The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.
Diseases of the cervical (and first thoracic) roots, nerve trunks, cords, and peripheral nerve components of the BRACHIAL PLEXUS. Clinical manifestations include regional pain, PARESTHESIA; MUSCLE WEAKNESS, and decreased sensation (HYPESTHESIA) in the upper extremity. These disorders may be associated with trauma (including BIRTH INJURIES); THORACIC OUTLET SYNDROME; NEOPLASMS; NEURITIS; RADIOTHERAPY; and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp1351-2)
A syndrome associated with inflammation of the BRACHIAL PLEXUS. Clinical features include severe pain in the shoulder region which may be accompanied by MUSCLE WEAKNESS and loss of sensation in the upper extremity. This condition may be associated with VIRUS DISEASES; IMMUNIZATION; SURGERY; heroin use (see HEROIN DEPENDENCE); and other conditions. The term brachial neuralgia generally refers to pain associated with brachial plexus injury. (From Adams et al., Principles of Neurology, 6th ed, pp1355-6)
Mechanical or anoxic trauma incurred by the infant during labor or delivery.
A villous structure of tangled masses of BLOOD VESSELS contained within the third, lateral, and fourth ventricles of the BRAIN. It regulates part of the production and composition of CEREBROSPINAL FLUID.
Paralysis of an infant resulting from injury received at birth. (From Dorland, 27th ed)
Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.
A major nerve of the upper extremity. The fibers of the musculocutaneous nerve originate in the lower cervical spinal cord (usually C5 to C7), travel via the lateral cord of the brachial plexus, and supply sensory and motor innervation to the upper arm, elbow, and forearm.
Surgical reinnervation of a denervated peripheral target using a healthy donor nerve and/or its proximal stump. The direct connection is usually made to a healthy postlesional distal portion of a non-functioning nerve or implanted directly into denervated muscle or insensitive skin. Nerve sprouts will grow from the transferred nerve into the denervated elements and establish contact between them and the neurons that formerly controlled another area.
A network of nerve fibers originating in the upper four CERVICAL SPINAL CORD segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head. It also distributes motor fibers to muscles of the cervical SPINAL COLUMN, infrahyoid muscles, and the DIAPHRAGM.
A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45)
One of two ganglionated neural networks which together form the ENTERIC NERVOUS SYSTEM. The myenteric (Auerbach's) plexus is located between the longitudinal and circular muscle layers of the gut. Its neurons project to the circular muscle, to other myenteric ganglia, to submucosal ganglia, or directly to the epithelium, and play an important role in regulating and patterning gut motility. (From FASEB J 1989;3:127-38)
The ventral rami of the thoracic nerves from segments T1 through T11. The intercostal nerves supply motor and sensory innervation to the thorax and abdomen. The skin and muscles supplied by a given pair are called, respectively, a dermatome and a myotome.
A neurovascular syndrome associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the superior thoracic outlet. This may result from a variety of anomalies such as a CERVICAL RIB, anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, PARESIS or PARALYSIS of brachial plexus innervated muscles, PARESTHESIA, loss of sensation, reduction of arterial pulses in the affected extremity, ISCHEMIA, and EDEMA. (Adams et al., Principles of Neurology, 6th ed, pp214-5).
The articulation between the head of the HUMERUS and the glenoid cavity of the SCAPULA.
A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)
Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.
Paired bundles of NERVE FIBERS entering and leaving the SPINAL CORD at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots are efferent, comprising the axons of spinal motor and PREGANGLIONIC AUTONOMIC FIBERS.
A bone on the ventral side of the shoulder girdle, which in humans is commonly called the collar bone.
One of two ganglionated neural networks which together form the enteric nervous system. The submucous (Meissner's) plexus is in the connective tissue of the submucosa. Its neurons innervate the epithelium, blood vessels, endocrine cells, other submucosal ganglia, and myenteric ganglia, and play an important role in regulating ion and water transport. (From FASEB J 1989;3:127-38)
A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.
Prolonged shortening of the muscle or other soft tissue around a joint, preventing movement of the joint.
The twelve spinal nerves on each side of the thorax. They include eleven INTERCOSTAL NERVES and one subcostal nerve. Both sensory and motor, they supply the muscles and skin of the thoracic and abdominal walls.
A congenital or acquired protrusion of the meninges, unaccompanied by neural tissue, through a bony defect in the skull or vertebral column.
Neoplasms which arise from peripheral nerve tissue. This includes NEUROFIBROMAS; SCHWANNOMAS; GRANULAR CELL TUMORS; and malignant peripheral NERVE SHEATH NEOPLASMS. (From DeVita Jr et al., Cancer: Principles and Practice of Oncology, 5th ed, pp1750-1)
Benign or malignant tumors which arise from the choroid plexus of the ventricles of the brain. Papillomas (see PAPILLOMA, CHOROID PLEXUS) and carcinomas are the most common histologic subtypes, and tend to seed throughout the ventricular and subarachnoid spaces. Clinical features include headaches, ataxia and alterations of consciousness, primarily resulting from associated HYDROCEPHALUS. (From Devita et al., Cancer: Principles and Practice of Oncology, 5th ed, p2072; J Neurosurg 1998 Mar;88(3):521-8)
A complex network of nerve fibers including sympathetic and parasympathetic efferents and visceral afferents. The celiac plexus is the largest of the autonomic plexuses and is located in the abdomen surrounding the celiac and superior mesenteric arteries.
The lumbar and sacral plexuses taken together. The fibers of the lumbosacral plexus originate in the lumbar and upper sacral spinal cord (L1 to S3) and innervate the lower extremities.
Also called the shoulder blade, it is a flat triangular bone, a pair of which form the back part of the shoulder girdle.
Part of the body in humans and primates where the arms connect to the trunk. The shoulder has five joints; ACROMIOCLAVICULAR joint, CORACOCLAVICULAR joint, GLENOHUMERAL joint, scapulathoracic joint, and STERNOCLAVICULAR joint.
The superior part of the upper extremity between the SHOULDER and the ELBOW.
Displacement of the HUMERUS from the SCAPULA.
Surgical procedure by which a tendon is incised at its insertion and placed at an anatomical site distant from the original insertion. The tendon remains attached at the point of origin and takes over the function of a muscle inactivated by trauma or disease.
Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)
A widely used local anesthetic agent.
Self-administered health questionnaire developed to obtain details of the medical history as an adjunct to the medical interview. It consists of 195 questions divided into eighteen sections; the first twelve deal with somatic complaints and the last six with mood and feeling patterns. The Index is used also as a personality inventory or in epidemiologic studies.
A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm.
A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand.
The central part of the body to which the neck and limbs are attached.
Bone in humans and primates extending from the SHOULDER JOINT to the ELBOW JOINT.
A condition caused by an apical lung tumor (Pancoast tumor) with involvement of the nearby vertebral column and the BRACHIAL PLEXUS. Symptoms include pain in the shoulder and the arm, and atrophy of the hand.
A hinge joint connecting the FOREARM to the ARM.
Deformities acquired after birth as the result of injury or disease. The joint deformity is often associated with rheumatoid arthritis and leprosy.
The pectoralis major and pectoralis minor muscles that make up the upper and fore part of the chest in front of the AXILLA.
Pain during the period after surgery.
X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space.
The region of the upper limb in animals, extending from the deltoid region to the HAND, and including the ARM; AXILLA; and SHOULDER.
The 11th cranial nerve which originates from NEURONS in the MEDULLA and in the CERVICAL SPINAL CORD. It has a cranial root, which joins the VAGUS NERVE (10th cranial) and sends motor fibers to the muscles of the LARYNX, and a spinal root, which sends motor fibers to the TRAPEZIUS and the sternocleidomastoid muscles.
The field which deals with illustrative clarification of biomedical concepts, as in the use of diagrams and drawings. The illustration may be produced by hand, photography, computer, or other electronic or mechanical methods.
A usually benign neoplasm that arises from the cuboidal epithelium of the choroid plexus and takes the form of an enlarged CHOROID PLEXUS, which may be associated with oversecretion of CSF. The tumor usually presents in the first decade of life with signs of increased intracranial pressure including HEADACHES; ATAXIA; DIPLOPIA; and alterations of mental status. In children it is most common in the lateral ventricles and in adults it tends to arise in the fourth ventricle. Malignant transformation to choroid plexus carcinomas may rarely occur. (Adams et al., Principles of Neurology, 6th ed, p667; DeVita et al., Cancer: Principles and Practice of Oncology, 5th ed, p2072)
Complete or severe weakness of the muscles of respiration. This condition may be associated with MOTOR NEURON DISEASES; PERIPHERAL NERVE DISEASES; NEUROMUSCULAR JUNCTION DISEASES; SPINAL CORD DISEASES; injury to the PHRENIC NERVE; and other disorders.
An oviparous burrowing mammal of the order Monotremata native to Australia, Tasmania, and New Guinea. It has hair mingled with spines on the upper part of the body and is adapted for feeding on ants.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
Sharp instruments used for puncturing or suturing.
Mechanical compression of nerves or nerve roots from internal or external causes. These may result in a conduction block to nerve impulses (due to MYELIN SHEATH dysfunction) or axonal loss. The nerve and nerve sheath injuries may be caused by ISCHEMIA; INFLAMMATION; or a direct mechanical effect.
A set of twelve curved bones which connect to the vertebral column posteriorly, and terminate anteriorly as costal cartilage. Together, they form a protective cage around the internal thoracic organs.
The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium.
The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder.

