CA2046612A1 - Pocket chart for localizing lesions of the peripheral nervous system - Google Patents

Pocket chart for localizing lesions of the peripheral nervous system

Info

Publication number
CA2046612A1
CA2046612A1 CA002046612A CA2046612A CA2046612A1 CA 2046612 A1 CA2046612 A1 CA 2046612A1 CA 002046612 A CA002046612 A CA 002046612A CA 2046612 A CA2046612 A CA 2046612A CA 2046612 A1 CA2046612 A1 CA 2046612A1
Authority
CA
Canada
Prior art keywords
section
muscles
chart
consultation
lesion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002046612A
Other languages
French (fr)
Inventor
Paolo Fardin
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2046612A1 publication Critical patent/CA2046612A1/en
Abandoned legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • GPHYSICS
    • G09EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09BEDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B3/00Manually or mechanically operated teaching appliances working with questions and answers
    • G09B3/02Manually or mechanically operated teaching appliances working with questions and answers of the type wherein the student is expected to construct an answer to the question which is presented or wherein the machine gives an answer to the question presented by a student
    • G09B3/04Manually or mechanically operated teaching appliances working with questions and answers of the type wherein the student is expected to construct an answer to the question which is presented or wherein the machine gives an answer to the question presented by a student of chart form
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/08Detecting, measuring or recording devices for evaluating the respiratory organs
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B42BOOKBINDING; ALBUMS; FILES; SPECIAL PRINTED MATTER
    • B42DBOOKS; BOOK COVERS; LOOSE LEAVES; PRINTED MATTER CHARACTERISED BY IDENTIFICATION OR SECURITY FEATURES; PRINTED MATTER OF SPECIAL FORMAT OR STYLE NOT OTHERWISE PROVIDED FOR; DEVICES FOR USE THEREWITH AND NOT OTHERWISE PROVIDED FOR; MOVABLE-STRIP WRITING OR READING APPARATUS
    • B42D15/00Printed matter of special format or style not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/45For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4519Muscles

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Educational Administration (AREA)
  • Business, Economics & Management (AREA)
  • Educational Technology (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Physiology (AREA)
  • Pulmonology (AREA)
  • Professional, Industrial, Or Sporting Protective Garments (AREA)
  • Accommodation For Nursing Or Treatment Tables (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Medical Treatment And Welfare Office Work (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Instructional Devices (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)
  • Prostheses (AREA)
  • Medicines Containing Material From Animals Or Micro-Organisms (AREA)
  • Mobile Radio Communication Systems (AREA)

Abstract

ABSTRACT OF THE DISCLOSURE

The present invention refers to a pocket chart for localizing lesions of the peripheral nervous system, consisting of a flexible card divided in four sections, indicated respectively with A, B, C and D, wherein section A lists the test muscles for the innervation of the upper extremity, section B shows the consultation graph for locating the nerve lesion in the area of the brachial plexus, section C lists the test muscles for the innervation of the lower extremity, and section D show the consultation graph for locating the nerve lesion in the lumbosacral plexus area.

