Stingers Flashcards

1
Q

What are the absolute contraindications for an athlete to return to play after a stinger?

A
  • More than 2 previous episodes of transient quadriparesis/quadriplegia
  • clinical history/findings with confirmation of cervical myelopathy
  • continued neck discomfort, decreased ROM or any evidence of a neurologic deficit from baseline after a c-spine injury
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2
Q

Describe a stinger:

A

A temporary episode of UE dysesthesia with motor weakness

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3
Q

What are the 3 different mechanisms of a stinger?

A
  1. stretch/traction injury to the brachial plexus
  2. extension of cervical spine resulting in nerve root compression
  3. direct blow resulting in injury to the brachial plexus
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4
Q

What are the most common nerve roots affected?

A

C5 and C6

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5
Q

What is the most common truck affected?

A

Upper trunk:
Supraspinatus
Deltoid
Biceps

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6
Q

What is the Torg ratio?

Torg ratio less than ___ is 3x greater risk of suffering a stinger

A

Developed to evaluate congenital cervical spine stensois

less than 0.8

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7
Q

Return to play criteria after 1st stinger?

A
  • complete symptom resolution
  • full ROM
  • normal spine on XRay
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8
Q

If sx persist beyond 2-3 weeks what should be ordered?

A

EMG

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9
Q

Erb’s Palsy:

Nerve root:
Deformity:

A

Upper root (C5-C6)

Deformity: arm hangs by side, adducted and IR

AKA “policeman’s tip hand”

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10
Q

Klumpke:

Nerve root:
Deformity:

A

Lower root (C8-T1)

Deformity: claw hand

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11
Q

Neuropraxia

A

Transient episode of motor/and or sensory paralysis

Resolves in mins to hours, but can last up to 6-8 weeks

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12
Q

What would you notice if the transverse ligament was disrupted?

A

Increased anterior translation of C1 and C2

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13
Q

Brown-Sequard Syndrome

A

Hemi-section of spinal cord

- loss of ipisilateral motor function
- contralateral spinothalamic
pain & temperature

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14
Q

When can a player return to game:

After 1st stinger:
After 2nd stinger:
After 3rd stinger:

A

After 1st stinger:
- return to same game once sx free & full ROM
After 2nd stinger:
- sit out remainder of same game, return next game once sx free & full ROM
After 3rd stinger:
- remove from game, advanced imaging & clearance from physician

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