Use of positron emission tomography in evaluation of brachial plexopathy in breast cancer patients. (1/462)

18-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has previously been used successfully to image primary and metastatic breast cancer. In this pilot study, 19 breast cancer patients with symptoms/signs referrable to the brachial plexus were evaluated with 18FDG-PET. In 11 cases computerized tomography (CT) scanning was also performed. Of the 19 patients referred for PET study, 14 had abnormal uptake of 18FDG in the region of the symptomatic plexus. Four patients had normal PET studies and one had increased FDG uptake in the chest wall that accounted for her axillary pain. CT scans were performed in 9 of the 14 patients who had positive brachial plexus PET studies; six of these were either normal or showed no clear evidence of recurrent disease, while three CTs demonstrated clear brachial plexus involvement. Of two of the four patients with normal PET studies, one has had complete resolution of symptoms untreated while the other was found to have cervical disc herniation on magnetic resonance imaging (MRI) scan. The remaining two patients almost certainly had radiation-induced plexopathy and had normal CT, MRI and PET study. These data suggest that 18FDG-PET scanning is a useful tool in evaluation of patients with suspected metastatic plexopathy, particularly if other imaging studies are normal. It may also be useful in distinguishing between radiation-induced and metastatic plexopathy.  (+info)

Source of inappropriate receptive fields in cortical somatotopic maps from rats that sustained neonatal forelimb removal. (2/462)

Previously this laboratory demonstrated that forelimb removal at birth in rats results in the invasion of the cuneate nucleus by sciatic nerve axons and the development of cuneothalamic cells with receptive fields that include both the forelimb-stump and the hindlimb. However, unit-cluster recordings from primary somatosensory cortex (SI) of these animals revealed few sites in the forelimb-stump representation where responses to hindlimb stimulation also could be recorded. Recently we reported that hindlimb inputs to the SI forelimb-stump representation are suppressed functionally in neonatally amputated rats and that GABAergic inhibition is involved in this process. The present study was undertaken to assess the role that intracortical projections from the SI hindlimb representation may play in the functional reorganization of the SI forelimb-stump field in these animals. The SI forelimb-stump representation was mapped during gamma-aminobutyric acid (GABA)-receptor blockade, both before and after electrolytic destruction of the SI hindlimb representation. Analysis of eight amputated rats showed that 75.8% of 264 stump recording sites possessed hindlimb receptive fields before destruction of the SI hindlimb. After the lesions, significantly fewer sites (13.2% of 197) were responsive to hindlimb stimulation (P < 0.0001). Electrolytic destruction of the SI lower-jaw representation in four additional control rats with neonatal forelimb amputation did not significantly reduce the percentage of hindlimb-responsive sites in the SI stump field during GABA-receptor blockade (P = 0.98). Similar results were obtained from three manipulated rats in which the SI hindlimb representation was silenced temporarily with a local cobalt chloride injection. Analysis of response latencies to sciatic nerve stimulation in the hindlimb and forelimb-stump representations suggested that the intracortical pathway(s) mediating the hindlimb responses in the forelimb-stump field may be polysynaptic. The mean latency to sciatic nerve stimulation at responsive sites in the GABA-receptor blocked SI stump representation of neonatally amputated rats was significantly longer than that for recording sites in the hindlimb representation [26.3 +/- 8.1 (SD) ms vs. 10.8 +/- 2.4 ms, respectively, P < 0.0001]. These results suggest that hindlimb input to the SI forelimb-stump representation detected in GABA-blocked cortices of neonatally forelimb amputated rats originates primarily from the SI hindlimb representation.  (+info)

Nerve injury associated with anesthesia: a closed claims analysis. (3/462)

BACKGROUND: Nerve injury associated with anesthesia is a significant source of morbidity for patients and liability for anesthesiologists. To identify recurrent and emerging patterns of injury we analyzed the current American Society of Anesthesiologists (ASA) Closed Claims Project Database and performed an in-depth analysis of claims for nerve injury that were entered into the database since the authors' initial report of the subject. METHODS: The ASA Closed Claims Database is a standardized collection of case summaries derived from the closed claims files of professional liability insurance companies. Claims for nerve injury that were not included in the authors' 1990 report were reviewed in-depth. RESULTS: Six hundred seventy (16% of 4,183) claims were for anesthesia-related nerve injury. The most frequent sites of injury were the ulnar nerve (28%), brachial plexus (20%), lumbosacral nerve root (16%), and spinal cord (13%). Ulnar nerve (85%) injuries were more likely to have occurred in association with general anesthesia, whereas spinal cord (58%) and lumbosacral nerve root (92%) injuries were more likely to occur with regional techniques. Ulnar nerve injury occurred predominately in men (75%) and was also more apt to have a delayed onset of symptoms (62%) than other nerve injuries. Spinal cord injuries were the leading cause of claims for nerve injury that occurred in the 1990s. CONCLUSION: New strategies for prevention of nerve damage cannot be recommended at this time because the mechanism for most injuries, particularly those of the ulnar nerve, is not apparent.  (+info)

Respiratory effects of low-dose bupivacaine interscalene block. (4/462)

In this double-blind study, interscalene brachial plexus (ISBP) block was performed in 11 volunteers using 10 ml of either 0.25% (n = 6) or 0.5% (n = 5) bupivacaine with epinephrine 1:200,000. Diaphragmatic excursion, respiratory function and neural function were assessed for 90 min. Our results showed that hemidiaphragmatic excursion declined significantly after block in the 0.5% group and paradoxical movement during inspiration was more common than in the 0.25% group. Forced vital capacity and forced expiratory volume in 1 s declined significantly in the 0.5% group (mean 74.6 (SD 13.0)% and 78.2 (19.9)% of baseline, respectively) but not in the 0.25% group. Sensory anaesthesia in the upper limb was found consistently in both groups, although biceps paralysis occurred earlier after 0.5% bupivacaine. We conclude that ISBP block using 10 ml of 0.25% bupivacaine provided upper limb anaesthesia to pinprick in C5-6 dermatomes with only occasional interference with respiratory function.  (+info)

