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LEZIUNI PLEX BRAHIAL - ETIOLOGIE

TRUNCHI SUPERIOR Accidente rutiere Leziuni la nastere Luxatii de humerus Mononeuropatii Leziuni arme albe Tumori Coasta cervicala TRUNCHI MEDIAL TRUNCHI INFERIOR FASCICUL LATERAL FASCICUL POSTERIOR FASCICUL MEDIAL

PLEX BRAHIAL MANIFESTARI CLINICE


Scaderea fortei TRUNCHI SUPERIOR Abdductia umarului Flexie cot Rotatia bratului Fata laterala brat +/TRUNCHI MEDIAL Extensia cotului Flexia si extensia pumnului Degelele 2-3 TRUNCHI INFERIOR Muschii intrinseci ai miinii Degetele 4-5 +/FASCICUL LATERAL Muschii inervati de median si musculocutanat Degetele 1 - 3 Muschii inervati de radial si axilar FASCICUL POSTERIOR Muschii inervati de radial si axilar FASCICUL MEDIAL Muschii inervati de median si cubital

Tulburari senzoriale Atrofie

Strategia l evidentierea EMG a afectarii neurogene in muschii inervati de un anumit fascicul l excluderea radiculopatiei
LEZIUNI PLEX BRAHIAL - EMG
TRUNCHI SUPERIOR Paravertebrali Romboid (Dorsal al scapulei) Infra/supraspinos (Colaterala plex) Deltoid (Axilar) Biceps brahial (Musculocutanat) Triceps (Radial) Rotund pronator (Median) Extensorul indexului (radial) Interosos dorsal (Cubital/median) Scurt abductor police (Median) TRUNCHI MEDIAL TRUNCHI INFERIOR FASCICUL LATERAL FASCICUL POSTERIOR FASCICUL MEDIAL

LEZIUNI PLEX BRAHIAL - Stimulodetectie


TRUNCHI SUPERIOR VCS median dg. 1 VCS median dg. 2,3 VCS cubital dg. 5 VCS radial VCM median VCM radial VCM cubital TRUNCHI MEDIAL TRUNCHI INFERIOR FASCICUL LATERAL FASCICUL POSTERIOR FASCICUL MEDIAL

Muchi Romboid Supraspinos Infraspinos Deltoid Rotund mic Biceps Brahioradial Pectoralul mare Pectoralul mic Supinator Rotund pronator Dorsalul mare Rotund mare Extensor digitorum Flexor carpi radialis Triceps Extensor indicis Dorsal interosseus I Abductor pollicis brevis

Nerv Dorsal scapular Suprascapular Suprascapular Axilar Axilar Musculocutanat Radial Pectoral lateral Pectoral medial Radial Median Toracodorsal Toracodorsal Radial Median Radial Radial Ulnar Median

C5

RDCIN C6 C7 C8

T1

TRUNCHI Sup Med Inf

FASCICUL Lat Post Med

Sup = Superior; Inf = Inferior; Med = Medial; Lat = Lateral; Post = Posterior

median Stinga Dreapta

(ms) 9.6 8.3

N-P(mV) 3.4 6.5

(mVms) 10.1 22.5

ELBOW-WRIST ELBOW-WRIST

(ms) 4.4 4.2

(mm) 210 215

(m/s) 47.73 51.19

radial dr distal prox imal

(ms) 4.0 6.3

N-P(mV) 7.1 4.9

(mVms) 21.0 14.1

(ms) ELBOW-WRIST 2.3

(mm) 160

(m/s) 69.57

Dorsal interosos dr. Dg. Leziune fascicul posterior si lateral

Deltoid dr.

Radial dr.
dist proximal AXILLA (ms) 1.6 3.4 7.0 N-P(mV) 1.2 0.66 1.9 (mVms) 4.1 3.3 7.9 (ms) ELBOW-WRIST AXILLA-ELBOW 1.8 3.6 (mm) 100 210 (m/s) 55.56 58.33

Triceps

Biceps

Brahioradial

Ext. Com. Deg.

Dg. Functional : leziune trunchi medial + fascicul lateral