Brachial Plexus

Question 1

what type of nerve surgery has a faster recovery?

Answer 1

transfers

Question 2

how much does peripheral nerves grow per month?

Answer 2

1 mm or 1 inch

Question 3

_____ cells allow peripheral nerve regrowth

Answer 3

Schwann

Question 4

which part of the nerve muscle interface cannot regenerate?

Answer 4

motor endplates

Question 5

long bone growth is problematic for _____

Answer 5

contractures

Question 6

the GHJ is what shape initially?

Answer 6

flat

Question 7

remodeling potential of GHJ decreased at age ____

Answer 7

4 yo

Question 8

maternal risk factors for BPI

Answer 8

AMA (>35 yo)
pelvic anatomy
high BMI
infections
gestational diabetes
primiparity

Question 9

labor and delivery risk factors for BPI

Answer 9

high birth weight (>4 kg)
breech
shoulder dystocia
forceps or vacuum
clavicle fracture
previous births with BBPI

Question 10

which type of BBPI is more common?

Answer 10

upper trunk (C5-6)

Question 11

how long does it take for clavicle fractures to heal in newborns? how long immobilized?

Answer 11

healed - 21 days
immobile - 14 days

Question 12

how long does it take for humeral fractures to heal in newborns? how long immobilized?

Answer 12

healed - 6 weeks
immobile - 4 weeks

Question 13

what pain scale can be used for infants with BBPI?

Answer 13

FLACC

Question 14

Horner’s sign indicates ___

Answer 14

T1 nerve root avulsion

Question 15

Horner’s sign presentation

Answer 15

partial ptosis
miosis
facial anhidrosis

Question 16

____% of kids with BBPI have torticollis

Answer 16

43%

Question 17

remodeling potential of plagio/brachycephaly decreases significantly after ____ of age

Answer 17

9 mo

Question 18

the active movement scale can be used to assess children ages ____ with BBPI

Answer 18

0-8 years old

Question 19

what are the key reflexes to check for BBPI?

Answer 19

Moro*
ATNR*
palmar reflex
forward protective response
sideward protective response

Question 20

a child with C5-7 BBPI will likely skip what milestone?

Answer 20

crawling

Question 21

outcome measures for BPPI

Answer 21

active movement scale
AHA
AIMS
modified mallet classification (3+ yo)

Question 22

what is a common complication due to compensatory strategies of BBPI?

Answer 22

posterior GHJ dislocation (30%)

Question 23

if CSF is seen in SC on MRI, what is the prognosis?

Answer 23

recovery not possible due to avulsion injury

Question 24

when <___ deg of ER & adduction is available, US is recommended

Answer 24

60

Question 25

what is the most important PROM HEP for preventing posterior dislocation of humeral head?

Answer 25

shoulder ER & add

Question 26

which treatment helps correct shoulder IR?

Answer 26

elbow flexion & bimanual play

Question 27

casting in ER cannot be done past ___ mo

Answer 27

8-9 mo

Question 28

what is neurolysis?

Answer 28

surgical separation of adhesions from the nerve

Question 29

____ is a major limiting factor for BP surgery

Answer 29

nerve regrowth

Question 30

when can formal sensation testing be done?

Answer 30

>5 yo

Question 31

which surgery promotes increased ER & abd ROM?

Answer 31

lat transfer

Question 32

how does a humeral derotational osteotomy work?

Answer 32

changes where motion occurs but does not change how much motion occurs

Question 33

desired age for initial eval w/i specialty clinic

Answer 33

1 mo

Question 34

desired age for surgical intervention for global BBPI

Answer 34

3 mo

Question 35

age at which clavicle and humeral fractures most healed for BBPI

Answer 35

1 mo

Question 36

age at which evidence of nerve root avulsion will manifest

Answer 36

3 mo

Question 37

age at which the majority of BBPI pt's shoulders dislocate

Answer 37

3-6 mo

Question 38

____% of 3-6 mo with motor deficits develop dysplasia

Answer 38

60-80%

Question 39

___% of infants with BBPI dislocate w/i 1st year

Answer 39

30%

Question 40

age range when most primary nerve surgeries take place

Answer 40

6-12 mo

Question 41

age cutoff for no-surgical management of GH dysplasia and dislocation (casting and botox)

Answer 41

9 mo

Question 42

age cutoff for all primary nerve surgeries

Answer 42

15 mo

Question 43

desired age for secondary orthopedic procedures for GH dysplasia and dislocation (ex: lat transfer)

Answer 43

2-4 yo

Question 44

cutoff for releases and tendon transfers at GHJ (ex: humeral derot) why?

Answer 44

4-5 yo ossification centers close