Migraine complicated by brachial plexopathy as displayed by MRI and MRA: aberrant subclavian artery and cervical ribs. (5/462)

This article describes migraine without aura since childhood in a patient with bilateral cervical ribs. In addition to usual migraine triggers, symptoms were triggered by neck extension and by arm abduction and external rotation; paresthesias and pain preceded migraine triggered by arm and neck movement. Suspected thoracic outlet syndrome was confirmed by high-resolution bilateral magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brachial plexus. An unsuspected aberrant right subclavian artery was compressed within the scalene triangle. The aberrant subclavian artery splayed apart the recurrent laryngeal and vagus nerves, displaced the esophagus anteriorly, and effaced the right stellate ganglia and the C8-T1 nerve roots. Scarring and fibrosis of the left scalene triangle resulted in acute angulation of the neurovascular bundle and diminished blood flow in the subclavian artery and vein. A branch of the left sympathetic ganglia was displaced as it joined the C8-T1 nerve roots. Left scalenectomy and rib resection confirmed the MRI and MRA findings; the scalene triangle contents were decompressed, and migraine symptoms subsequently resolved.  (+info)

Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy. (6/462)

MRI was performed on the spinal roots, brachial and lumbar plexuses of 14 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Hypertrophy of cervical roots and brachial plexus was demonstrated in eight cases, six of whom also had hypertrophy of the lumbar plexus. Of 11 patients who received gadolinium, five of six cases with hypertrophy and one of five without hypertrophy demonstrated enhancement. All patients with hypertrophy had a relapsing-remitting course and a significantly longer disease duration. Gross onion-bulb formations were seen in a biopsy of nerve from the brachial plexus in one case with clinically evident nodular hypertrophy. We conclude that spinal root and plexus hypertrophy may be seen on MRI, particularly in cases of CIDP of long duration, and gadolinium enhancement may be present in active disease.  (+info)

Effect of brachial plexus co-activation on phrenic nerve conduction time. (7/462)

BACKGROUND: Diaphragm function can be assessed by electromyography of the diaphragm during electrical phrenic nerve stimulation (ES). Whether phrenic nerve conduction time (PNCT) and diaphragm electrical activity can be reliably measured from chest wall electrodes with ES is uncertain. METHODS: The diaphragm compound muscle action potential (CMAP) was recorded using an oesophageal electrode and lower chest wall electrodes during ES in six normal subjects. Two patients with bilateral diaphragm paralysis were also studied. Stimulations were deliberately given in a manner designed to avoid or incur co-activation of the brachial plexus. RESULTS: For the oesophageal electrode the PNCT was similar with both stimulation techniques with mean (SE) values of 7.1 (0.2) and 6.8 (0.2) ms, respectively (pooled left and right values). However, for surface electrodes the PNCT was substantially shorter when the brachial plexus was activated (4.4 (0.1) ms) than when it was not (7.4 (0.2) ms) (mean difference 3.0 ms, 95% CI 2.7 to 3.4, p<0.0001). A small short latency CMAP was recorded from the lower chest wall electrodes during stimulation of the brachial plexus alone. CONCLUSIONS: The results of this study show that lower chest wall electrodes only accurately measure PNCT when care is taken to avoid stimulating the brachial plexus. A false positive CMAP response to phrenic stimulation could be caused by inadvertent stimulation of the brachial plexus. This finding may further explain why the diaphragm CMAP recorded from chest wall electrodes can be unreliable with cervical magnetic stimulation during which brachial plexus activation occurs.  (+info)

Rapid loss of dorsal horn lectin binding after massive brachial plexus axotomy in young rats. (8/462)

Lectins are proteins with binding affinities for specific sugars in complex glycoconjugates, some of which have been implicated in limiting synaptic plasticity or modulating nerve growth and guidance. We studied the expression of the glycoconjugate recognized by the isolectin B4 of Griffonia simplicifolia (Gs-IB4) in spinal dorsal horns after massive axotomy of the brachial plexus in weanling rats. Gs-IB4+ binding sites in Rexed's lamina II were rapidly reduced after massive peripheral axotomy. This rapid loss suggests that multiple nerve lesions minimize the number of intact fibers that converge with lesioned fibers into the same cord segments and thus may prevent the plastic changes accompanying the lesion of single nerves.  (+info)

