Tom Quick @TJQPNI Twitter profile | Pikagi

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Tom Quick

@TJQPNI

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Consultant peripheral nerve surgeon @clecliniclondon AssProf @UCL ABC fellow CMO @Bush_company #brachialplexus #nerveinjury

London

https://t.co/0wnKkbxhWL

Joined March 2013

Don't wanna be here? Send us removal request.

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@TJQPNI

Tom Quick

4 years

Let me introduce you to this amazing structure. It scares many people who learned it as medical or paramedical student, but to me it’s wonderful clever & beautiful. A triumph of developmental neurology and essential in all we do- let me introduce the brachial plexus via a thread

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@TJQPNI

Tom Quick

4 years

Hope this goes chiral !

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@TJQPNI

Tom Quick

3 years

My #Ulnar Nerve #clinicalexamination sheet with @OrthohubXYZ is available in full quality at () #anatomy #MedEd

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@TJQPNI

Tom Quick

3 years

Here are my first three #MedEd #Anatomy #ClinicalExam Study sheets for #nerveanatomy - #radial #median #ulnar : videos and sheets on @OrthohubXYZ

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Tom Quick

4 months

Platysma, let’s explore this intriguing structure: An anatomic, functional and evolutionary thread 🧵…

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Tom Quick

3 years

Did you catch my #MedianNerve #clinical #examination sheet with @OrthohubXYZ (full quality download at ) #anatomy #MedEd #upperlimb

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Tom Quick

3 years

Fancy some endoftheweekend nerve updates? @OrthohubXYZ and I present examination tips on sheets for each of the major nerves of the hand. #ulnar #median #radial .

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Tom Quick

2 years

[With consent] What can you notice about this individual? He has had difficult lifting his left arm for 15 months.

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Tom Quick

1 year

Injections that stop pain are an amazing thing. How do local anaesthetics stop pain? What makes the numbing effect wear off? And what should be done if it doesn’t? A thread on nerve function by a nerve surgeon. #regionalanaesthesia #localanaesthetic #neurapraxia #conductionblock

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Tom Quick

3 years

Here’s some sketches for #Radialnerve #anatomy teaching. #surgicalanatomy #surgicalapproaches . My @OrthohubXYZ video and full anatomy sheet coming this week.

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Tom Quick

4 years

Our #BrachialPlexus model in the #nerveinjury unit ⁦ @RNOHnhs ⁩. It’s origin is legend, created by a visiting fellow back in the midst of time as a present to the unit. It is an essential education tool and object of beauty.

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Tom Quick

3 years

#PlexiformNeurofibroma of Left Sciatic nerve. (With consent). Often described as looking like a 💼 of 🪱 🪱 . #nerve

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Tom Quick

4 years

Morning Trauma meeting with another referral for #brachialplexus #nerveinjury from #pronepositioning after #COVID treatment. We will have guidance on this and a referral protocol published by next week. #PNIUnit @RNOHnhs

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Tom Quick

4 years

I’ve never seen a glow bug- this has me grinning!

@gunsnrosesgirl3

Science girl

@gunsnrosesgirl3

4 years

“The universe is not required to be in perfect harmony with human ambition.” — Carl Sagan

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3 years

Ok #MedTwitter here’s a thing, (with patient consent) severe heavy aching across the shoulder and pain down to the hand. What are you thinking ?

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Tom Quick

3 years

The #BrachialPlexus is a complex web of nerves which control the upper limb. All the information on controlling tone, complex movements, touch, pain and temperature regulation run back and forth through these nerves. All of these functions can be disrupted by injury.

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Tom Quick

4 years

Open water swimmers and winter people all, do you wonder how you feel cold? Well it’s the wonder of nerves again - let me tell you some nerve nerdy stuff... #openwaterswimming #thestoics #sensorynerve #cold A thread :

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Tom Quick

3 years

Want to learn more nerve anatomy? I’m trying some education content for patients and clinicians on my web site- #MedEd #brachialplexus #nerveinjury

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Tom Quick

3 years

Gilliatt-Sumner hand is a term for a loss of both median and Ulnar intrinsics with intact median sensation as is seen her (with consent) in a patient with a longstanding undiagnosed thoracic outlet compression #TOS

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Tom Quick

3 years

The #Radial nerve continues from the posterior cord after the exit of the Axillary nerve through the quadrilateral space. It’s motor fibres extend the elbow, wrist and fingers and extends and abducts the thumb. My examination guide is coming with @OrthohubXYZ this coming week.

