brachial plexues Flashcards by Afnan Katlo

The brachial plexus consists

cervical c5-c8
thoracic T1
and variable C4 (pre-fixed) or T2 (post-fixed) contributions.

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in BP there are 5 roots and 3 trunks
true or false?

true

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what are the trunks of BP?

superior
middle
inferior

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the BP goes as roots, trunks,divisions,cords ,and branches
true or false?

true

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what is the reason for obstetric brachial plexus injury?

traction to the brachial plexus during labor

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what are the results of OBPI?

flaccid paralysis of the arm
muscle weakness, atrophy and contractures, inability to load weight on the affected arm, sensory disturbances,and growth retardation

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C7 had the shortest root and T1 had the longest root length.
true or false?

false, its the opposite

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Nerves with short spinal root lengths are more prone to deformation due to longitudinal traction
true or false?

true

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C5 and T1 nerve roots are more difficuilt injured by traction maneuver
true or false?

false, more easily

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what are the etiology of OBPI?

Shoulder dystocia
fetal size of more than 4000g
comorbid birth trauma
gestational diabetes leading to macrosomia
second stage of delivery (<15mins) and vacuum birth

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OBPI is more often encountered in overweight mothers (BMI>29) and those aged over 35 years
true or false?

true

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There is a higher incidence of OBPI in cesarean than in vaginal birth
true or false?

false

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breech birth is a risk factor OBPI
true or false?

true

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The most common finding accompanying OBPI is humeral fracture
true or false?

false clavicular fracture

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There is difference in gender of the new borns with OBPI
true or false?

false

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what are the common injured roots nerve when the shoulder is squeezed because of excessive pulling during labor?

c5-c6 and upper trunk

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what are the injured roots nerve related to breech labor?

C8-T1 roots and lower trunk

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how can the BPI happen during normal birth?

develops after traction applied to the nerves with excessive lateral bending of the head and neck during the outflow of the shoulders

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what are the types of nerve injuries?

neuropraxia
axontonmesis
neurotmesis

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what is the blockage of conduction called?

neuropraxia

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what is called when the axon not continues but the nerve is intact?

axontonmesis

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rupture of the nerve is neurotmesis
true or false?

true

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Wallerian degeneration takes place in axontonmesis but not in neuropraxia
true or false?

true

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Upper Brachial Plexus Lesions (Erb-Duchenne) Injury in C5-6 (±C7).
true or false?

true

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UBPL is common during head presentation labor? true or false?

true

paralysis of UBPI to which muscles?

biceps, deltoid, brachioradialis, infra and supraspinatus, brachialis, rhomboid and teres minör muscles abduction and external rotation of the arm are lost, forearm flexion and supination weaken

sensory impairments are to which muscles in UBP?

deltoid and radial forearm

what are the lost reflex in UBPI?

biceps,moro,radial

Lower Brachial Plexus Lesions (Klumpke) the affected nerves are?

c8-t1

klumpke characterized by paralysis and atrophy of the small muscles of the hand, the claw hand occurs, sensory impairment is in the ulnar part of the hand true or false?

true

Skin edema, cyanosis, trophic nail changes may occur in?

lower brachial plexus injuries

Forearm flexor muscles, hand intrinsic muscles, finger extensors and wrist flexor muscles are not affected in LBPI true or false?

false, are affected

Sensory defect is seen in the medial of the forearm in LBPI true or false?

true

which reflex is lost in LBPI?

grasp reflex

horner syndrom can be seen in UBPI true or false?

false, LBPI

horner syndrome happens because of the parasympathetic fibers injury of T1 true or false?

false, sympathetic fibers of T1

Miosis Ptosis Enophthalmos Anhidrosis are all related to?

horner syndrome

neglect of the arm happens in ?

total BP injury

winging scapula is related to which nerve roots?

c5-c6

torticollis should be evaluated to any OBPI true or false?

true

phrenic nerve involvement related to ?

respiratory

primitive reflexes are used to evaluate motor function true or false?

true

Mallet Classification that is most commonly used to?

OBPI

what is the ability to recognize letters and numbers written on certain parts of the body with a blunt object?