Background: The aim of this study was to compare the analgesic efficacy of subacromial bursae block (LA), suprascapular nerve block (SSB), and interscalene brachial plexus block (ISB) after arthroscopic shoulder surgery. Methods: 91 patients scheduled to undergo an arthroscopic shoulder acromioplasty under GA in an outpatient setting were included. The patients were prospectively randomized into 4 groups: 1) interscalene brachial plexus block, 2) suprascapular nerve block, 3) subacromial bursae block, 4) control group for comparison. Pain scores (VAS), supplemental analgesia, and side effects were recorded in the recoveryroom, 4 hours and 24 hours after surgery. Results: Group ISB had significantly lower pain scores at rest in the postanesthesia care unit than the SSB group (p = 0.037) and the control group (p = 0.0313). The same results were seen 4 hours follow-up. The LA group had significantly lower pain scores at rest in the postanesthesia care unit than the control group (p = 0.046) and after 4
The use of ultrasound in regional anesthesia enables reduction in the local anesthetic volume. The present study aimed to determine the minimum effective volume of 0.375% bupivacaine with epinephrine for interscalene brachial plexus block for shoulder surgery. Following approval by the Research Ethics Committee, patients with a physical condition of I or II according to the American Society of Anesthesiologists, between 21 and 65 years old and subjected to elective surgery of the shoulder and interscalene brachial plexus block will be recruited. The volume of the anesthetic will be determined using a step-up/step-down method and based on the outcome of the preceding block. Positive or negative block results in a 1mL reduction or increase in volume, respectively. The success of the block is defined as the presence of motor block in two muscle groups and the absence of thermal and pain sensations in the necessary dermatomes within 30 minutes of the injection. Diaphragmatic paralysis, pulmonary ...
The use of ultrasound in regional anesthesia enables reduction in the local anesthetic volume. The present study aimed to determine the minimum effective volume of 0.375% bupivacaine with epinephrine for interscalene brachial plexus block for shoulder surgery. Following approval by the Research Ethics Committee, patients with a physical condition of I or II according to the American Society of Anesthesiologists, between 21 and 65 years old and subjected to elective surgery of the shoulder and interscalene brachial plexus block will be recruited. The volume of the anesthetic will be determined using a step-up/step-down method and based on the outcome of the preceding block. Positive or negative block results in a 1mL reduction or increase in volume, respectively. The success of the block is defined as the presence of motor block in two muscle groups and the absence of thermal and pain sensations in the necessary dermatomes within 30 minutes of the injection. Diaphragmatic paralysis, pulmonary ...
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With the rapid growth of the elderly population, along with increased comorbidities and greater life expectancy, geriatric surgery has become more frequent and requires careful tailoring of anesthesia technique. Preanesthetic evaluation should concentrate on the identification of age-related diseases and an estimation of physiological reserve. Age-related cardiovascular changes are leading factors impacting perioperative outcomes among elderly patients. The management of a patient with dilated cardiomyopathy, who undergoes a non-cardiac surgery is always a challenge for an anesthesiologist, as this situation is associated with a high mortality rate. We report a use of the ultrasound guided supraclavicular brachial plexus block in 87-year old woman for revision of wound of left wrist and reposition and immobilization of left forearm and elbow. Her previous medical records revealed that she arterial hypertension, chronic atrial fibrillation with dilated cardiomyopathy and chronic kidney disease, ...
TY - JOUR. T1 - Development of an avian brachial plexus nerve block technique for perioperative analgesia in mallard ducks (Anas platyrhynchos)*. AU - Brenner, Deena J.. AU - Larsen, R. Scott. AU - Dickinson, Peter J. AU - Wack, Raymund F.. AU - Williams, D. Colette. AU - Pascoe, Peter J. PY - 2010/3. Y1 - 2010/3. N2 - Surgical procedures of the wing are commonly performed in companion, captive, and wild avian species. To develop a clinically applicable brachial plexus nerve block technique for perioperative analgesia in birds, 8 adult female mallard ducks (Anas platyrhynchos) were anesthetized and used in several local anesthetic trials with bupivacaine (2 or 8 mg/kg) or a combination of lidocaine (15 mg/kg) and epinephrine (3.8 μg/kg) perineurally; equal volumes of saline were administered as control treatments. Both axillary and dorsal approaches to the brachial plexus were evaluated. With the axillary approach, radial and ulnar compound nerve action potentials (CNAP), sensory nerve ...
Spinal cord herniation (SCH) is a rare cause of myelopathy. When reported, SCH has most commonly been described as occurring spontaneously in the thoracic spine, and being idiopathic in nature (anterior thoracic spinal cord herniation, ATSCH) [1-3]. Several theories have been proposed to explain its occurrence, including congenital, inflammatory, and traumatic etiologies alike [1-4]. Even more rarely, SCH has been described to occur in the cervical spine in association with brachial plexus avulsion injuries (BPAI-SCH). In our accompanying article, Late Cervical Spinal Cord Herniation Resulting from Post-Traumatic Brachial Plexus Avulsion Injury, two cases of BPAI-SCH are presented and discussed in the context of the reviewed literature [5]. Here, pertinent accompanying follow-up data was collected and is presented for the cases, including postoperative radiographic outcome imaging. Furthermore, a table is presented comparing and contrasting ATSCH to BPAI-SCH. Although the two phenomena have been
This study compared the efficacy and effects of adding dexmedetomidine to bupivacaine versus bupivacine alone for a supraclavicular brachial plexus blockade to
05/31/2013 // Concord, CA, USA // LifeCare123 // Greg Vigna, MD, JD, Joe Motta, JD // (press release). Life Care Solutions Group Medical Perspective on Brachial Plexus Injuries:. Motor vehicle accidents are the most frequent cause of brachial plexus injuries with .67% of motor vehicle accident victims admitted to acute care hospitals suffering from brachial plexus injuries. These serious injuries from car accidents involve high force and velocity which causes multiple associated injuries including TBI with 72% having some loss of consciousness and 19% of victims in coma, cervical spine fractures in 13%, and shoulder injuries in 20%.. From my experience, says Greg Vigna MD/JD, diagnosis is fairly straightforward in the acutely injured cognitively intact patient. There will usually be markedly asymmetric finding of weakness involving the proximal or distal upper extremity. Diagnosis may be delayed by the presence of associated injuries that cause loss of function of the upper extremity including ...
U.S., March 20 -- ClinicalTrials.gov registry received information related to the study (NCT03081728) titled Incidence Of Hemidiaphragmatic Pralysis After Usg Guided Low Dose Interscalene Brachial Plexus Block on March 12. Brief Summary: to put a catheter in interscalene brachial plexus USG guided and give a bolus of drug followed by 24 hours continous infusion of drug Study Start Date: Study Type: Interventional Condition: Respiratory Insufficiency Intervention: Device: Interscalene Block with Ropivacaine Hcl 0.2% Inj Vil 10Ml bolus 10ml of 0.5% ropivacaine followed by infusion @ 2ml/hr of 0.2% ropivacaine Other Name: Ropiv Drug: IV diclofenac and IV paracetamol iv diclofenac 75 mg TDS iv paracetamol 1gm TDS Other Name: voveran and perfalgen Recruitment Status: Not yet recruiting Sponsor: Postgraduate Institute of Medical Education and Research Information provided by (Responsible Party): Dr. Pankaj, Postgraduate Institute of Medical Education and Research ...
TY - JOUR. T1 - Pulmonary function changes after interscalene brachial plexus anesthesia with 0.5% and 0.75% ropivacaine. T2 - A double-blinded comparison with 2% mepivacaine. AU - Casati, Andrea. AU - Fanelli, Guido. AU - Cedrati, Valeria. AU - Berti, Marco. AU - Aldegheri, Giorgio. AU - Torri, Giorgio. PY - 1999/3. Y1 - 1999/3. N2 - The purpose of this investigation was to compare, in a prospective, double-blinded fashion, 0.5% and 0.75% ropivacaine with 2% mepivacaine to determine their effects on respiratory function during interscalene brachial plexus (IBP) anesthesia. With ethical committee approval and written, informed consent, 30 healthy patients presenting for elective shoulder capsuloplastic or acromioplastic procedures were randomized to receive IBP anesthesia by 20 mL of either 0.5% ropivacaine (n = 10), 0.75% ropivacaine (n = 10), or 2% mepivacaine (n = 10). Block onset time, pulmonary function variables, ipsilateral hemidiaphragmatic motion (ultrasonographic evaluation), and first ...
