Week 8 - Obstetrical Brachial Plexus Injuries Flashcards
how is obstetrical brachial plexus palsy defined?
defined as a flaccid paresis of an UE due to traumatic stretching of the brachial plexus received at birth, with the PROM greater than the AROM
obstetrical brachial plexus palsy results from injury to which parts of brachial plexus?
- cervical roots C5-C8
- thoracic root T1
what % of individuals with obstetrical brachial plexus palsy have recover spontaneously?
70%-92%
describe 2 aspects of the pathophysiology of obstetrical brachial plexus injury.
- excessive traction applied to nerves
- intrauterine maladaptation
name 3 causes of excessive traction applied to nerves in OBP injury.
- shoulder dystocia
- use of excessive or misdirected traction
- hyperextension of the arms in breech extraction
name 3 neonatal risk factors of OBP.
- high birth weight (>8.8 lbs)
- fetal position - breech
- poor tone
birth weight is strongly associated with what?
increased risk of shoulder dystocia
name 3 maternal risk factors of OBP.
- diabetes/obesity/excessive weight gain
- maternal age (>35 years)
- maternal pelvic anatomy
name 3 labor-related risk factors
- shoulder dystocia
- prolong duration of labor
- the mode of delivery
anterior shoulder impacted behind pubic synthesis
shoulder dystocia
describe the severity of OBP classifications in order of most severe to least severe.
- avulsion
- neurotmesis
- axonotmesis
- neurapraxia
which roots of the BP are affected if it is classified as “upper?”
C5, C6 and sometimes C7
which roots of the BP are affected if it is classified as “intermediate?”
C7 and sometimes C8, T1
which roots of the BP are affected if it is classified as “lower?”
C8 and T1
what is an upper BP injury also known as?
Erb’s Palsy
what is a lower BP injury also known as?
Klumpke paralysis
