Brachial Plexus Injuries

Question 1

List 3 types of brachial plexus injuries.

Answer 1

1. Erb’s C5-6
2. Extended Erb’s C5-C7
3. Klumpke’s C7-T1

Question 2

Brachial plexus injuries range from _____ to _____.

Answer 2

Edema to avulsion

Question 3

True or False: Brachial Plexus injuries are typically bilateral.

Answer 3

FALSE

Typically UNILATERAL

Question 4

What is the expected recovery for brachial plexus injuries?

Answer 4

Expected recovery except with unrepaired total axonal tear (whole arm 7-8 months)

Question 5

What prognostic indicator is best for recovery from brachial plexus injuries?

Answer 5

Prognosis best if biceps is greater than fair grade by 3 months for Erb’s types

Question 6

_____ and _____ are the primary impairments present with brachial plexus injuries.

Answer 6

Paralysis

Sensory Loss

Question 7

List 5 secondary impairments associated with brachial plexus injuries.

Answer 7

1. Posturing/contractures
2. Substitutions/lack of scap/humeral rhythm
3. GH subluxation/dislocation
4. Radial head dislocation
5. Deformity/poor bone growth

Question 8

What 3 things should be assessed when examining patients with possible brachial plexus injuries?

Answer 8

1. Sensation
2. ROM
3. Muscle activity

Question 9

What 2 ROM should be assessed specifically?

Answer 9

1. ER with scapula stabilized

2. Scapulohumeral dissociation

Question 10

List 4 things to assess when examining muscle activity.

Answer 10

1. Spontaneous activity and posture
2. During reflex and reaction testing
3. Waiter’s tip
4. Trumpeter’s sign

Question 11

_____ activity precedes clinical evidence of function by several weeks.

Answer 11

EMG activity

Question 12

List 6 treatment considerations used to treat brachial plexus injuries.

Answer 12

1. Daily ROM exercises
2. Stimulation of muscle activity (ES, FES)
3. Prevent learned nonuse
4. Prevent deformities
5. Training effective functional movement
6. Stimulate motor milestones

Question 13

List 4 surgical procedures used to treat brachial plexus injuries.

Answer 13

1. Microsurgery to repair or graft nerve
2. Release or transfer (tendon or bipolar)
3. Osteotomy
4. Humeral fusion