The increased incidence of motor vehicle accidents during the past century has been associated with a significant increase in brachial plexus injuries. New imaging studies are currently available for the evaluation of brachial plexus injuries. Myelography, CT myelography, and magnetic resonance imaging (MRI) are indicated in the evaluation of brachial plexus. Moreover, a series of specialized electrodiagnostic and nerve conduction studies in association with the clinical findings during the neurologic examination can provide information regarding the location of the lesion, the severity of trauma, and expected clinical outcome. Improvements in diagnostic approaches and microsurgical techniques have dramatically changed the prognosis and functional outcome of these types of injuries.
BENEFITS Facilitates skills acquisition to perform an infraclavicular brachial plexus block and PEC I block Allows injection and needling practice Teaches ultrasound anatomy pattern recognition and needle-eye coordination INTERNAL LANDMARKSPectoralis major and minor muscles; Serratus anterior muscle; Axillary artery an
INTRODUCTION: Active wrist extension initiates most functions of the hand. Extended brachial plexus injury usually has loss of wrist extension. We report a case with extended brachial plexus injury (BPI) treated with SAN to SSN and AIN branch to pronator quadratus to radial branch of ECRB nerve transfer. MATERIALS & METHODS: A 26 year-old gentleman involved in road traffic accident resulted in a flail left upper limb. Nerve conduction studies showing evidence of left pan-plexus injury. Over 8 months he recovered lower trunk function and was planned for nerve transfer surgery for shoulder abduction and wrist extension. The SAN to SSN transfers were performed where two branches of SAN to the upper trapezius were preserved and stimulated to confirm function. The nerve was divided below these branches and coaptate to SSN. The AIN was sectioned 3-4 cm proximal to PQ and coaptation to ECRB motor branch performed before the first division of motor branch to ECRB. RESULTS: 6 months post-surgery, wrist ...
Brachial plexus block is a regional anesthesia technique that is sometimes employed as an alternative or as an adjunct to general anesthesia for surgery of the upper extremity. This technique involves the injection of local anesthetic agents in close proximity to the brachial plexus, temporarily blocking the sensation and ability to move the upper extremity. The subject can remain awake during the ensuing surgical procedure, or s/he can be sedated or even fully anesthetized if necessary. There are several techniques for blocking the nerves of the brachial plexus. These techniques are classified by the level at which the needle or catheter is inserted for injecting the local anesthetic - interscalene block on the neck, supraclavicular block immediately above the clavicle, infraclavicular block below the clavicle and axillary block in the axilla (armpit). General anesthesia may result in low blood pressure, undesirable decreases in cardiac output, central nervous system depression, respiratory ...
The brachial plexus is a network of nerves that conducts signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to those nerves. Erb-Duchenne (Erbs) palsy refers to paralysis of the upper brachial plexus. Dejerine-Klumpke (Klumpkes) palsy refers to paralysis of the lower brachial plexus. Although injuries can occur at any time, many brachial plexus injuries happen when a babys shoulders become impacted during delivery and the brachial plexus nerves stretch or tear. There are four types of brachial plexus injuries: avulsion, the most severe type, in which the nerve is torn from the spine; rupture, in which the nerve is torn but not at the spinal attachment; neuroma, in which the nerve has torn and healed but scar tissue puts pressure on the injured nerve and prevents it from conducting signals to the muscles; and neuropraxia or stretch, in which the nerve has been damaged but not torn. Neuropraxia is the most common type of brachial plexus injury. ...
TY - JOUR. T1 - Brachial plexus anesthesia. T2 - A review of the relevant anatomy, complications, and anatomical variations. AU - Mian, Asma. AU - Chaudhry, Irfan. AU - Huang, Richard. AU - Rizk, Elias. AU - Tubbs, R. Shane. AU - Loukas, Marios. PY - 2014/3/1. Y1 - 2014/3/1. N2 - The trend towards regional anesthesia began in the late 1800s when William Halsted and Richard Hall experimented with cocaine as a local anesthetic for upper and lower limb procedures. Regional anesthesia of the upper limb can be achieved by blocking the brachial plexus at varying stages along the course of the trunks, divisions, cords and terminal branches. The four most common techniques used in the clinical setting are the interscalene block, the supraclavicular block, the infraclavicular block, and the axillary block. Each approach has its own unique set of advantages and indications for use. The supraclavicular block is most effective for anesthesia of the mid-humerus and below. Infraclavicular blocks are useful ...
TY - JOUR. T1 - Brachial plexus injury. T2 - Clinical manifestations, conventional imaging findings, and the latest imaging techniques. AU - Yoshikawa, Takeharu. AU - Hayashi, Naoto. AU - Yamamoto, Shinichirou. AU - Tajiri, Yasuhito. AU - Yoshioka, Naoki. AU - Masumoto, Tomohiko. AU - Mori, Harushi. AU - Abe, Osamu. AU - Aoki, Shigeki. AU - Ohtomo, Kuni. PY - 2006/10. Y1 - 2006/10. N2 - Brachial plexus injury (BPI) is a severe neurologic injury that causes functional impairment of the affected upper limb. Imaging studies play an essential role in differentiating between preganglionic and postganglionic injuries, a distinction that is crucial for optimal treatment planning. Findings at standard myelography, computed tomographic (CT) myelography, and conventional magnetic resonance (MR) imaging help determine the location and severity of injuries. MR imaging sometimes demonstrates signal intensity changes in the spinal cord, and enhancement of nerve roots and paraspinal muscles at MR imaging ...
In 1911 a patient described the pain from a serious brachial plexus injury as follows; The pain is continuous, it does not stop a minute either day or night. It is either burning or compressing...in addition, there is, every few minutes, a jerking sensation similar to that obtained by touching...a Leydon Jar. It is like…
Brachial Plexus injury intervention Patient with a brachial plexus injury will usually present with arm internally rotated, abducted and wrist somewhat flex d
Having a brachial plexus injury or a child with a brachial plexus injury is devastating news especially to any new parent. You need knowledge, support, and direction to immediately become involved in your or your childs recovery and help improve overall functional outcome. This requires determination, hope, and education. Our team of experts at the Texas Brachial Plexus Institute is here to help. We have built this web site as a place where you can find answers to some of your questions and to connect with other patients and families facing the same challenges. But, more importantly, were here to evaluate your situation and help you develop a plan for treatment that leads to the best outcome for you. If youre facing a brachial plexus injury and need help, please contact us today.. contact us today ...
Opening injection pressure consistently detects needle-nerve contact during ultrasound-guided interscalene brachial plexus block.
The Brachial Plexus Center at Childrens Hospital Colorado cares for kids with brachial plexus conditions and injuries. Learn more about how we treat brachial plexus injuries here.
ROBLA-COSTALES, J. et al. Nerve Reconstruction Techniques in Traumatic Brachial Plexus Surgery (Part 2): Intraplexal nerve transfers. Neurocirugía [online]. 2011, vol.22, n.6, pp.521-534. ISSN 1130-1473.. After the great enthusiasm generated in the 70s and 80s in brachial plexus surgery as a result of the incorporation of microsurgical techniques and other advances, brachial plexus surgery has been shaken in the last two decades by the emergence of nerve transfer techniques or neurotizations. This technique consists in sectioning a donor nerve, sacrificing its original function, to connect it with the distal stump of a receptor nerve, whose function was lost during the trauma. Neurotizations are indicated when direct repair is not possible, i.e. when a cervical root is avulsed at its origin in the spinal cord. In recent years, due to the positive results of some of these nerve transfer techniques, they have been widely used even in some cases where the roots of the plexus were preserved. In ...
Background: Brachial plexus block has now evolved into a valuable and safe alternative to general anaesthesia for upper limb surgeries. Various approaches like interscalene, supraclavicular, infraclavicular and axillary have been used for blocking the brachial plexus. Supraclavicular approach gives the most effective block for upper extremity and is carried out at level of trunks of brachial plexus. Objectives: To determine and compare the efficacy of supraclavicular block of brachial plexus with bupivacaine (0.5%) with dexmedetomidine (30 µg) and levobupivacaine (0.5%) with dexmedetomidine (30 µg) for brachial plexus blockade. Material & Method: This prospective, randomized, double blinded, controlled trial was conducted on patients of either sex, aged between 18 to 60 years with ASA class I and II posted for upper limb surgeries. Two groups comprising of 30 patient in each group, who received bupivacaine + dexmedetomidine, or levobupivacaine + dexmedetomidine, were selected to compare their ...
