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pediatrics > brachial plexues > Flashcards

brachial plexues Flashcards

1
Q

The brachial plexus consists

A

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

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2
Q

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

A

true

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3
Q

what are the trunks of BP?

A

superior
middle
inferior

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4
Q

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

A

true

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5
Q

what is the reason for obstetric brachial plexus injury?

A

traction to the brachial plexus during labor

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6
Q

what are the results of OBPI?

A

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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7
Q

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

A

false, its the opposite

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8
Q

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

A

true

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9
Q

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

A

false, more easily

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10
Q

what are the etiology of OBPI?

A

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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11
Q

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

A

true

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12
Q

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

A

false

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12
Q

breech birth is a risk factor OBPI
true or false?

A

true

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13
Q

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

A

false clavicular fracture

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14
Q

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

A

false

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14
Q

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

A

c5-c6 and upper trunk

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15
Q

what are the injured roots nerve related to breech labor?

A

C8-T1 roots and lower trunk

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16
Q

how can the BPI happen during normal birth?

A

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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17
Q

what are the types of nerve injuries?

A

neuropraxia
axontonmesis
neurotmesis

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18
Q

what is the blockage of conduction called?

A

neuropraxia

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19
Q

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

A

axontonmesis

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20
Q

rupture of the nerve is neurotmesis
true or false?

A

true

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21
Q

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

A

true

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22
Q

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

A

true

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23
Q

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

A

true

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24
Q

paralysis of UBPI to which muscles?

A

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

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25
Q

sensory impairments are to which muscles in UBP?

A

deltoid and radial forearm

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26
Q

what are the lost reflex in UBPI?

A

biceps,moro,radial

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27
Q

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

A

c8-t1

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28
Q

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?

A

true

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29
Q

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

A

lower brachial plexus injuries

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30
Q

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

A

false, are affected

31
Q

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

A

true

32
Q

which reflex is lost in LBPI?

A

grasp reflex

33
Q

horner syndrom can be seen in UBPI
true or false?

A

false, LBPI

34
Q

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

A

false, sympathetic fibers of T1

35
Q

Miosis
Ptosis
Enophthalmos
Anhidrosis
are all related to?

A

horner syndrome

36
Q

neglect of the arm happens in ?

A

total BP injury

37
Q

winging scapula is related to which nerve roots?

A

c5-c6

38
Q

torticollis should be evaluated to any OBPI
true or false?

A

true

39
Q

phrenic nerve involvement related to ?

A

respiratory

40
Q

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

A

true

41
Q

Mallet Classification that is most commonly used to?

A

OBPI

42
Q

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

A

Grafesthesia

43
Q

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

A

true

44
Q

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

A

True

45
Q

how can we evaluate deep sensations?

A

Semmens-Weinstein monofilament test

46
Q

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

A

false, t0th

47
Q

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?

A

2nd and 3rd

48
Q

what are the purposes of PT in BPI

A

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

49
Q

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?

A

true

50
Q

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

A

true

51
Q

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

A

splints

52
Q

what is the rehabilitation for phase one?

A

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

53
Q

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?

A

2nd phase 2 weeks-4 months

54
Q

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

A

3rd phase 4-6 months

55
Q

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?

A

true

56
Q

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

A

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

57
Q

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?

A

true

58
Q

when the preventing physiotherapy or immobilization position is applied?

A

1st 3 weeks

59
Q

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

A

true

60
Q

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 ?

A

supine positioning

61
Q

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?

A

sidelyine

62
Q

what is the aim of side-lying positoining?

A

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

63
Q

how prone position is applied?

A

a roll under the chest

64
Q

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

A

prone position

65
Q

how can we provide sensory inputs?

A

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

66
Q

2-3 weeks later
for?

A

PROM

67
Q

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

A

false, flex=140
ABD= 90

68
Q

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

A

true

69
Q

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

A

false, 10 repetitons

70
Q

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

A

early rehabilitation surgery

71
Q

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

A

true

72
Q

electrical stimulation is applied during?

A

4weeks-3 months

73
Q

weight bearing and strengthening exercises when are applied?

A

more than 6 months

74
Q

immobilization splint are applied in?

A

0-3 weeks

75
Q

sensory education is done after?

A

4th month

76
Q

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?

A

rehabilitation after tendon transfer

77
Q

what type of assessments should be done for BPI?

A

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

pediatrics (5 decks)

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