Congenital brachial plexus paralysis

Question 1

about brachial plexus

Answer 1

a peripheral nerve network responsible for the sensory, motor, and sympathetic innervations of upper extremities from spinal cord

Question 2

obstetric brachial plexus paralysis

Answer 2

a flaccid paralysis mostly seen in one arm after injury in BP during delivery

Question 3

risk factors for OBPP

Answer 3

**high birth weight
**prolonged birth
**interventional birth
**over 40 years
**macrosomia
**use of delivery assistive devices

Question 4

problems caused by OBPP

Answer 4

fracture ** clavicle, humerus
SCM hematoma
Horner’s syndrome
shoulder dislocation
ceptial hematoma
neurological hematoma

Question 5

confused as OBPP but are not

Answer 5

clavicle fracture
proximal humerus fracture
infection of glenohumeral joint
intrauterine radial nerve compression

Question 6

types of OBPP

Answer 6

Duchenne Erb BPP [upper BPP]
upper middle
Klumpke’s palsy [lower BPP]
total BPP

Question 7

Erb Duchenne

Answer 7

**common
**C5-C6
**sometimes C7
**no arm flexion and abduction
**infraspinatus, supraspinatus, biceps, deltoid and brachioradialis are affected
**biceps radial and Moro reflexes are absent

Question 8

Klumpke’s paralysis

Answer 8

**C8-T1
**forearm flexors, intrinsic muscles of hand, finger extensors and wrist flexors are affected
**sensory deficiency on the medial side of the arm
**grasp reflex is absent
**drop wrist and claw hand
**Horner’s syndrome
Edematous finger ie cannot hold objects with fingers

Question 9

total plexus paralysis

Answer 9

**C5-T1
**flaccid paralysis
**sensory defect
**no reflex
**motionless muscles
**Horner’s syndrome

Question 10

Horner’s syndrome

Answer 10

a disease caused by damage to the upper cervical sympathetic nerve supply and C8-T1
**respiratory problems due to phrenic nerve injury
Intrinsic muscles weakness
Miosis,ptosis and anhidrosis

Question 11

symptoms of HS

Answer 11

flask upper extremities
extended elbow
motionless arm

Question 12

early signs of OBPP

Answer 12

inability to move both arms equally
discolorations
softness
no palmar reflexes
difficult holding
inability to make fist
no grasp
unilateral swelling on clavicle

Question 13

signs that conservative treatment will fail

Answer 13

Horner’s syndrome with paralysis
dorsal scapula nerve involvement
sensory nerve involvement
total involvement

Question 14

Signs that Conservative treatment of OBPP will work

Answer 14

Spontaneous recovery
Isolated upper trunk lesion

Question 15

Muscle strength assessment in CBPP

Answer 15

Active movement scale
A 7-muscle system

Question 16

Active M.S scoring when G is eliminated

Answer 16

0=no contraction
1..contraction
2…mvmnt less than half of the range
3…movement more than half the range
4…full movement

Question 17

Against gravity scoring

Answer 17

5. Movement less than half the Rom
6. Movement more than half the Rom
7. Full motion

Question 18

Sensory evaluation on BPP

Answer 18

0. No response to painful or other stimulus
1. Reaction to painful stimulus
2. Reaction to touch
3. Almost Normal

Question 19

Classification used in assessment of the shoulder

Answer 19

Mallet classification

Question 20

Aim of early approach

Answer 20

Correct positioning
Care
Prohibitions

Question 21

Why arm is rest for 2 weeks after birth

Answer 21

Due to,
Edema
Possible bleeding in the nerve surrounding tissues

Question 22

What to avoid in 1st month

Answer 22

Traction
Lying on affected side
Passive shoulder joint movements
Hanging the arm down and swinging
Avoid statue of liberty position (ER)

Question 23

Rehab after nerve repair

Answer 23

Early protection
Exercise
Splinting
Family education
Periodic evaluations

Question 24

Aim of tendon transfer osteotomy

Answer 24

Increase ER

Question 25

Aim of kinesiological taping in OBPP

Answer 25

Increase hand function