Shoulder Dystocia with Brachial Plexus Birthing Injury. This medical illustration series dramatically depicts iatrogenic injury of the brachial plexus nerves as the babys left shoulder becomes trapped beneath the mothers pubic bone during delivery. Subsequently, the nerves of the brachial plexus are stretched and torn as the baby is pulled from the birth canal.
Shoulder Dystocia with Brachial Plexus Birthing Injury. Dramatically depicts iatrogenic injury of the brachial plexus nerves as the babys left shoulder becomes trapped beneath the mothers pubic bone during delivery. Subsequently, the nerves of the brachial plexus are stretched and torn as the baby is pulled from the birth canal.
TY - JOUR. T1 - Normal brachial plexus. T2 - MR imaging. AU - Blair, D. N.. AU - Rapoport, S.. AU - Sostman, H. D.. AU - Blair, O. C.. PY - 1987. Y1 - 1987. N2 - Magnetic resonance (MR) imaging of the brachial plexus was performed in the axial, coronal, and sagittal planes in seven volunteers. Normal structures were delineated by comparison with axial and sagittal cadaver sections and with gross dissection. Differentiation of soft tissues with MR imaging enabled the brachial plexus to be defined from surrounding muscle and vascular structures. Multiplanar imaging demonstrated anatomic detail not previously demonstrated with other radiologic modalities and provided excellent delineation of the components of the brachial plexus from the ventral rami to the peripheral nerve branches.. AB - Magnetic resonance (MR) imaging of the brachial plexus was performed in the axial, coronal, and sagittal planes in seven volunteers. Normal structures were delineated by comparison with axial and sagittal cadaver ...
The brachial plexus can be injured in many different ways - from pressure, stress, or being stretched too far. The nerves may also be cut or damaged by cancer or radiation treatment. Sometimes, brachial plexus injuries happen to babies during childbirth.
The brachial plexus can be injured in many different ways - from pressure, stress, or being stretched too far. The nerves may also be damaged by cancer or radiation treatment. Sometimes, brachial plexus injuries happen to babies during childbirth.
The brachial plexus can be injured in many different ways - from pressure, stress, or being stretched too far. The nerves may also be damaged by cancer or radiation treatment. Sometimes, brachial plexus injuries happen to babies during childbirth.
The brachial plexus can be injured in many different ways - from pressure, stress, or being stretched too far. The nerves may also be damaged by cancer or radiation treatment. Sometimes, brachial plexus injuries happen to babies during childbirth.
The brachial plexus can be injured in many different ways - from pressure, stress, or being stretched too far. The nerves may also be damaged by cancer or radiation treatment. Sometimes, brachial plexus injuries happen to babies during childbirth.
The brachial plexus can be injured in many different ways - from pressure, stress, or being stretched too far. The nerves may also be damaged by cancer or radiation treatment. Sometimes, brachial plexus injuries happen to babies during childbirth.
Kauvery hospital launched the Brachial Plexus Injury support group on 22.09.2017 and supports through technical help, arranging meetings, formation of a support group committee, policy making and advocacy. Kauvery Hospital considers this as a CSR activity with no business intention. The core committee comprises of a few of the Brachial Plexus Injured and operated patients and some of the doctors who have signed up as a part of support group.. ...
Kauvery hospital launched the Brachial Plexus Injury support group on 22.09.2017 and supports through technical help, arranging meetings, formation of a support group committee, policy making and advocacy. Kauvery Hospital considers this as a CSR activity with no business intention. The core committee comprises of a few of the Brachial Plexus Injured and operated patients and some of the doctors who have signed up as a part of support group.. ...
Does your child suffer from a brachial plexus injury? Let our brachial plexus injury attorney, Mike Stephenson review your case. Free consultations.
TY - JOUR. T1 - An approach to obstetrical brachial plexus injuries. AU - Clarke, H. M.. AU - Curtis, C. G.. AU - Abbott, III, Ira Richmond. PY - 1995. Y1 - 1995. N2 - The approach of one clinic to the early evaluation of the infant with an obstetrical brachial plexus palsy has been presented. The need for a reproducible and standardized grading system has been identified. The natural history of these lesions will be better understood as further studies elucidate key principles. The final goals are the precise prognostication of natural outcome and the early prediction of the need for surgical intervention.. AB - The approach of one clinic to the early evaluation of the infant with an obstetrical brachial plexus palsy has been presented. The need for a reproducible and standardized grading system has been identified. The natural history of these lesions will be better understood as further studies elucidate key principles. The final goals are the precise prognostication of natural outcome and ...
Brachial Plexus/*injuries,Brain Diseases/etiology/pathology,Humans,Magnetic Resonance Imaging,Male,Meninges/*pathology,Middle Aged,Siderosis/*etiology/*pathology,Subarachnoid Hemorrhage/complications/ ...
The symptoms of brachial plexus birth injuries range from mild to severe, and often include numbness, paralysis or lack of motor control in the affected limb. In some cases, a condition known as Horner Syndrome may develop, causing changes in the appearance of the eye and face on the injured side of the body.. Depending on the severity of the injury and how it is treated, the symptoms of a brachial plexus injury may be temporary or permanent. Long-term complications may include muscle atrophy and deformity of the affected body parts, as well as an abnormal curvature of the spine known as scoliosis. ...
TY - JOUR. T1 - The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures. T2 - Cadaveric feasibility study - Laboratory investigation. AU - Tubbs, R. Shane. AU - Loukas, Marios. AU - Shoja, Mohammadali M.. AU - Shokouhi, Ghaffar. AU - Wellons, John C.. AU - Oakes, W. Jerry. AU - Cohen-Gadol, Aaron A.. PY - 2009/4. Y1 - 2009/4. N2 - Object. Various donor nerves, including the ipsilateral long thoracic nerve (LTN), have been used for brachial plexus neurotization procedures. Neurotization to proximal branches of the brachial plexus using the contralateral long thoracic nerve (LTN) has, to the authors knowledge, not been previously explored. Methods. In an attempt to identify an additional nerve donor candidate for proximal brachial plexus neurotization, the authors dissected the LTN in 8 adult human cadavers. The nerve was transected at its distal termination and then passed deep to the clavicle and axillary neurovascular bundle. This passed segment of ...
Secrets of Life with Brachial Plexus Palsy is the story of a baby girl who grows up with dreams and ambitions like everybody else. Some of her dreams are to play like other children, to show others that there is nothing that she cannot do, and to pursue any career that she chooses when she grows up. Life with this condition can be challenging, and as the years pass, Marie uncovers secrets that allow her to overcome the stigma of her Brachial Plexus Palsy - secrets she would like to share with you ...
Birth related brachial plexus palsy refers to an injury occurring in the perinatal period to all or part of an infants brachial plexus (the network of nerves connecting your spine to your upper limbs). Birth related brachial plexus palsies can be defined as either Erbs palsies or Klumpkes palsies. Erbs palsies are injuries occurring in the upper brachial plexus, whereas Klumpkes palsies are injuries which occur in the lower brachial plexus. Various factors can increase an infants risk of suffering a brachial plexus palsy during childbirth. Improper, unskilled or negligent treatment by a medical professional can also cause an infant to suffer a brachial plexus palsy. ... ...
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Information on brachial plexus palsy, a birth injury in babies that is caused by injury to the brachial plexus. Learn more about the symptoms, diagnosis and treatment options available at St. Louis Childrens Hospital.
