلي من الضَفيرة العَضُدية وخاصة في الجَذر العَصبي رَقم (C8,T1) ،ويُعرف هذا الشَلل أيضاً بإسم اليَد المِخلبية الكامِلة Erb-Duchenne (Erb's) palsy refers to paralysis of the upper brachial plexus. Dejerine-Klumpke (Klumpke's) palsy refers to paralysis of the lower brachial plexus. Although injuries can occur at any time, many brachial plexus injuries happen when a baby's shoulders become impacted during delivery and the brachial plexus nerves stretch or tear In the 1870s, Duchenne and Erb described cases of upper trunk nerve injury, attributing the findings to traction on the upper trunk, now called Erb's palsy (or Duchenne-Erb's palsy). In 1885, Klumpke described injury to the C8-T1 nerve roots and the nearby stellate ganglion that now bears her name The types of birth injuries that may benefit from surgical intervention are discussed in more detail in separate articles. (See Infant Brain Damage, Cerebral Palsy, Erb's Palsy, Klumpke's Palsy, Brachial Plexus Injury and Infant Spinal Cord Damage)

(PPT) Ac seminar Brachial plexus

The brachial plexus is a network of nerve fibres that supplies the skin and musculature of the upper limb. It begins in the root of the neck, passes through the axilla, and runs through the entire upper extremity. The plexus is formed by the anterior rami (divisions) of cervical spinal nerves C5, C6, C7 and C8, and the first thoracic spinal nerve, T1 Definition/Description [edit | edit source]. Erb's palsy or Erb-Duchenne palsy is a form of obstetric brachial plexus palsy. It occurs when there's an injury to the brachial plexus, specifically the upper brachial plexus at birth. The injury can either stretch, rupture or avulse the roots of the plexus from the spinal cord.It is the most common birth-related brachial plexus injury (50- 60%) Erb's Palsy (Brachial Plexus Birth Injury) Brachial plexus is a structure comprising of several nerves that send signals to upper limbs and control their functioning. These nerves root from the spinal cord at an area near the neck, and extend throughout the shoulders, arms and hands to regulate the movement, flexibility and sensation of these. Erb's palsy is a form of brachial plexus palsy. It is named for one of the doctors who first described this condition, Wilhelm Erb. The brachial plexus (BRAY-key-el PLEK-sis) is a network of nerves near the neck that give rise to all the nerves of the arm. These nerves provide movement and feeling to the shoulder, arm, hand, and fingers Dejerine-Klumpke paralysis (Augusta Marie Klumpke was his American wife) Dejerine-Roussy syndrome. Dejerine-Sottas disease. Dejerine-Thomas olivopontocerebellar atrophy. Landouzy-Dejerine syndrome. History of Neurology France Late 1800's - SalpêtrièreVisiting Scholars

PPT - Birth injury PowerPoint Presentation, free download

Start Aktualności Bez kategorii obstetric brachial plexus injury ppt. obstetric brachial plexus injury ppt. Brachial palsy, also referred to as Erb's palsy, Klumpke paralysis, or Erb-Duchenne paralysis, is characterized by a general weakness or paralysis of the arm. This is caused when damage occurs to the brachial plexus, or the nerves located around the shoulder.This condition is often brought on by a traumatic birth experience, such as when the infant's head is pulled to one side or when the. Erb's palsy Kristín Ólína Kristjánsdóttir Barnalæknisfræði feb 2005 Læknadeild HÍ Almennt Langflestir plexus brachialis skaðar (BPP) við fæðingu eru skammvinnir (<1 vika) Lítið hlutfall barna hafa áfram máttleysi til lengri tíma (3-25%) 0,5-4,4 á hver 1000 fullburða börn Dæmigerðar aðstæður Stórt barn (3,8-5,0kg) Erfið fæðing fjölbyrja konu Þarf að nota. Klumpke's palsy - Horner's syndrome is present, ie meiosis, ptosis, anhydrosis. Investigations. High-resolution MRI requires no radiation exposure, is non-invasive and provides more detail than CT myelography. Plain X-rays can be useful to diagnose hemidiaphragm paralysis from phrenic nerve involvement, or fractures of the clavicle or humerus

Klumpke's Palsy Symptoms, Treatment, Prognosi

The results formed the basis for her first research paper on brachial plexus palsy, which was published in 1885 and awarded the Godard Prize of the French Academy of Medicine in 1886. The condition is now known as Dejerine-Klumpke's palsy, and her work is still considered a breakthrough. But her journey to prominence was difficult Klumpke's palsy. Birth injuries. Hospital Universitario Materno-Infantil de Canarias. Las Palmas de Gran Canaria 1Servicio de Rehabilitación. 2Servicio de Obstetricia y Ginecología. 3Departamento de Ciencias Clínicas. Universidad de Las Palmas de Gran Canaria Klumpke's Paralysis (lower plexus injury) It is caused by the hyperabduction of the arm, which may occur when one falls on an outstretched hand or an arm is pulled into machinery or during delivery (extended arm in a breech presentation. The nerve roots involved in this injury are C8 and T1 and sometimes C7. The clinical features of Klumpke.

