Wednesday 11 March 2009

Brachial plexus injury

A 25 year old female sustained lacerations to the right side of her neck when she fell from a table about 2m from the ground on to broken glass. She sustained lacerations to her subclavian, vertebral and internal jugular veins and ruptured C5 and C6
The injuries to the veins were successfully tied and treated. The nerve of C5 and C6 level were repaired by nerve grafts. Her arm was immobilized in a sling for 4 weeks. Active hand, wrist and finger movements were encouraged. After 4 weeks the patient was admitted for a week of rehabilitation

Main problems


-Reduced function and ROM in shoulder and elbow
-Adhered scar on right side of neck and volar side of elbow which restricted neck and elbow ROM
-Reduced grip strength in right hand and triceps grade 2 MRC
-Poor postural awareness of shoulder/arm alignment
-Reduced balance and core stability

QUESTIONS

1. Explain physiotherapy goals for this patient
2. Explain physiotherapy intervention for this patient

10 comments:

  1. Salam kepada semua student sem 4...utk soalan diatas, sila discuss bersama supaya u all boleh faham mcm mana jawapannya.............

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  2. aisyah..
    thanks en haidzir...sy ad jmpe kes brachial plexus kt sini..pt tu dh lme trima tx, skrg die still tak leh angkat tgn

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  3. en. haidzir...nk tnye...

    1)MRP tu ape..physio kat sini kate kalo nk facilitate muscle for neuro pt boleh gne MRP..

    2)selain drpd stretching ngan PNF, ape lg manual teknik utk stroke patient?

    -pelatih physio SJ, nadia,aisyah-

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  4. MRP tu Motor Relearning Program..betul x? untuk patient neuro (of course).function die untuk re-educate motor semula.kita ajar untuk ajar patient untuk duduk sendiri, bangun sendiri n functional yg laen..sama cam bed mobility..betul x en haidir?

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  5. sorry.........lama tak berhubung.......saya cuti lama memandangkan wife saya baru bersalin...MRP tu adalah motor relearning programme...hasil kerja carr and shepherd.......pada tahun 1985 tak salah saya mereka ada keluarkan theory untuk treat patient stroke....buku terbaru mereka membuktikan hasil kerja mereka melalui research...MOTOR ASSESSMENT SCALE adalah outcome measure dari mereka.......

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  6. e. haidzir...
    tahniah dpt baby baru...ktorg tertanye gak nape lame page xupdate...neway thanks utk jawapan tu...tp mcmane ngn jwapan utk soalan no 2?

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  7. aisyah

    MAS tu yg en haidzir ajar la tu ek? mknenenye MAS tu slh satu dpd MRP ye?

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  8. MAS tu outcome measure..........MRP tue techniquenya...kalau nak tengok ada improvement...pakai MAS la....boleh rekod peningkatannya.....gred 1-6

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  9. Untuk soalan no 2........saya merasakan awak tak baca lagi buku neuro rehab bab technique of treatment....FACILITATION technique....stimulation technique......

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  10. en.haidzir td sy ader msg en haidzir tnye pasal ms power and muscle strength.ade selisih pendapat ngan physio cnie..pasal actin myosin tu xpela...sy da dpt jwpan dlm anatomy.cume yg perselisihan pndpt tu la sbb physio cni ckp dorang pkai ms power yg ader grade 0-5..yg grade tu bkn ms strength ker...?

    time kasih....

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