Description

WO 91/()X701 r~cr/El~s(~ 23~
~:~3~6~

POC~ET CHART FOR LOCALIZIN~ LESIONS OF ~-~E PEP~IPHERAL NERVO~S

SYSTEM~
Description The present invention refers to a pocket chart for localizing lesions of the peripheral nervous system in the area of brachial-and lumbosacral plexus distribution.
Said chart has the advantage of being a handy tool of rapid use for a safe diagnosis of the location of a nerve lesion, which constitutes the basis for an adequate prognosis and therapy strategy.
Thus an aid is given to the physician, be he a specialist (neurologist, neurosurgeon, physiatrist, orthopedist) or a general practitioner, for acquiring a correct orientation in such pathologies.
In particular, it is possible, by means of the chart according to the invention, through the examination of a number of the member muscles and of their normal or pathological condition, which can be evaluated from a correct clinical muscle balance or from ~ne analytical report of an accurate electromyographic examination, to establish the location of the possible nerve lesion without the laborious and time consuming consultation of more or less exhaustive textbooks, which onl~ report the simple anatomical distribution of the nervous fibers.
The chart of the invention allows thus to b~pass the task of combining the study, in the books, of the anatomy and functionality t ~
~ . .
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~O 91/08702 ~'C'~/EP~0/0223' of the brachial- or lumbosacral plexus with the clinical electromyographic examination of the patient. In practice it is often problematic, through the syr1thesis of said two elements, to reach a rapid diagnostic conclusior" while the use of the chart 5 according to the invention permits to immediately integrate the two elements.
The characteristics and advanta~es of the chart according to the invention will be further illustrated in the following detailed description.
With reference to the enclosed figures l .md 2, the chart consists of a flexible card divided into four sections designed respectively as A, B, C and D.
In section A are listed the test muscles for the innervation of the upper extremity, in section B the consultation graph for locsting the nerve lesion in the area of the brachial plexus is reported, in section C are listed the test muscles for the innervation of the lower extremity and in section D a consultation graph for locating the nerve lesion in the lumbosacral plexus area is reported.
We are calling the attention to the fact that, as test muscles of the radicular innervation, those muscles are considered which, in most individuals, are prevailingly innervated by nervous fibers coming from a motor root; their, normal or pathological, situation ~? may therefore be considered a test of the functionalit~ of the root itself. For the trunk innervation not all muscles are considered, but a number of them sufficient to allow to locate not only a -, ~'O 91/0870' PC1/Er'~)~)/0~23~
3 ~ 6~

lesion of the main trunk Dut also of its single ramifications.
Considering the test muscles for the upper extremity innervationlisted in section A, those for radicular innervation are in heavy type, with the respective motor root in parenthesis, while the muscles innervated by the three maii1 trunks (median, ulnar and radial) are grouped separately, mainly for the sake of mnemonics.
~e muscles are indicated both with their names in extenso and with the initials, which are reported also in the consultation graph of section B.
In section B we represent the distribution graph of the brachial plexus indicating, from left to right, the motor roots and the various nervous trunks that are gradually formed down to their terminal ramifications~ In the lower part of section B the various abbreviations are listed.
More particularly, the brachial ple~us is represented in the successive stages at which the mixing takes place of the nervous fibers coming from motor roots (C5-Tl) and which converge to form the primary trunks, which on their tur~ subdivide to form secondary trunks from which last the peripheral trunks and the single terminal ramifications originate.
For each stage are marked in apposite cases the initials of the various muscles the deficit of which may al.low to locate the lesion at that very point; the site of the lesion is given by the level of the case in which all and onl~ the deter~orated muscles are comprised.

. ~ , - .

W O 9l/0870' PCr/EP~0/02232 4 ~ 2 Because of the complexity of the brachial plexus, ~hile only a few muscles are considered for the radi.cular levels. those at trunk level are more numerous, often bei.ng muscles with such a multiple root innervation as to indicate a clear deficit only in the lesions of single nervous trunks.
The evaluation of the muscle functionality is expressed in a numerical scale in which 5 indicates normality and O the to~al absence of motion, the intermediate deficit degrees being indicated with numbers between 0 and 5. As an example, let's consider a patient showing a marked deficit (indicated with 2) of the deltoid-, triceps brachii-, brachioradialis-, extensor digitorum-, abductor pollicis longus-muscle. This situation is represented in the following table l which reproduces section A of fig. 1. In the third and in the sixth column the functionality evaluations for the various muscles are reported.

: " ' : ;, .