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Tom Quick

4 years

#brachialplexus yes it’s #brachialplexusstuffagain #anatomy #art

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Tom Quick

8 months

May I interest anyone in these wonderful images of a right ulnar nerve #schwannoma ( #neurolemmoma ) in the axilla? Beautiful hey! #nervenerds

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Tom Quick

4 years

To all parents sending through phone pics of Radiographs (X-ray Pictures) of your child’s broken arm for comment & advice from surgeon friends - please remember take 📸 of both of the pictures. Even a 🍌 looks straight on 1 view! #askafriend #whattasappconsult #bendybones .

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Tom Quick

4 years

She emerges from the track through the tunnel and knows the last turn is her. She rounds the corner and sees the promised land. Muscle fibres she has dreamt of. Much better than any she ever seen. She will make them hers and rule here for ever! The end..

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Tom Quick

9 months

With consent ✅ Right #brachialplexus #TOS variant with an aberrant transverse cervical artery abdominal vein (and a mother large vein) running behind the upper trunk with facial window also running over and obscuring middle trunk. Using @Olympus_Corp Orbeye 3D magnified camera

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Tom Quick

2 years

#RadialNerve #clinical examination @OrthohubXYZ

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Tom Quick

4 years

#Schwannoma is a benign tumour of the glial (supporting) cell in a peripheral nerve. These tumours cause numbness and tingling. They grow within a nerve and can be removed by opening up the nerve and removing the fascicle which has become overgrown. #nerve #tumour

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Tom Quick

4 years

#PronePositionPlexopathy advice sheet from @TJQPNI @hoopoe_swana @RNOHnhs . #PPP #COVID -19

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Tom Quick

3 years

Nerves can be stretched gently by about 5%. After around 8% the nerve cells snap. This is an average as different parts of nerves have different ability to tolerate stretch. The lengths of nerves around the joints are more stretchy. #CrackingNervesGromit

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Tom Quick

3 years

The genius of @artibiotics with the ‘body language of pain’ 🥖 ⚡️

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Tom Quick

2 years

@AnatomyStandard Amazing stuff. Easily understandable and visually very elegant. The tone, texture and lighting are gorgeous.

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Tom Quick

6 years

This, is a radial nerve squashed between a metal plate used to fix a broken bone, and that bone (the humerus or arm bone). This should not happen. The nerve does not work; creating pain, wrist drop (floppy wrist) and numbness over the back of the hand. #radialnerve #palsy .

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Tom Quick

4 years

The brachial plexus is a mixing and crossing of nerves (that’s what plexus means) which controls the whole arm (which is what brachial means). This beautiful picture was drawn by @artibiotics and is the map for our story.

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Tom Quick

2 years

Tendon transfer outcome for #radial #nerve injury. A delayed reconstruction using PT-ECRB FCU-EDC (you can see the tendon running around the ulna near the end of the clip) & PL-EPL. This outcome is thanks to great PT/OT rehabilitation and an engaged patient (shared with consent).

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Tom Quick

4 years

I’ve had requests for a copy of the brachial plexus illustration which sits on the wall in view on my video calls - here it is. I’m not sure if it’s origin and can’t credit the author(s). It is though beautiful (even for a plexus!). #anatomy #medEd #brachialplexus

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Tom Quick

3 years

#Schwann cells are instrumental in encouraging & guiding #axonal regeneration. The loss of the glial-axonal relationship prompts the SC to change to a regenerating phenotype and is key to #nerverecovery . (Art by @artibiotics ) @PhillipsLab @PNIResearchUnit

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Tom Quick

1 year

Pearls of nerve injury management (post THR)

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@TJQPNI

Tom Quick

3 years

Having contributed a tiny part, it is a real pleasure to sit back and enjoy reading the rest of this great book expertly edited by @ChrisDyMD @BroganMd @EricWagnerMD #nervenerds @BritOrthopaedic SteveKey #nerveinjury #THR #Arthoplasty

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Tom Quick

3 years

#brachialplexus variation of the day- yesterday (posted with patient’s expressed consent) the lateral cord forgot to give the MCN and left it to the median nerve half the way down the forearm. Clinical pics in next tweets in thread. #nerveinjury

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Tom Quick

4 years

Having operated today @RNOHnhs it is even more clear now than usual that our porters, orderlies and cleaners undertake invaluable work( these contributions are generally unrecognised) Exposing themselves to the #COVID VIRUS in their work to help us help those in need. Thank you.