Grafesthesia

grafesthesia is measured form age 5 and 2 pont tactil descrimination mesured from age 9 ture or false?

true

grafesthesia is measured from age 5 and 2 pont tactil descrimination mesured from age 9 True or false?

True

how can we evaluate deep sensations?

Semmens-Weinstein monofilament test

EMG should be taken after the 20th day for OBPI true or false?

false, t0th

1-Swinging the arm next to the body should be prevented. 2-The baby should be held under the belly. 3-The arm should be kept at the level of the baby's neck. 4-Shoulder and elbow should be checked continuously for subluxation which are wrong?

2nd and 3rd

what are the purposes of PT in BPI

Protecting ROM Prevent contractures Prevent asymmetry To provide sense-motor integration Facilitate reflex development (protective extension) Guiding activities involving bilateral limb movements

passive movements should be started in the first week and ABD+elevation of shoulder should not exceed 90 degress in the first 3 weeks true or false?

true

Weight transfer exercises must be done to prevent the difference in arm length in the developing child true or false?

true

Reducing contracture To prevent the development of deformity Supporting movement are done by?

splints

what is the rehabilitation for phase one?

in the first 2 weeks, the caregiver should be informed about the positioning, holding and daily life

Weight transfer exercises to prevent muscle tension, increase ROM, sensory and muscle strength, provide proprioceptive stimulation and isometric muscle contraction are done in which rehab stage?

2nd phase 2 weeks-4 months

Providing age-appropriate skills, rolling-turning, protective reactions, and reaching out. Preventing contractures and deformities are done in which rehab phase?

3rd phase 4-6 months

Phase 4 (6-12 months) is about Increasing muscle strength and sensation, promoting sitting, crawling, standing, walking. Prevention of contractures and deformities, revealing functional movement with electrical stimulation (Russian Current-NMES). true or false?

true

what is Phase 5 (1-4 year) in rehb?

Acquiring age-appropriate skills, preventing learned use, preventing contracture and deformity, hydrotherapy

phase one =first 2 weeks phase 2= 2 weeks-4 months phase 3= 4- 6 months phase 4= 6-1 year phase 5= 1-4years true or false?

true

when the preventing physiotherapy or immobilization position is applied?

1st 3 weeks

Supine Positioning -A roll should be placed under the head, neck, shoulders and elbows true or false?

true

To prevent head and neck extension -To prevent excessive retraction of the shoulder -To prevent excessive extension of the arm -Supporting bilateral active movements are achieved in ?

supine positioning

A roll under the head, thoracic and lumbar areas should be supported with a roll, and a roll between the arms to reach under the elbow to which position is this?

sidelyine

what is the aim of side-lying positoining?

To provide the aid of gravity to active arm movement. To provide active mobilization of the scapula

how prone position is applied?

a roll under the chest

Facilitation of bilateral weight transfer to forearms and hands with head control is the aim of?

prone position

how can we provide sensory inputs?

-Classic massage -Weight transfer in the prone position and in the crawling position -Stimulating the affected side with different surfaces and brushes

2-3 weeks later for?

PROM

Shoulder flexion 90 Shoulder abduction 140 for PROM ture or false?

false, flex=140 ABD= 90

5 seconds should wait at the end of the movement for PROM true or false?

true

3-4 times a day, 20 repetitions for PROM true or false?

false, 10 repetitons

Early protection Exercise Electrical stimulation Splinting Scar treatment Desensitization Family Education Periodic evaluation are for?

early rehabilitation surgery

before 6 month is PROM and after is AROM true or false?

true

electrical stimulation is applied during?

4weeks-3 months

weight bearing and strengthening exercises when are applied?

more than 6 months

immobilization splint are applied in?

0-3 weeks

sensory education is done after?

4th month

0-6 weeks: Immobilization 6-8 weeks: Exercise without the gravity, Electric stim. 8-10: weeks: Night use of the splint. Mild strengthening exercise, mild functional exercise 12 weeks: Stretching exercise,Functional exercise is program for?

rehabilitation after tendon transfer

what type of assessments should be done for BPI?

motor functional physical respiratory tonus sensory UE length and circumference volume scolioses balance EMG

brachial plexues Flashcards

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