Brachial Plexus Birth Palsy – Board-Style Questions

What this deck covers

brachial plexus birth palsy in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Nothing went wrong at the birth
2. The first look in the delivery room
3. Who is most at risk
4. Breathing hard as well
5. The leg is not right either
6. A pouch beside the cord
7. An arm that does nothing
8. The shorter sleeve
9. Three months and no elbow yet
10. What the parents do at home
11. Pinned to the vest
12. He cannot reach behind his head
13. An operation on the muscles
14. Putting a number on it
15. A burn he never noticed
16. Getting him dressed
17. Planning the next baby
18. Who sees him and when

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: It means that the notes were written carelessly by the midwife, How each arm moves, and the Moro compared on the two sides, Her own height, which decides the outcome entirely by itself, An infection acquired around the time of birth from the birth canal, A cause in the brain, since the leg on that side is affected too, Normal fluid spaces seen around the cord, A limp arm recovers faster than one that moves a little, A bone infection that has quietly damaged the growing end of the bone, Referral for nerve repair, since elbow flexion has not returned, Keep the arm completely still until the nerve has recovered, Pin the other arm as well so that the two sides match, The muscles have become too strong on the outer side, Moving a working tendon to restore turning the arm outwards, The circumference of the upper arm, measured with a tape at each visit.

Clinical pearls from this deck

• An easy delivery does not rule this injury out.
• Record movement in both arms on the very first day.
• A big baby and a previous event carry the most risk.
• A weak arm with paradoxical breathing: the diaphragm.
• Arm and leg together means the brain, not the plexus.
• Fluid pouch, no root leaving it: the root has avulsed.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and orthopaedics case decks · pediatric reference values.