~'O~)1/08702 1~C1`/~:P')()/1)223 ~ 6~

T.~BLE l: Test muscles, upper extreM1ty Upper Trapezius ~T 5 Ulnar N.
Median " MT 5 Fle;cor Carpi FCU 5 Ulnaris Lower " LT 5 Flexor Digitorum FP III-IV
Profundus III-IV
Serratus Anterior SA ; Abductor Digiti ADM 5 min:imi Deltoid (C5) D 2 First Dorsal FDI
Interosseus Infraspinatus (C5) IF 5 Adductor Pollicis AP
Biceps Br. (C6) BB 5 Radialis N.
Median N. Triceps Br.(C7) TB 2 Flexor Carpi Rad. FCR 5 Brachioradialis BR 2 ~C6) Flexor Digitorum FDS 5 Extensor Carpi ECP 2 Sup. Rad.
Flexor Digitorum FP I~II 5 Extensor Digitorum ED 2 15 Profundus I-II
Flexor Pollicis FPL 5 Abductor Pollicis APL 2 Longus Longus Abductor Pollicis APB 5 Brevis 0=no contraction; l=Flicker or trace of contraction; 2=Actlve movement with gravity eliminated; 3=Active movement agains~
gravity; 4=Active movement against gravit and resistance: 5=~orma~
power The related lesion site is identified in the case which contains all and only the deterior~ted muscles of diagram l which reproduces section B of fig. l.

WO 9 1 /OX702 I Cl /190/()22.~2 G

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'~ L 8 r--t ~ __ ~ ~- L

~1 1 1 ~ 5 ~ C ^ ~ Q ~

. ~ L ~ ~ ~ L

¦ ~)a~ ¦ ¢ ~ ~ o~ ~
~, _ j ~ ~J~ _ J-. -r'~ 0 z I i ~
~ ~ ~ ~' ~ ~

_ ~1 ~g~ I ~ ~ .
~ ~ , .~ ~ ~. ~ ~ . .

~5t2 _ ~ ~ ~ _ I
.¢" I C~ ~ I ~

d ~ ~ S ~

,~ .

: . ..

WO 91/()g70' r~cr/Er~so/0~232 7 2~ 2 In the specific examples the lesion is located in correspondence of the brachial plexus posterior cord (PC).
In another case. the patient shows 5 deficit of the brachioradialis-(BR), extensor carpi radialis- (ECR), extensor digitorum-(ED); abductor Pollicis Longus (APL) muscles.
In diagram 1 one finds that said muscles are grouped in the case corresponding to the spiral groove and therefore the lesion site is the radial nerve at the level of the spiral groove.
In ~ection C of figure 1 are listed the test muscles for the lower extremity innervation and in section D a graph of the lumbosacrsl plexus distribution is represented.
For this sections the considerations made for section A and B
apply, both as to the interpretation and the use for diagnostic ends.
In the following table 2 the list of section C is reproduced.

~ .:
` ~. .

W O 91/0~702 f'C~'/E ~)O/02232 8 ;~6~ L2 TAf3LE 2 TEST MUSCLES LOWER EXTREMITY
Adductor Longus (L3) AL Common Peroneal N.
Iliopsoas (L3) IP Peroneus longus PL
5 Rectus Femoris (L4) RF Tibialis Anterior TA
Biceps Femoris BF Extensor Digitorum EDL
Longus (L5) Tibial N. f~tensor Hallucis EHL
Longus Medial Gastoonemius MG Cluteus medius CMe Flexor Hallucis FHB Cluteus maximus CMa Brevis Diagram 2 reproduces the graph of saction B.

,: . ~ . , , ;
- , ': , , . ., ' , ~
2 PCr/EI:~)()/02232 9 ~ 66~
r~ r~
~J~

,; ", , ., ;, ..

W O 91/0870'. PCI/E}")0/02232 lo ;~ 6'~

On the back of the foldable card of the present inventlon schematic drawings of the brachial- and of` the lumbosacral- plexus are reported with the indication of the various nerve trunks, the summary of its contents as well as the instructions for its use.

