Nerve Injuries Flashcards
what are common MOIs of nerve injuries?
compression, laceration, stretch, radiation , electricity and injection
what are the most common causes of biomechanical injuries to the PNS?
friction, compression, stretch
describe neuropraxia.
segmental demyelination where AP is normal before and after the block; mild ischemia might occur but muscle doesn’t atrophy and sensory symptoms are temporary
describe axonotmesis.
prolonged compression/stretch> connective tissue coverings intact w/ loss of axonal continuity, ft. Wallerian degeneration, muscle fibers do atrophy and nonsurgical recovery often incomplete
describe neurotmesis
lacerations (gunshot/stab, avulsion)> complete severance of nerve fiber and connective tissue covering, ft. Wallerian degeneration distally, no recovery w/o surgery
what factors are associated with nerve injury recovery?
age, motivation, nature and level of injury, extent of injury, timing and technique of repair
how long is the acute phase for nerve injuries ?
3 weeks min of postsurgical immobilization
what are the acute interventions for nerve injuries?
pain and edema management, ROM, orthosis use, pt education for protection
Musculocutaneous N
- coracobrachialis, biceps, brachialis
- dec forearm flex (supinated ; weak supination
Axillary N
- deltoids, teres minor
- shoulder ABD, weakened ER
Radial N
- triceps, anconeus, brachioradialis, supinaor, wrist/hand ext
- loss of elbow, wrist and hand ext
Median N
- pronators, radial side wrist, lumbricals, opponens pollicis, ABD pollicis, flexor profundus of fingers/wrist
- loss of forearm pronation, thumb opp, flexion and ABD
Ulnar N
- flexor carpi ulnaris, flexor dig profundus (medial) , interossi, 4th and 5th lumbricals
- loss of ulnar dev, thumb ADD, and most intrisics (claw), weakened wrist/hand flex
Sciatic N (list 3 branches)
- tibial, superficial and deep fibular
- loss of knee flexion, weak hip ADD and all fn below the knee
Femoral N
- sartorius, quad, iliacus, pectineus
- hip flexion and knee ext
Tibial N
- gastroc, soleus, plantaris, popliteus, and post tib
- loss of PF and knee flexion
superficial fibular (peroneal) N
- fibularis longus and brevis
- loss of eversion
deep fibular N
- tib ant, ext hallucis longus, ext dig longus, fibularis tertius, ext dig brevis, ext hallucis brevis
- loss of DF and weak dorsal intrinsics
Median N Syndromes
CAPS
Carpal Tunnel
Ant Interosseous
Pronator Teres
Ligament of Suthers