Radial nerve palsy is a condition that affects the radial nerve. It can be cause by pressure injuries caused by awkward body positions for long periods of time (often while working or sleeping). Learn more about radial palsy signs, symptoms, diagnosis, & treatment protocol at Baptist Health Lower Trunk Injury (Klumpke's Palsy) Lower trunk injuries (C8-T1) may occur with tumors (such as Pancoast tumors of the lung), childbirth, a cervical rib, and other causes. With trauma, these often include abduction of the arm (movement away from the body) while holding an object and falling. These spinal nerves eventually emerge as the radial. Start studying OTH 203 - BRACHIAL PLEXUS PPT. Learn vocabulary, terms, and more with flashcards, games, and other study tools summary. Gait Disorders in Cerebral Palsy are commonly caused by lower limb spasticity and are the primary reason for orthopaedic consultations in CP patients. Diagnosis is made with quantitative evaluation using kinematic, kinetic and EMG analysis. Treatment is usually physical therapy, orthotics and bracing in patients with mild gait disorders

Klumpke's Paralysis - Physiopedi

Not all children with cerebral palsy are going to have sensory deficits. In fact, sensory problems and cerebral palsy aren't even directly related. Although they commonly co-occur, they're caused by different sources of brain damage. In this study of 96 children with cerebral palsy, sensory deficits were present in 41.7% Klumpke's paralysis is a much rarer type of brachial plexus injury which affects the forearm and the hand. It can cause paralysis of the hand muscles and weakness in the arm. Erb's palsy and Klumpke's paralysis are usually complications of shoulder dystocia. In about 10% of shoulder dystocia cases, the babies suffer brachial plexus injury Duty, in tort law, is a legal obligation imposed on one individual which requires that they adhere to a standard of behavior in the course of actions where others could foreseeably be harmed. Healthcare providers have a legal duty to adhere to the standard of care within their field. If a plaintiff brings forth a claim of medical malpractice. Klumpke palsy is rare and is a lower plexus injury that causes weakness or paralysis of the hand and wrist. The grasp reflex is usually absent, but the biceps reflex is present. Often, the sympathetic fibers of T1 are involved causing an ipsilateral Horner syndrome (miosis, ptosis, facial anhidrosis). Passive range-of-motion exercises are. Q.2 : Klumpke s Palsy involves A/E: A : C6 B : C7 C : C8 D : T1 Ans: A Q.3 : Branch of Cervical part of ICA is : A : Opthalmic B : Ant. cerebral C : Post. communicating D : None. Ans: D Q.4 : If median nerve is injured at the wrist then loss of function of all of the foll. will take place except: A : Lumbrical muscles to index finge

An ulnar claw, also known as claw hand, or ' spinster's claw ' is a deformity or an abnormal attitude of the hand that develops due to ulnar nerve damage causing paralysis of the lumbricals.A claw hand presents with a hyperextension at the metacarpophalangeal joints and flexion at the proximal and distal interphalangeal joints of the 4th and 5th fingers Damage to the lower roots (C7, C8 and T1) produces weakness of the intrinsic muscles of the hand, especially on the medial side, which is the ulnar or 'power' side. This is known as Klumpke's paralysis Klumpke's palsy refers to paralysis of the lower brachial plexus. This typically affects only the muscles in the hand and is not common in babies. Total plexus involvement includes damage to all five nerves of the brachial plexus C5-T1. This can cause a child to have no movement in the shoulder, arm, wrist, and hand Obstetric Brachial Plexus Palsy refers to a medical condition in which there is paralysis of the arm as a result of injury to the nerves originating behind the neck and going down the arm. The classic presenting features of Obstetric Brachial Plexus Palsy include atrophied muscles of the hands, symptoms of Horner syndrome to include ptosis of the eyes and face For weakened muscles in Erb's palsy, imagine BIRDS eating h ERBS served by a waiter: B iceps brachii, I nfraspinatus, w R ist extensors, D eltoid, S upraspinatus, waiter 's tip posture. Klumpke palsy. Injury to the lower trunk of the brachial plexus (C8-T1) Etiology. Hyperabduction of the arm. Trauma (e.g., breaking a fall by grabbing a branch

PPT - Describe the lymphatic circulation of the mammary

ob·stet·ric pal·sy a brachial plexus lesion sustained by the infant during the birthing process; three types are recognized: upper plexus type, affecting the shoulder and upper arm (Erb palsy, q.v., by far the most common form); total plexus type, involving the whole arm; and lower plexus type, involving the forearm and hand (Klumpke palsy, q.v. The inferior neonatal plexus injury, Klumpke palsy, involves C8 and T1. It presents with hand interosseous and forearm muscle weakness. It may be associated with Horner syndrome. Rarely, there is a question of differential diagnostic considerations. The knowledge of fetal trauma during delivery and the expected recovery course may, in some. Paralysis Definition Paralysis is defined as complete loss of strength in an affected limb or muscle group. Description The chain of nerve cells that runs from the brain through the spinal cord out to the muscle is called the motor pathway. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the.