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Tom Quick

2 years

Sunset hour no filters no changes just as it is.

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Tom Quick

3 years

Here are the links to my examinations for #Ulnar #Median & #Radial nerves with @OrthohubXYZ

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Tom Quick

4 years

Imagine the quest of a single nerve cell leaving its home in the spine and knowing she was heading for a muscle she knew was called Abductor pollicis brevis. In a land far far away - the hand. At the base of thumb mountain!

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Tom Quick

4 years

Thoracic outlet sketching this afternoon for education resources on #TOS #cervicalrib #thoracicoutletsyndrome @KEVIIHospital

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Tom Quick

5 years

An end #neuroma . When a nerve is cut it tries to reconnect; and grows a blob like this. This can be painful (a symptomatic post traumatic neuroma). To make sure this does not reform a painful stump a new technique called #TMR can be used (Targetted Muscle Reinnervation)

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Tom Quick

6 years

This is what a ‘Schwannoma’ looks like - it’s a growth (or tumour) of one of the cells that support and insulate nerve cells. They grow slowly (this one was at least 15years old) and cause a buzzing pain if knocked. Removing it cures the problem and leaves no functional loss.

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Tom Quick

4 years

The left #brachialplexus in all is wonderful glory. It’s very close to lots of other anatomy too!

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Tom Quick

3 years

#WorldAnatomyDay I give you the #BrachialPlexus

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Tom Quick

3 years

A graphical representation of a muscle’s force as represented by the MRC grade of muscle force. (4% of a muscle’s normal force is required for activity against gravity).

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Tom Quick

5 years

The #sciatic nerve running behind the #hip joint. A posterior approach. The thigh bone (femur) in green has its ball visible as the hip capsule (blue) has been cut open. The Sciatic nerve (which gives movement and feeling to the foot) yellow seen coming out from #piriformis red.

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Tom Quick

4 years

In a lovely message today I found out I was someone’s hero. My eyes are a tiny bit sweaty. To the author : I hope you continue to get better- we will see each other in a few months I’m sure. #nervesurgery

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Tom Quick

2 years

Found in Edinburgh and posted with out comment @ #RAUKISURA22 #regionalanaesthesia #chloroform

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Tom Quick

4 years

External rotation, shoulder: infraspinatus (suprascapular nerve) teres minor (axillary nerve) #nervousTrump

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Tom Quick

4 years

Supraspinatus (suprascapular nerve) #nervousTrump

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Tom Quick

3 years

What does the Ulnar nerve do?? Well strange you should ask as here’s something I made earlier for that exact question @orthohub

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How to examine the ulnar nerve - watch orthohub examinations with UK...

Learn how to examine the ulnar nerve in orthohub’s examinations series. In our first episode, focusing on the first of the upper limb trunk nerves, get your...

www.youtube.com

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Tom Quick

4 years

Nerve illustrating. Feel free to use this in your own work - (please just credit @TJQPNI ) #medicalillustration #nervenerdery

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Tom Quick

3 years

An asymmetric anatomic variant of #CervicalRib . The neck (cervical spine should not have any ribs. They come from the chest, thoracic spine) The left side has developed a joint with the first rib. The right side is likely to have fibrous elements (that don’t show on X-ray). #TOS

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4 years

Video of an MRI SCAN of a #Schwannoma of the tibial portion of a sciatic nerve.

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4 years

Thoracic outlet Compression #TOS #ScaleneSickle #CervicalRib #FibrousRib

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Tom Quick

4 years

Normal Thoracic Outlet #anatomy #BrachialPlexus #scalenes

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Tom Quick

4 years

The nerves of your brachial plexus grew out from your neck when you were only a few weeks old as an embryo. At that point your arm had already formed with bones and muscles but the nerves set out on their journey. This is one such:

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Tom Quick

8 years

Ever wondered how to examine a nerve injury? #clinicalskills #EDmed #ortho #plasticsurgery #generalsurgery

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Tom Quick

4 months

Primary nerve repair: when a nerve has been cut the axons in the distal part die away this leaves empty tracks in the ‘downstream nerve’. If the cut ends can be brought together under no tension and held together with small stitches the nerve cells grow back along the tracks.