Expertise, Disease and Conditions: Bells Palsy, Brachial Plexus Injuries, Chest Wall Reconstruction, Cleft Lip, Cleft Palate, Complex Skull Reconstruction, Cranial Nerve Palsies, Craniofacial Injuries, Craniofacial Reconstruction, Craniofacial Surgery, Craniomaxillofacial Surgery, Craniomaxillofacial Trauma and Reconstruction, Cranioplasty, Cutaneous Surgery, Dermatologic Surgery, Ear Surgery, Endoscopic Skull Base Surgery, Face Transplant, Facial Lesions, Facial Nerve Disorders, Facial Pain, Facial Paralysis, Facial Reanimation, Facial Reconstruction, Facial Scar Revision, Facial Surgery, Facial Trauma, Facial Trauma Reconstructive Surgery, Flaps, General Reconstruction, Genital Reconstruction, Keloids, Maxillofacial Surgery, Maxillofacial Transplant, Nasal Reconstruction, Obstetric Brachial Plexus Palsy, Pediatric Brachial Plexus, Pediatric Burn Reconstruction, Pediatric Burns, Pediatric Craniofacial Disorders, Pediatric Facial Trauma, Penile Deformities, Perinatal Brachial Plexus Injury, ...
Axillary Block: N block suplement. The axillary block is the most distal nerve blocked on brachial plexus. Used for surgeries of hand or forearm. Benefits: negligible risks of respiratory compromise 2/2 pneumothorax or phrenic nerve blockade, can tamponade artery if inadvertent puncture occurs. Review brachial plexus anatomy The goal is to block the nerves surrounding the axillary artery. Median, radial and ulnar nerves all travel with the axillary artery within the axillary sheath; the musculocutaneous nerve travels separately within the belly of the coracobrachialis muscle. **Must block musculocutaneous nerve separately!**. Similar keyword: Axillary block: N block supplement. ...
Learn the Brachial plexus reconstruction (intercostal to radial nerve transfer) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Brachial plexus reconstruction (intercostal to radial nerve transfer) surgical procedure.
Nerve Block for NTOS. Thoracic Electrical Outlet Disorder, TOS is a term made use of to define a team of problems that occur when capillary, or nerves, are compressed within a space called the thoracic electrical outlet. The thoracic outlet is the flow means between your collarbone and first rib. There are 3 sorts of TOS. Neurogenic, compression of the brachial plexus, venous, compression of the subclavian vein, and arterial, compression of the subclavian artery. Depending upon the type of TOS you have, therapies vary from physical therapy and drug to surgical procedure. The most common type or TOS is neurogenic TOS, NTOS. This disorder could happen if there are physiological irregularities, such as a rare cervical rib, injury, or most generally, repetitive arm motion resulting in compression of the interscalene triangle. Individuals with NTOS frequently experience pain or feeling numb of the top limb. When the advised physical therapy wants, carrying out an interscalene brachial plexus block ...
Work-related upper limb disorders constitute a diagnostic challenge. However, patterns of neurological abnormalities that reflect brachial plexus dysfunction are frequent in limbs with pain, weakness and/or numbness/tingling. There is limited evidence about the association between occupational physical exposures and brachial plexopathy. 80 patients with brachial plexopathy according to defined criteria and 65 controls of similar age and sex without upper limb complaints were recruited by general practitioners. Patients and controls completed a questionnaire on physical and psychosocial work-exposures and provided psychophysical ratings of their perceived exposures. The exposures of cases and controls were compared by a Wilcoxon rank sum test. Odds ratios and dose-response relationships were studied by logistic regression. Whether assessed as the extent during the workday or days/week, most physical exposures, in particular upper limb posture and repetition, were significant risk indicators with clear
This exhibit depicts traumatic left brachial plexus neuromas, scarring, and nerve graft repairs. Pre-operatively, neuromas are seen at C5-6 and C7-8. Severe scar tissue surrounds the brachial plexus and entraps the phrenic nerve that controls the diaphragm. Post-operatively, the scar tissue has been removed, and the C5-6 neuroma has been partially excised. C4 sensory nerves were harvested and used to create two nerve grafts. One graft was placed from C6 to the anterior division of the upper trunk, and the other was placed from C5 to the posterior division of the upper trunk.
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A currently pending birth injury lawsuit underscores the dangers of shoulder dystocia and the need for doctors, nurses and other health care professionals to act with the requisite standard of care during the labor and delivery process. This is especially true when complications arise. Shoulder dystocia is a type of birth injury that occurs when a babies shoulder gets stuck behind a mother
June 19 - 21 The MBPN is excited to be hosting its 20th annual summer camp session for families of children affected by brachial plexus injury, or Erbs Palsy. Children and their family members are invited to spend the weekend […]. ...
Accumulating evidence suggests that brachial plexopathy following head and neck cancer radiotherapy may be underreported and that this toxicity is associated with a dose-response. Our purpose was to determine whether the dose to the brachial plexus (BP) can be constrained, without compromising regional control. The radiation plans of 324 patients with oropharyngeal carcinoma (OPC) treated with intensity-modulated radiation therapy (IMRT) were reviewed. We identified 42 patients (13%) with gross nodal disease |1 cm from the BP. Normal tissue constraints included a maximum dose of 66 Gy and a D05 of 60 Gy for the BP. These criteria took precedence over planning target volume (PTV) coverage of nodal disease near the BP. There was only one regional failure in the vicinity of the BP, salvaged with neck dissection (ND) and regional re-irradiation. There have been no reported episodes of brachial plexopathy to date. In combined-modality therapy, including ND as salvage, regional control did not appear to be
The axillary block aims to block the terminal branches of the brachial plexus which include the median, ulnar, radial and musculocutaneous nerves. The musculocutaneous nerve often departs from the lateral cord in the proximal axilla and is commonly spared by the axillary approach. The median, ulnar and radial nerves lie next to the axillary artery and are surrounded by the biceps, coracobrachialis and triceps muscles. It is important to locate and occlude the axillary vein(s) by transducer applied pressure to avoid unintentional intravascular injection ...
Birth injuries can happen. Get your questions answered on birth asphyxia, brachial plexu & other birth injuries. We are here to help.
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For many people, there is no happier occasion than the birth of a child. Unfortunately, not every birth goes perfectly, and an infant or mother may suffer from serious complications. While certain birth defects are unavoidable, obstetrical error can lead to severe birth injuries during labor and delivery. Inadequate fetal monitoring, unnecessary use of forceps or vacuum extraction, lack of appropriate maternal care or prenatal care, and other failures of the nurses, obstetrician, technicians, or anesthesiologists leading to birth injury is considered medical malpractice. If your family has suffered from stillbirth, traumatic brain injury or brain damage, cerebral palsy, Erbs palsy (brachial plexus injury), nerve damage, fractures, or other preventable birth injury, consult an Oklahoma birth injury lawyer to find out how to get the compensation you deserve. Compensation awarded in birth injury lawsuits generally considers the costs of lifelong care of a severely disabled person. Recently, a jury ...
|p|Continuous interscalene blocks involve the insertion of a perineural catheter along the brachial plexus to provide a continuous local anesthetic infusion with or without patient-controlled bolus dosing. Most commonly used to produce surgery-specific analgesia for major shoulder surgery, continuous interscalene blocks may also play a role in improving surgical outcomes by facilitating early physical therapy as a result of superior pain control. This article reviews the current evidence supporting the benefits of continuous interscalene blocks in improving the quality and duration of postsurgical recovery, as well as indications, contraindications, potential complications, and adverse effects. Although a limited number of studies on continuous interscalene blocks have been published, findings suggest improvements in the time to achieve set discharge criteria, pain control, and mobility that meet or exceed surgeon-defined physical therapy goals and patient satisfaction. While the benefits in terms of
Dr. Kelly Ross with the pediatric hospitalist team at St. Louis Childrens Hospital and Washington University School of Medicine shares information about a common birth injury called brachial plexus.. ...
Presently, What information/ support is out there? Specifically in Sri Lanka/ Asia as there are many reported motor cycle accidents that occur on a daily basis. 17 years living with this injury Ive ever only known of 2 other support groups. One in the UK (http://www.tbpi-group.org/) and one in the US (Mostly for patients when…
