Nerve Injury Flashcards
Double crush syndrome
two separate lesions along the same nerve that create more severe symptoms thatn if only one lesion existed
Mononeuropathy
Isolated nerve lesion; associated conditions include trauma and entrapment
Neuroma
abnormal growth of nerve cells, associated conditions include vasculitis, AIDS, and amyloidosis
Peripheral neuropathy
Impairment or dysfunciton of the peripheral nerves, associated conditions include diabetic peripheral nueropathy, trauma, alcoholism
Polyneuropathy
diffuse nerve dysfunction that is symmetrical and typically secondary to pathology and not trauma, associated conditions include Guillain Barre syndrome, peripheral neuropathy, use of neurotoxic drugs, and HIV
Wallerian Degeneration
Degeneration that occurs distally specifically to the myelin sheath and axon
Acute Nerve Injury - Neurapraxia (6)
- Mildest form, no nerve fiber damage, typically pressure injuries
- Conduction block with axonal continuity
- Axon, epi/peri/endoneurium intact
- Conduciton preserved proximally and distally to the injury
- Sx: pain, min mm atrophy, numbness/sensory loss, dec proprioception
- complete, rapid recovery in 4-6 wks
Acute Nerve Injury - Axonotmesis
- More severe, due to traction, compression, cursh injury
- Reversible injury b/c fibers maintain anatomical relationship to each other
- Damage to axon
- Preservation of endo/epineurium, schwann cells
- Distal wallerian degeneration cna occur
- recovery varies/is spontaneous, rate of regrowth 1mm/day
Neurotmesis
- Most severe
- Damage/transectoin to axon, myelin, CT
- Irreversible, no sontaneous recovery (requires surgery)
- All motor/sensory distal to the injury is lost
- Flaccid paralysis, mm wasting
- If surgically reattached, 1mm/day regrowth, sensory returns before motor
Cause of Axillary N Injury (2)
- humeral neck fx
- anterior shoulder dislocation
Cause of Musculoskeletal N Injury
- Clavical fx
Cause of Radial N Injury
- Humeral fx
- Compression in radial tunnel
Cause of Median N Injury (2)
- Pronator teres entrapment
- Compression in carpal tunnel
Cause of Ulnar N Injury
- Guyon’s canal entrapment
- Compression of cubital tunnel
Cause of Femoral N Injury
- THA
- Displaced acetabular fx
- Anterior femur dislocation
- Hypterectomy
- Appendectomy