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Tom Quick

4 years

Tilt you head away to the other side and you will feel it get tight. That called Erbs point on the upper trunk. It is a starting point for another story but today we have this story:

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Tom Quick

4 years

@RevRichardColes Agree! We run our #NHS nerve injury clinic a block away and eye it every week walking to get lunch: Such a looming dilapidated elegance. There is a large hole in the roof, though. We have a nerve injury diagnosis that fits with this- ‘degenerative unfavourable prognosis’

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Tom Quick

2 years

#Ulnarnerve #ClinicalExamination @OrthohubXYZ

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Tom Quick

4 years

You can feel yours in your neck- find your collar bone (it’s proper name is a clavicle) run your fingers along the top edge of it at the base of your neck. At about halfway along you will feel a cable running diagonally.

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Tom Quick

6 months

Don’t know your suprascapular from your upper and lower subscapular nerves? @OrthohubXYZ gotcha covered : #brachialplexus #mervenerds

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Tom Quick

4 years

She knows she is hugely important. Destined for great things. Set to change hand function from a primate grip and to give function to an opposable thumb. All of humanity will thank her. She will change the world...

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Tom Quick

3 years

Symptomatic, post traumatic end neuroma (SPTN). Here we see a cause of neuropathic pain. This patient (with consent) had both spontaneous & evoked neuropathic pain. The neuroma was excised after LA blockade of the nerve, and the proximal stump relocated into muscle. #nerveinjury

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Tom Quick

8 months

Another thoracic outlet variant. A scalene muscle slip running between upper and middle trunks. Along with this muscle was a tight paraneurium. There were other anatomic variants ; all decompressed. Results awaited. #TOS . #scalene .

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11 months

#WorldAnatomyDay here are my cheat sheets for #UpperLimb #Nerves

@TJQPNI

Tom Quick

3 years

Here are my first three #MedEd #Anatomy #ClinicalExam Study sheets for #nerveanatomy - #radial #median #ulnar : videos and sheets on @OrthohubXYZ

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Tom Quick

1 year

I know! I know! I’ve covered this previously -but classics signs again in #London Nerve Clinic (With full consent ☑️ obvs). What is the diagnosis? (and for extra points which two British neurologist are associated with the clinical sign seen)

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3 years

To surgical colleagues - It’s ok, you can go & identify that nerve in your surgical approach, identify it, enjoy its beauty, protect it & see it won’t bite you! Don’t avoid nerves, treat them with respect. More likely to bite you if you haven’t seen it. ⚡️ 🦈 #nervenerd #ASPN

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Tom Quick

1 year

@LegoLostAtSea I’m on team #Velellavelella they are beautiful magical colonies of creatures. Imagine if they could talk - the journeys they have had, the stories they hold in those little wonderful sail-like, amethyst- coloured disks!

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4 years

The gorgeous anatomic illustrations drawn in a ‘lifelike style’ are by Nicolas Henri Jacob; his illustrations in this huge text book are mesmerising and give such clarity. An amazing collaboration to educate, train and please the eye. #nerveanatomy #brachialplexus @artibiotics

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3 years

The @OrthohubXYZ team invited me in to be grilled - The ABC of Nerve injury is the result. @petebates @kashakhtar are a class act and it was a lot of fun- hope you laugh & learn. #nerveinjury #laughandlearn #MedEd #brachialplexus #bees #swiming

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3 years

On the Friday of Erb’s Palsy week I hope you find the following infographics we have developed useful. @artibiotics @hoopoe_swana @erbspalsygroup @Erbspalsyirl #erbspalsyawareness #erbspalsyweek

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Tom Quick

3 years

Having contributed a tiny part, it is a real pleasure to sit back and enjoy reading the rest of this great book expertly edited by @ChrisDyMD @BroganMd @EricWagnerMD #nervenerds @BritOrthopaedic SteveKey #nerveinjury #THR #Arthoplasty

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4 years

Clinical colleagues, as we see the start of the next #COVID peak please consider safe Procedures for #Proning patients to avoid Positional #Plexopathy . If you identify any neuropathy please refer early @RNOHnhs PNIUnit #nerveinjury #PPP

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Reducing the Risk and Impact of Brachial Plexus Injury Sustained From Prone Positioning—A Clinical...

