LEZIUNI PLEX BRAHIAL - ETIOLOGIE

Accidente
rutiere
Leziuni la
nastere
Luxatii de
humerus
Mononeuropatii
Leziuni arme
albe
Tumori

TRUNCHI
SUPERIOR

TRUNCHI
MEDIAL

TRUNCHI
INFERIOR

FASCICUL
LATERAL

FASCICUL
POSTERIOR

FASCICUL
MEDIAL

D
D
D
D
D
D

D
D
D
D
D
D

D
D
D
D
D
D
D

D
D
D
D
D
D

D
D
D
D
D
D

D
D
D
D
D
D

Coasta
cervicala

PLEX BRAHIAL MANIFESTARI CLINICE

Scaderea
fortei

Tulburari
senzoriale
Atrofie

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

FASCICUL
LATERAL
Muschii inervati
de median si
musculocutanat

Degetele
4-5

Degetele 1 - 3

+/-

FASCICUL
POSTERIOR
Muschii
inervati de
radial
si
axilar

Muschii
inervati de
radial
si
axilar

FASCICUL
MEDIAL
Muschii
inervati
de
median si
cubital

Strategia
l
evidentierea EMG a afectarii neurogene in muschii inervati de un
anumit fascicul
l
excluderea radiculopatiei
LEZIUNI PLEX BRAHIAL - EMG
TRUNCHI
SUPERIOR

TRUNCHI
MEDIAL

TRUNCHI
INFERIOR

FASCICUL
LATERAL

FASCICUL
POSTERIOR

FASCICUL
MEDIAL

Paravertebrali
Romboid (Dorsal
al scapulei)
Infra/supraspinos
(Colaterala plex)
Deltoid (Axilar)
Biceps brahial
(Musculocutanat)
Triceps (Radial)

D
D
D
D

D
D
D
D
D

Rotund pronator
(Median)
Extensorul
indexului (radial)
Interosos dorsal
(Cubital/median)
Scurt abductor
police (Median)

D
D

D
D

D
D

D
D

D
D

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

D
D
D
D
D
D
D

TRUNCHI
INFERIOR

FASCICUL
LATERAL

FASCICUL
POSTERIOR

D
D

FASCICUL
MEDIAL

D
D
D

D
D
D

D
D

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

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

T1

TRUNCHI
Sup Med
Inf

FASCICUL
Lat Post Med

median
Stinga
Dreapta

(ms)
9.6
8.3

N-P(mV)
3.4
6.5

(mVms)
10.1
22.5

radial dr
distal
prox imal

(ms)
4.0
6.3

N-P(mV)
7.1
4.9

(mVms)
21.0
14.1

Dorsal interosos dr.

Dg. Leziune fascicul posterior si lateral

ELBOW-WRIST
ELBOW-WRIST

ELBOW-WRIST

Deltoid dr.

(ms)
4.4
4.2

(mm)
210
215

(m/s)
47.73
51.19

(ms)

(mm)

(m/s)

2.3

160

69.57

Radial dr.
(ms)
1.6
3.4
7.0

dist
proximal
AXILLA

N-P(mV)
1.2
0.66
1.9

(mVms)
4.1
3.3
7.9

(ms)
ELBOW-WRIST
AXILLA-ELBOW

Triceps

Biceps

Brahioradial

Ext. Com. Deg.

Dg. Functional : leziune trunchi medial + fascicul lateral

1.8
3.6

(mm)
100
210

(m/s)
55.56
58.33