Brachial Plexus Injuries--help!

[Clair de Lune]

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Got this question on Q bank and now I can't remember the answer--something about a guy who is skiing down a mountain, and grabs onto the limb of a tree as he skis by. I can't remember if it injures the upper trunk or the lower trunk.

Also, does anyone have common examples of what kinds of injuries cause the different brachial plexus neuropathies? I know that breech birth can cause Erb's and Klumpke's, but it would be helpful to know of some common causes for specific neuropathies. For a non-brachial plexus example, parathyroid surgery can lead to injury of the recurrent laryngeal nerve, and hoarseness.

Hopefully we'll be given enough info to figure out what has been injured, but it can't hurt to have immediate recognition of certain common injuries.

 

[MedPuck]

Claire de lune, the skier's accident probably lead to lower trunk injury. Another popular example of this is when one falls from a tree and grabs a branch on the way down, thus tearing the lower trunk. Hope this helps and good luck!

 

[Idiopathic]

Clavicle fracture - Ulnar
Pronator teres entrapment - Median
Anterior/Middle scalene entrapment - Brachial Plexus
Anterior/Inferior shoulder dislocation (most common) - Axillary
Breech birth - Erb-Duchenne (upper trunk-C5,C6)
Grabbing tree limp - Klumpke's (lower trunk-C8,T1)

Dont forget possibility of Horner's syndrome with Klumpke's (T1)

From Goljan:
Surgical neck of humerus - Axillary
Midshaft humerus - Radial
Distal humerus - Median

ARM

The midshaft fracture correlates with 'Saturday night palsy' or 'Honeymoon palsy', where the midshaft humerus is compressed for a period of time, resulting in a transient loss of radial nerve function.

 

[EMDrMoe]

For me, the easiest way to think about Erb's & Klumpke's is functionally - when your arm is stretched over your head (as in grabbing a tree) it will stretch the lower trunk/muscles/etc. When your shoulder gets depressed (as in caught in the birth canal or in a motorcycle crash) it stretches the superior shoulder structures.

Hope it helps a bit. It's always easier for me to think of things in context.

 

[Clair de Lune]

Thanks, ya'll are the best! 🙂

 

[csmith1]

forgive my ignorance, but what does 'Saturday Night Palsy' mean, and I'm not asking about the injury, just the reference. Thanks. Oh, 'Honeymoon' is a new one on me, too.

 

[BrooklynDO]

forgive my ignorance, but what does 'Saturday Night Palsy' mean, and I'm not asking about the injury, just the reference. Thanks. Oh, 'Honeymoon' is a new one on me, too.

sat night palso refers to when you go out drinking and come home soo drunk you fall asleep on your big chair with your arm draped over the back/arm of it
this compresses the radial nerve....
honeymoon palsy...errr we wont get into, this is a kids show 😛

 

[Idiopathic]

Nerd...honeymoon palsy refers to your new wife/husband, sleeping on your arm, especially the middle part of the humerus, rather than 'in the crook' of your shoulder. But 'Saturday night palsy' is the best known, where you fal asleep with your arm over a chair, after getting too lit the night before.

honeymoon cystitis...now thats a different story 😉

 

[BrooklynDO]

Nerd...honeymoon palsy refers to your new wife/husband, sleeping on your arm, especially the middle part of the humerus, rather than 'in the crook' of your shoulder. But 'Saturday night palsy' is the best known, where you fal asleep with your arm over a chair, after getting too lit the night before.

honeymoon cystitis...now thats a different story 😉

whats your wife/husband doin SLEEPIN during your honeymoon!? and im the nerd? 🙄

 

[Idiopathic]

 

[LovelyRita]

sat night palso refers to when you go out drinking and come home soo drunk you fall asleep on your big chair with your arm draped over the back/arm of it
this compresses the radial nerve....
honeymoon palsy...errr we wont get into, this is a kids show 😛

honeymoon palsy...isn't that the "chew your arm off" thing?

 

[DRealDrZ]

Naw...I think the chew off your arm thing is "beer goggles" palsy...

 

[LovelyRita]

tee hee 😀

 

[drchris33]

That's the coyote ugly technique!!