Introduction: Prone positioning is deployed as a critical treatment for improving oxygenation in patients with Acute Respiratory Distress Syndrome. This regimen...

journals.sagepub.com

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Tom Quick

4 years

This nerve runs from her home at the T1 spine and joins with the exodus of many others over the fast flowing artery to form the lower trunk. This band of thousands half C8ers and half her T1 clan all running through new territory.

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Tom Quick

3 years

The Ulnar nerve, the nerve that creates hand power grasp, the overseer and monitor of hand function. A nerve that runs a long way from the neck prior to giving any motor branches and a long way before innervating any skin. @OrthohubXYZ #nerveexam #ulnar

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@OrthohubXYZ

orthohub.xyz

3 years

Get ready for a new @OrthohubXYZ examination! 🤸🏽 @TJQPNI examines @louiscollins9 . Tune in this Monday to learn how to examine a patient’s Ulnar Nerve! #nerve #joint #orthopaedic #orthotwitter

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3 years

The #RadialNerve functions via the 5 compartments of the dorsum of the wrist. A beautiful dissection here (but no accreditation for the dissection and image?)

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Tom Quick

3 years

If, like the artist and anatomist who created this image, you know all about everything but forget the brachial plexus here is a v Quick ™️ brachial plexus examination. @OrthohubXYZ

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@OrthohubXYZ

orthohub.xyz

3 years

🎬 Watch the first part of our new @OrthohubXYZ examination episode “how to examine the #brachialplexus ” with @TJQPNI vs @louiscollins9 ! In this installment, we will give a quick run-through of the examination 'dance' 👉🏼 #nerves #joints #orthotwitter

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Tom Quick

3 years

@sfkhanvisuals Agree !! Isn’t it gorgeous? - I got a copy this week

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Tom Quick

3 years

It is a difficult decision for anyone to come to amputation, even in those with a flail insensate limb. The operation is often something I dread undertaking but so many patients do gain a huge benefit. In the right case, at the right time, it is the right thing to decide todo.

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2 years

#MedianNerve #Clinical #examination @OrthohubXYZ

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Tom Quick

4 years

Starting to loose some T1 friends who settle staking claims to the land of the skin of the inner arm. Most though stay with her looking for muscles. She parts with some of her band at the next break in the road.

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Tom Quick

5 years

This is what a #lipofibrohamatoma looks like. It’s a long word and hard to say so it gets called #LFH . It’s a problem of the nerve where all parts of the nerve grow too much - it makes the hand weak and v tingly. There is no cure but cutting the tight ligament over it helps. #CTD

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4 months

#BrachialNeuritis ( #ParsonageTurner , #NeuralgicAmyotrophy ) a condition characterised by a period of severe pain then muscle function loss. Characteristic #SpiralBands seen on Post Interosseous Nerve - USS & operative intervention (to neurolyse these constrictions) #nervenerds

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3 years

#NerveInjury in kids - lots of paediatric fractures and dislocations can produce nerve injury. Here are resources to for our younger patients to answer “why does my finger sparkle?”

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4 years

Now much much longer than she ever thought she would be. She took a breather and looked back at her course. Her long course millions of times longer than she was wide. She still had such a strong connection with her home land at T1. She could feel it. But she must push on ...

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Tom Quick

4 years

Published now online @springerlink . This book chapter edited by @PhillipsLab is the result of a lot of hard work by Matt Wilcox @PNIResearchUnit and @hoopoe_swana . Im very lucky to work in this wonderful talented team. #clinicaloutcomes #nerveinjury @UCL_NerveEng @Health_Eng

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Tom Quick

4 years

They settle in nicely together till the elbow bend - a change, under the archway of Pronator she had heard tell of as a baby neurone. Again loosing some of their number to farm muscle in the upper arm.

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Tom Quick

4 years

I like it. Next stop Pectoralis Central.

@BranGSmith

Brandon G. Smith, PhD

4 years

Slightly different from #brain art, dabbling in some more #MedicalIllustration with a take on a #NYC subway-themed Brachial Plexus

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Tom Quick

4 years

“...and there are no more surgeons, urologists, orthopaedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us...” Dr Daniele Macchine, Bergamo, Italy. 9 March 2020 #COVID -19 #nervesurgery #oneworldvstheenemy

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Tom Quick

9 months

Consent ✅ this is an MR arteriogram: It is rare in my practice of #neurologic #TOS to see such a marked loss of subclavian artery flow. In surgical cases such as this I will operate with a vascular surgeon colleague. To provide care for both plexus and artery. #brachialplexus

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