Brachial Plexus Etc

Question 1

Movements of brachial plexus (6)

Answer 1

Shoulder abduction/external rotation c5
Elbow flexion c5,6
Elbow extension c7,8
Wrist flexion/extension c6, 7 
Finger flexion c7,8 
Small musclws of the hand c8, t1

Question 2

Plexus damaged (5)

Answer 2

Pressure
Tumours
Radiation
Stabbing
Traction (motorcycle accident, head moves away from shoulder)

Question 3

Gleno humeral arthrodesis reasons (2)

Answer 3

Weight flail arm causes shoulder to sublux causing pain

Can regain some movement of humerus by moving shoulder girdle

Question 4

Obstetric brachial plexus palsy (1)

Answer 4

Bpi caused by traction on the shoulder girdle at birth

Question 5

Erbs palsy (3)

Answer 5

Obstetric brachial plexus palsy
Upper roots c5 and c6 affected
Loss of shoulder abduction/external rotation and elbow flexion

Question 6

Orthotics for brachial plexus (5)

Answer 6

Who
Flail arm and glenohumeral arthodesis - locking elbow/wrist hand orthosis
Simple cuff or sling to prevent shoulder subouxation
Prosthetic terminal device
Sewho with who in position of function

Question 7

Aims for bpi pt (4)

Answer 7

Prevent shoulder joint pain and subluxation
Prevent contractures
Cosmesis
Positioning of hand in space

Question 8

Wilmer shoulder orthosis ( 2)

Answer 8

Prevents subluxation and holds elbow in pre-set position

Holds hand in a pronated position

Question 9

Stanmore flail arm orthosis (3)

Answer 9

Hand locking elbow joint, shoudler joint and socket, who
Attachment of terminal devices to forearm section
Wings on custom leather shoulder section

Question 10

Problems with stanmore orthosis (6)

Answer 10

• lack of adjustability in upper steel section which can make positioning of the shoulder joint in the correct place a challenge - sometimes the orthotist needs to compromise with the position of the shoulder joint
• the elbow lock is inefficient and frequent repair and maintenance is required
• fitting process takes time
• orthosis is bulky and heavy
• some users have commented that the orthosis is poor cosmetically
• because such a small number are produced, kit is expensive

Question 11

Alternative brachial plexus designs (1)

Answer 11

-silicone suspension cap or socket

Question 12

Brachial plexus (4)

Answer 12

Group of nerves from c5 to t1
Supply upper limb
Main nerves of the arm arise: musculocutaneous, medial, ulnar, radial and axillary nerves
Partial or complete loss of motor and sensation to upper limb