Brachial Plexus Injury: Mechanisms of Injury скачать в хорошем качестве

Brachial Plexus Injury: Mechanisms of Injury

Join this channel to support the channel.    / @nabilebraheim   Brachial Plexus Injury: Mechanisms of Injury Introduction The brachial plexus is a complex network of nerves that originates from the cervical and upper thoracic spinal cord (C5-T1) and controls motor and sensory function in the upper limb. Injury to the brachial plexus can result in partial or complete loss of function in the affected limb, depending on the severity and location of the damage. These injuries can occur due to various mechanisms, including trauma, pathological conditions, or birth-related complications. Mechanisms of Brachial Plexus Injury There are two primary mechanisms of brachial plexus injury: Depression of the Shoulder – This mechanism involves excessive downward traction on the shoulder, leading to avulsion of the upper trunk (C5-C6). This commonly occurs in motorcycle accidents, falls, or blunt trauma. Distraction Injury with Shoulder Extension – In this type of injury, the shoulder is forced into excessive abduction and extension, leading to damage to the lower trunk (C8-T1). This is often seen in violent traction injuries, such as those occurring in falls or industrial accidents. Power Modification of Leffert Classification Type I: Open Injury (Supraclavicular or Infraclavicular Lesion) a. Stabbing injuries b. Low-velocity/high-velocity gunshot wounds or blasts c. High-velocity gunshot wounds or blasts Type II: Closed Injury (Supraclavicular or Infraclavicular Lesion) a. Upper plexus injury (C5-C6) b. Lower plexus injury (C8-T1) c. Pan-plexus injury (C5-T1) Type III: Pathological and Iatrogenic Injury a. Iatrogenic injuries (caused by surgical complications) b. Post-radiation damage c. Malignancy-related compression or invasion Type IV: Obstetric Brachial Plexus Injury a. Erb’s Palsy (C5-C6) b. Klumpke’s Palsy (C8-T1) c. Mixed Injury (C5-T1) Brachial Plexus Birth Injuries Brachial plexus birth injuries occur during labor and delivery due to excessive stretching or traction on the baby's shoulder and neck. This can result from prolonged or difficult labor, the use of forceps or vacuum-assisted delivery, or shoulder dystocia, where the baby's shoulder becomes trapped behind the mother's pubic bone. Erb’s Palsy (C5-C6): The most common type of birth-related brachial plexus injury, leading to weakness or paralysis of the upper arm with preserved hand function. Klumpke’s Palsy (C8-T1): Less common, affecting the lower plexus, often causing hand weakness and claw hand deformity. Mixed Injuries (C5-T1): In severe cases, the entire brachial plexus may be affected, leading to global upper limb dysfunction. Early diagnosis and intervention, including physical therapy and, in severe cases, surgical repair, are crucial for optimal recovery. Most mild cases improve with time, but severe injuries may lead to long-term impairment. Conclusion Brachial plexus injuries can result from various traumatic, pathological, or birth-related causes. Understanding the mechanisms of injury and classification systems helps in diagnosis and management. Obstetric brachial plexus injuries remain a significant concern in neonatal medicine, with early treatment improving functional outcomes Quizzes 1. What is the most common type of obstetric brachial plexus injury? ✅ Erb’s Palsy (C5-C6) Erb’s Palsy (C5-C6) Klumpke’s Palsy (C8-T1) Pan-plexus injury (C5-T1) Radial nerve palsy Explanation: Erb’s Palsy is the most common birth-related brachial plexus injury, usually due to excessive traction on the baby's head during delivery. 2. Which mechanism is responsible for upper trunk brachial plexus injuries? ✅ Shoulder depression and lateral neck flexion Shoulder depression and lateral neck flexion Hyperabduction of the arm Forced elbow flexion External rotation of the arm Explanation: Upper trunk injuries (C5-C6) occur when the shoulder is depressed while the neck is forcibly flexed in the opposite direction. 3. What type of brachial plexus injury is commonly seen in motorcycle accidents? ✅ Closed injury (Type II) Open injury (Type I) Closed injury (Type II) Iatrogenic injury (Type III) Obstetric injury (Type IV) Explanation: High-energy trauma, such as motorcycle accidents, often leads to closed traction injuries of the brachial plexus. 4. Which nerve roots are affected in Klumpke’s Palsy? ✅ C8-T1 C5-C6 C6-C7 C8-T1 C5-T1 Explanation: Klumpke’s Palsy is caused by lower trunk injuries, affecting the C8-T1 nerve roots and leading to weakness in the hand and wrist. 5. Which classification system is used for brachial plexus injuries? ✅ Power modification of Leffert classification Sunderland classification Seddon classification Power modification of Leffert classification House-Brackmann classification Explanation: The Power modification of Leffert classification categorizes brachial plexus injuries into open, closed, pathological, and obstetric types.