Obstetric Brachial Plexus Injury Flashcards
traction to the Brachial Plexus during the birthing process
Obstetric Brachial Plexus Injury
Erb palsy
C5, C6 and at times C7 (more proximal)
Klumpe palsy brachial plexus injury
C8, T1 (more distal)
Total brachial plexus injury:
C5 to T1
is a specific case of obstructed labor whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head:
Shoulder Dystocia: a common occurrence in OBPI
Risk factors of OBPI
■ large size (weight more than 8 lb 13 oz)
■ breech delivery
■ mother with many previous deliveries
■ prolonged second stage of labor
■ maternal obesity
■ prolonged pregnancy (more than 42 weeks)
■ maternal diabetes
■ midpelvic operative delivery
■ vacuum or forceps delivery
physiologic block of nerve: Most Common, best for recovery of function
Neuropraxia
Nerve torn from the spine: worst for recovery most need neurosurgery
Avulsion
anatomic disruption of axon with little disruption of connective tissue
Axonotmesis
anatomic disruption of axon and connective tissue
Neurotmesis
Nerve Torn Healed but, scar tissue surrounding the injury also limits nerve conduction
Neuroma
A child with Erb’s palsy has a characteristic appearance that has been named the
“waiter’s tip.”
__________palsy affects the muscles of the hand and the sensation of the medial arm.
Klumpke’s
The hand is held in a claw position of extension of the metacarpal phalangeal joints and flexion of distal, intra, and proximal phalangeal joint. The thumb is in abduction.
Klumpke’s palsy affects the muscles of the hand and the sensation of the medial arm.
Klumpke’s palsy C-8 & T1
low brachial plexus (distal injuries)