Objectives: To determine the incidence and study the causes and outcome of congenital brachial palsy (CBP). Design: Active surveillance of newborn infants using the British Paediatric Surveillance Unit notification system and follow up study of outcome at 6 months of age. Setting: The United Kingdom and Republic of Ireland. Participants: Newborn infants presenting with a flaccid paresis of the. Summary. Cerebral palsy (CP) is a heterogenous group of disorders affecting the muscle tone and the development of movement and posture. CP results from a non-progressive damage to the brain in utero or during infantile development up to the age of 3 years.Depending on the affected brain area, spastic, ataxic, or dyskinetic cerebral palsy develops.. While, in many cases, there is no. nerve palsy such as focal weakness, atrophy or sensory loss and absent ankle reflexes [13]. Although HNPP is an uncommon cause of neuropathies, a detailed history including family history, neurologic exam and genetic testing may be helpful in identifying the disorder. In our case, radial nerve was the predominantly affected peripheral. No se encontraron resultados. Estas acciones pueden ayudarle a encontrar la información que busca: Escriba varias letras del trastorno o desorden; haga clic en los términos sugeridos que aparecen debajo del buscador

PPT - Brachial Plexus PowerPoint presentation free to

  1. Brachial Plexus Injuries - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. Scribd is the world's largest social reading and publishing site
  2. Klumpke's palsy. Sensory Loss in C8-T1 brachial plexus injury resulting in claw hand deformity; usually improves btwn 3-6 months PPT 4. 28 terms. Griffin_Gill7. Histology Test One - PPT 2. 30 terms. Griffin_Gill7. Histology Test One - PPT 3. 17 terms. Griffin_Gill7. Histology Test One - PPT 1. 27 terms
  3. 83506146 mcq upper lower limb 2 ppt human leg foot, clinical anatomy of the upper limb welcome to khima, anatomy mcqs on joints of upper limb mpt preparation mcqs, mcqs and seqs of lower limb anatomy for 1st year mbbs, free anatomy quiz the muscles of the upper limbs, upper limb anatomy mcq 7, anatomy mcqs fre
  4. Klumpke's. palsy. the lower nerve roots (C8,T1) small muscles of hand are paralysed (claw hand) Loss of sensation over medial border of upper limb. Injuries to individual nerves of the brachial plexus. Injury to long thoracic nerve (C5-7) Paralysis of serratus anterior muscl
  5. Klumpke's Palsy (C8-T1) General Comments Physical Exam . Rare in obstetric palsy . Deficit of all the small muscles of the hand (ulnar & median nerves) Usually avulsion injuries caused by excessive abduction (person falling from height clutching on object to save himself
Flashcards - MSK First Aid - Stratum Basalis Stratum1 = Erb&#39;s Palsy 2 = Musculocutaneous N

Klumpke's Palsy - Causes, Symptoms and Treatment Option

palsy: Erb-Duchenne C5/C6 No shoulder abduction, external rotation, elbow flexion Upper and middle trunc plexus palsy C5/C6/C7 + no elbow-, wrist-, finger- extension Lower trunc plexus palsy: Déjérine-Klumpke C8/TH1 No intrinsic muscle function, ulnar wrist-, finger flexion Total plexus paralysis C5/C6/C7/ C8/TH1 flail ar It is called Erb palsy or Klumpke palsy, depending on which part of the plexus is injured. Erb palsy affects between 1 and 2 babies in every 1,000 births. What causes a brachial plexus injury? The most common cause of this injury is when the neck is tilted while pulling (traction) happens on the other side of the neck.. Brachial palsy (Erb-Duchenne paralysis, Klumpke palsy). Phrenic nerve injury (paralisis diafragma) Cidera tulang belakang. Masalah dermatologik (kulit) Erythema toxicum neonatorum, Flea bite dermatitis . atau . newborn rash. 1. Oral candidiasis (thrush) beri nystatin. 2. Masalah dermatologik (kulit) 4. 5

What is Klumpke's Palsy? (with pictures

Peripheral Nerve Injuries

Claw hand deformity ppt This article may require cleanup to meet Wikipedia's quality standards. The specific problem is: the writing style should be improved Please help improve this article if you can. (November 2012) (Learn how and when to remove this template message) A hand imitating an ulnar claw Claw hand is a condition that causes curved or bent fingers. Claw hand is a hand characterized by curved or bent fingers, making the hand appear claw-like. This makes the hand appear like the claw of an animal. Causes of claw hand can also be due to anything that may lead to ulnar nerve palsy. Someone can be born with claw hand (congenital), or.