Tweet This is the second part of Radiation-Induced Brachial Plexopathy (RIBP) and Lymphedema. The last blog entry covered the causes and symptoms. This entry covers the treatment and how it relates to the presence of lymphedema.. How is RIBP treated?. Although surgical procedures to decompress the brachial plexus and re-vascularize the nerves and surrounding tissues . . . → Read More: Treatment of RIBP in the Presence of Lymphedema. ...
Tweet This is the second part of Radiation-Induced Brachial Plexopathy (RIBP) and Lymphedema. The last blog entry covered the causes and symptoms. This entry covers the treatment and how it relates to the presence of lymphedema.. How is RIBP treated?. Although surgical procedures to decompress the brachial plexus and re-vascularize the nerves and surrounding tissues . . . → Read More: Treatment of RIBP in the Presence of Lymphedema. ...
When injuries occur to the brachial plexus during childbirth, usually, Erbs Palsy is the result. This is when the damage happens to one of the upper nerves of the cluster. While in some rare instances Erbs Palsy has been diagnosed after an injury later in life, this is almost always something that happens during labor.. One of the most common reasons for Erbs Palsy is because the physician in charge of the birthing process pulled on the infants arm. If they pulled too hard, the nerves could be stretched beyond what theyre able to handle an injury happens.. The baby could need to be cleared from the birth canal for a few reasons. If the mom is obese, the canal may not be very wide to begin with. Likewise, if the child has an above-average weight at the time of birth, just about any canal might not be enough to move the baby through. Even very small women can have children with Erbs Palsy because of this.. Cesarean section is recommended in situations like this. However, like we just ...
The musculocutaneous nerve innervates the muscles in front portion of the arm. These include the coracobrachialis, the biceps brachii, and the brachialis. The nerve originates from spinal nerve roots C5, C6, and C7.
Nerve injury can be caused by traumatic stretching of the nerve, pressure from tumours or damage from radiation therapy. Symptoms of nerve damage may include difficulty moving the arm, shoulder, hand or fingers, and impairment of the arm or hand. Nerve reconstruction is an option when the nerves are severely damaged and will not recover on their own. This is an extremely complex and lengthy operation where the surgeon rebuilds the nerve with a graft or performs and nerve transfer. With a successful Brachial Plexus Reconstruction,some patients mayregain a little mobility or sensation, providing the surgery is carriedout within a few months from the injury. ...
The brachial plexus is formed by the anterior primary divisions of the four lower cervical nerves and the greater part of that of the first thoracic nerve. It is usually joined by small twigs from the fourth cervical and second thoracic nerves. The a...
The fifth through eighth cervical nerves and the first thoracic nerve contribute to the brachial plexus (shown splayed out). Notes ...
The authors review 118 operative brachial plexus gunshot wounds (GSWs), causing 293 element injuries that were managed over a 30-year period at Louisiana State University Health Sciences Center (LSUHSC). Retrospective chart reviews were performed. Using the LSUHSC grading system for motor sensory function, each elements grades were combined and averaged.. Most of the 293 injured elements were found to have gross continuity at operation and of 202 elements with complete neurological loss, only 16 (8%) exhibited total disruption. Of 293 injuries, 128 elements with complete or incomplete loss were not only in continuity when explored but also had positive intraoperative nerve action potentials (NAPs). After neurolysis, 120 of 128 elements in continuity (94%) improved to greater than or equal to Grade 3 function. Elements not regenerating early usually required repair. One hundred fifty-six of 202 completely or incompletely injured elements (77%) required resection and suture or graft repair based ...
back] Radiation. The brachial plexus is an arrangement of nerve fibers, running from the spine, formed by the ventral rami of the lower cervical and upper thoracic nerve roots, specifically from above the fifth cervical vertebra to underneath the first thoracic vertebra (C5-T1). It proceeds through the neck, the axilla (armpit region) and into the arm. [ref]. ...
Takahiro Mahara was diagnosed brachial plexus neuritis in his right shoulder. He will require a few days of complete rest at home and may not be ready for the start of the regular season. There is currently no timetable on when he will be able to return to practices.. Source: Nikkan Sports 3/8/2013, Sponichi 3/8/2013, Daily Sports 3/8/2013. ...
Fig. 3. Superior view of left upper limb illustrating formation of median nerve by three roots with muscular branches from the second lateral root. Note the absence of the musculocutaneous nerve. MC. Medial cord; LC. Lateral cord; LR1. First lateral root of median nerve; LR2. Second lateral root of median nerve; MN. Median nerve; UN. Ulnar nerve; NCb. Nerve to coracobrachialis muscle; BB. Biceps brachii muscle; NBB. Nerve to biceps brachii muscle; NBr. Nerve to brachialis muscle.. DISCUSSION. The knowledge of variations in anatomy is invaluable in clinical practice, especially in radiological diagnoses and surgical procedures. It is often used in the explanation of non-classical clinical signs and symptoms (Loukas et al., 2008a). This case report shows multiple variations in the branches of the brachial plexus. Alton & Huten (1977) said that all nerves of the brachial plexus are formed in two planes viz. anterior and posterior. The anterior planes comprise of nerves of the medial and lateral ...
Definition of inferior trunk of brachial plexus. Provided by Stedmans medical dictionary and Drugs.com. Includes medical terms and definitions.
HealthTap: Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Wu on brachial plexus tumor symptoms: No vaccine causes that.
Erbs Palsy is a birth injury that is caused when the nerves in the babys neck and upper arm are damaged during childbirth. During birth, doctors sometimes attempt to deliver the baby by pulling or tugging on the babys head if the baby is moving too slowly through the birth canal or if the baby becomes stuck. Unfortunately, the nerves in the babys neck and upper arm are fragile and vulnerable to injury if they are stretched too far or torn. If these nerves - the brachial plexus nerves - are damaged, the child can sustain a serious and permanent injury to the affected arm, shoulder and/or hand. The child may have weakness, immobility, absent or decreased reflexes, and deformity of the arm or hand known as Erbs Palsy or brachial plexus palsy.. ...
A baby being born in Worcester is supposed to be one of the happiest events of the parents lives. Unfortunately, many ... Birth Injury
For nine months you have waited, watched, and anticipated the birth of your child. Yet in one moment, all of your hopes and dreams could be shattered by an unanticipated birth injury. When medical negligence leads to the injury of your newborn, it is important to seek legal assistance immediately. Birth injuries can be catastrophic and can lead to a lifetime of pain and disability. You and your child have a right to be compensated for those injuries, the loss of life, or the future disabilities you and your child will now endure.. Brachial Plexus Injuries: This involves damage to the nerves that are present in the upper spine, neck, and shoulder area. Up to 10% of these injuries result in permanent disability and complete paralysis.. Bone Fractures: Sometimes, difficult deliveries can lead to bone fractures in the newborn. Most commonly, the clavicle is fractured and may lead to permanent nerve damage. Most fractures are easily treated and heal quickly, however.. Perinatal Asphyxia: There are ...
The median nerve is a major branch of the brachial plexus that is derived from the medial and lateral cords. It contains nerve fibres from all 5 roots of the brachial plexus (C5 - T1). It supplies the flexor muscles in the anterior compartment of the forearm (apart from flexor carpi ulnaris and part of flexor digitorum profundus, which are innervated by the ulnar nerve), the thenar muscles and the lateral two lumbricals. It supplies sensory innervation to the lateral side of the palm and the lateral three and a half fingers on the palmar surface of the hand.. Anatomy of the Median Nerve. The median nerve arises in the brachial plexus and enters the arm from the axilla at the inferior margin of teres major. It initially lies anterior to the axillary artery and then lateral to it and then descends down the arm lateral to the brachial artery. It then crosses over the brachial artery at the level of the mid-humerus to lie medial to the artery in the cubital fossa.. The median nerve passes beneath ...
A resource for neurologists, neurology residents, medical students on a neurology rotation, and people interested in neurology or neuroscience. Review questions to help you study for the Neurology boards or RITE exam. Helpful PDA medical software.

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