Cheatography
https://cheatography.com
Presentation, Management etc
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Causes
- Common site of entrapment: Supraclavicular where nerve breaches middle scalene |
- Can be injured by blunt trauma (rare) |
- Can be a result from repetitive compression/traction (common) |
- Anything that requires middle scalene activation, contralateral cx rotation + ipsilateral arm elevation can stretch the nerve |
- Iatrogenic lesions (surgery/biopsy/SOL) |
- Polio |
- Brachial neuritis (Parsonage Turner) |
- Radiation Therapy |
Presentation
- Often follows strenuous upper extremity activity/heavy weight lifting |
- Arm pain and rapid fatigue |
- Weakness/instability when pushing, pulling, lifting, arm above shoulder level |
- Some are unable to flex/abduct their shoulder >90 degrees |
- Scapula winging + inferior angle prominence |
- Palpation = tenderness in supraclavicular region, posterior to carotid artery |
- Symptoms increase with contralateral cx rot + ipsilateral arm elevation |
- EMG usually provides definite diagnosis |
Management
- Condition is rare, so diagnosis is usually delayed |
- Prognosis variable |
- Conservative treatment usually 1st |
- Some degree of recovery within 6-12 months - complete recovery is rare |
- Gentle nerve flossing exercises |
- Myofascial release and stretching of scalanes |
- Scapula stabilisation exercises in supine |
- Surgery is considered if no improvement with conservative care >6 months, however functional after effects are still reported (scapula winging, muscle fatigue) but pain levels drastically decrease |
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