Obstetric Brachial Plexopathy (Erb's, Klumpke's Palsy

Inferior parts: C8, T1: Klumpke Paralysis -caused when the arm is suddenly pulled superiorly, eg. when you grab something while falling vertically down - short muscles of the hand are affected, and you get a claw hand Branches DivisionsCords Trunks Roots Suprascapular nerve Nerve to subclavius Dorsal scapular nerve Supraclavicular branche It is called Erb palsy or Klumpke palsy, depending on which part of the plexus is injured. Erb palsy affects between 1 and 2 babies in every 1,000 births. What causes a brachial plexus injury? The most common cause of this injury is when the neck is tilted while pulling (traction) happens on the other side of the neck. But the causes of injury. Ulnar nerve palsy is the loss of sensory and motor function. This can occur after injury to any portion of the ulnar nerve. The ulnar nerve is the terminal branch of the medial cord (C8, T1). The ulnar nerve innervates the flexor carpi ulnaris after it passes through the cubital tunnel facial paralysis in newborn ppt. Check your BMI. Height. Weight. Age What does your number mean ? What does your number mean ? What does your number mean? Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. BMI values are age-independent and the same for. Lower-Trunk Palsy Injury. Lower-trunk palsy occurs when the angle between the arm and the chest wall forcibly widens. This may damage the lower nerves and the lower trunks. Patients with a lower-trunk palsy will typically maintain shoulder and elbow strength, but will lose hand function. Over time, this will cause the fingers to contract into a.

PPT - Shoulder Dystocia PowerPoint Presentation, freePPT - Peripheral Nervous System 1: The Somatic System

ERB'S PALSY. Definisi. Erb's palsy adalah kelumpuhan otot-otot di lengan bayi yang disebabkan oleh luka saraf di bahu waktu lahir (Warner, 2002). Erb's palsy adalah kelemahan pada lengan yang terjadi pada proses kelahiran (www.ecureme.com) Etiologi Erb's palsy atau yang biasa juga disebut dengan lesi plexus brahialis terjadi karena adanya kerusakan saraf yang mengontrol gerakan lengan. C8-T1 Lower Trunk Nerve Roots: Lower trunk paralysis is known as Dejerine-Klumpke Palsy. 1. Motor Strength: This is manifested by paralysis of all intrinsic muscles of the hand; weakness of the flexor carpi ulnaris and flexor digitorum profundus of the little finger; Horner syndrome (ptosis, myosis

Ppt Shoulder-dystocia Powerpoint Presentations and

Both heads may show neurogenic changes in (C8, T1, radiculopathy, Klumpke's palsy C8, T1, root avulsion), and anterior horn cell disease. Anatomical Illustrations 1st, 2nd Lumbricals. Innervation. Innervation is via the median nerve, medial cord, lower trunk, and roots C8, T1. Origi There are two types of brachial plexus paralysis in neonates: the upper plexus injury is called Erb's palsy; the lower plexus injury is called Klumpke's palsy. In the UK the incidence is 0.42 per 1,000 live births. Death and dying ppt. Importance of music in culture. Acupuncture points for sinus congestion

Cervical Rib (Accessory Rib) Occurs in 0.5% population There is an extra pair of ribs just above the 1st rib They arise from the transverse process of C7 vertebrae Anteriorly, they may be attached to 1st Rib or may be free Clinical Anatomy: Cervical Rib may compress Brachial plexus/Subclavian artery; causing Klumpke's paralysis/Ischemi For children with cerebral palsy, occupational therapy can help with muscle and joint coordination issues — issues that can make everyday tasks difficult. Some of these tasks include eating, brushing teeth and bathing. Occupational therapy can help to improve physical, cognitive and social abilities, as well as fine motor skills and posture Introduction. The nerve supply to the upper limb is an important and complex topic which will inevitably appear in anatomy questions, clinical case scenarios and OSCEs. It is also very relevant to clinical practice. This article will focus on the five terminal nerve branches of the brachial plexus which supply the upper limb.These are the musculocutaneous nerve, the axillary nerve, the radial. Cephalopelvic disproportion, sometimes also referred to as fetopelvic disproportion, occurs when the baby's head is too large to fit through the birth canal. CPD may be caused by gestational diabetes, post-dates pregnancy, small maternal pelvis, abnormally shaped pelvis, or abnormal presentation of the baby Excessive force should not be applied to the prolapsed limb as it may cause limb or brachial plexus injury (Klumpke's paralysis) or Horner's syndrome, or may displace the vertex and entrap the fetus converting it into a difficult shoulder presentation