Claims (6)

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. A pocket chart for localizing lesions of the peripheral nervous system, consisting of a flexible card divided in four sections, indicated respectively with A, B, C and D, characterized in that section A lists the test muscles for the innervation of the upper extremity, section B shows the consultation graph for locating the nerve lesion in the area of the brachial plexus, section C lists the test muscles for the innervation of the lower extremity, and section D shows the consultation graph for locating the nerve lesion in the lumbosacral plexus area.
2. Chart according to claim 1, characterized in that in section A
and C the respective muscles are reported both with their names in extenso and with their initials which are reported also in the consultation graphs in sections B and D.
3. Chart according to claim 1, characterized in that sections B and D represent from left to right the brachial- respectively lumbo-sacral plexus distribution in the various stages starting from the various nervous trunk roots that are gradually formed down to their terminal ramifications.
4. Chart according to claim 1, characterized in that for each stage the pertinent cases contain the initials of the various muscles the deficit of which nay allow to locate the site of the lesion at the same level.
5. Chart according to the preceding claims, characterized in that the lesion site is given by the level of the case in which all and only the deteriorated muscles are comprised
6. Pocket chart for localizing lesions of the peripheral nervous system according to claims 1 to 5 and as more amply described and illustrated and for the specified ends.
CA002046612A 1989-12-20 1990-12-18 Pocket chart for localizing lesions of the peripheral nervous system Abandoned CA2046612A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT22275U IT219004Z2 (en) 1989-12-20 1989-12-20 POCKET RULE TO IDENTIFY THE LOCATION OF THE INJURIES OF THE PERIPHERAL NERVOUS SYSTEM
IT22275B/89 1989-12-20

Publications (1)

Publication Number Publication Date
CA2046612A1 true CA2046612A1 (en) 1991-06-21

Family

ID=11194030

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002046612A Abandoned CA2046612A1 (en) 1989-12-20 1990-12-18 Pocket chart for localizing lesions of the peripheral nervous system

Country Status (12)

Country Link
EP (1) EP0458928A1 (en)
JP (1) JPH04503622A (en)
KR (1) KR920700580A (en)
AU (1) AU6950291A (en)
BG (1) BG1Y1 (en)
BR (1) BR9007100A (en)
CA (1) CA2046612A1 (en)
HU (1) HUT61453A (en)
IT (1) IT219004Z2 (en)
MC (1) MC2170A1 (en)
RO (1) RO108147B1 (en)
WO (1) WO1991008702A1 (en)

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2153993A1 (en) * 1992-01-16 1993-08-05 Rakesh K. Jain Method and apparatus for locating tumors
IT1254265B (en) * 1992-03-12 1995-09-14 Fardin Paolo POCKET ELECTRONIC RULE SUITABLE TO IDENTIFY THE LOCATION OF INJURIES OF THE PERIPHERAL NERVOUS SYSTEM
US7510525B2 (en) 2003-03-10 2009-03-31 Hisaki Kamo System for topical nerve diagnosis and neuroanatomical study

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2563162B1 (en) * 1984-04-18 1986-08-01 Gandois Joel CLOSED PLASTIC DOCUMENT CONSTITUTING A CONFIDENTIAL MEDICAL CARD
CA1276204C (en) * 1986-03-25 1990-11-13 Victor Kumar-Misir Bound book with bound holder carrying loose-leaf pages

Also Published As

Publication number Publication date
BG1Y1 (en) 1995-10-31
HUT61453A (en) 1993-01-28
IT219004Z2 (en) 1992-11-26
KR920700580A (en) 1992-08-10
MC2170A1 (en) 1992-05-22
BG95014U (en) 1993-12-03
JPH04503622A (en) 1992-07-02
BR9007100A (en) 1991-12-24
IT8922275U1 (en) 1991-06-20
RO108147B1 (en) 1994-02-28
WO1991008702A1 (en) 1991-06-27
IT8922275V0 (en) 1989-12-20
HU912583D0 (en) 1992-01-28
EP0458928A1 (en) 1991-12-04
AU6950291A (en) 1991-07-18

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Legal Events

Date Code Title Description
FZDE Discontinued