Peripheral Nerve Injuries

Question 0

Results of Radial Nerve Injury

Answer 0

Wrist drop

Question 1

Radial Nerve Injuries (C6-8, T1)

Answer 1

Most commonly injured peripheral nerve.
Causes:
   1. Fx. Of the humerus.
   2. Callus formation around a fx.
   3. Compression.
       A. Crutch palsy.
       B. Saturday night        palsy.

Question 2

Median Nerve Injury (C6-8, T1)

Answer 2

Causes of injury:

1. Lacerations
2. Compression (carpal tunnel syndrome)
3. Cervical rib (rare)

Question 3

Results of a Median Nerve Injury

C6-8, T1

Answer 3

Ape hand

Question 4

Ulnar Nerve Injury (C8, T1)

Answer 4

Causes of injury:

1. Bony spur/callus formation.
2. Fx/dislocations head of the humerus or elbow.
3. Lacerations.
4. Pressure.

Question 5

Ulnar Nerve Injury (C8, T1)

Answer 5

Claw hand deformity + interosseus atrophy

Question 6

Injuries to the Femoral/Obturator Nerve (L2-4)

Answer 6

Causes of injury

1. Fx. Pelvis and upper femur
2. Forceps delivery
3. Pelvic tumors
4. Psoas Abscess
5. Femoral artery aneurysm
6. Reduction of dislocated hip

Question 7

Injuries to the Obturator Nerve (L2-4)

Answer 7

Obturator nerve:

1. Difficulty with external rotation of the hip
2. Difficulty with adduction of the hip
3. Difficulty crossing legs (putting on shoes)

Question 8

Injuries to the Femoral Nerve (L2-4)

Answer 8

Femoral nerve:

1. Inability to flex hip
2. Inability to extend knee
3. Difficulty with forward ambulation (may substitute external rotation)

Question 9

Sciatic Nerve Injuries (L4-S1)

Answer 9

Combination of the tibial and peroneal nerves in one sheath
Causes:
1. Herniated disk
2. Dislocation of hip
3. Attempts to relocate a dislocated hip
Clinical Signs:
1. Pain along the course of the nerve when it is stretched.
2. Problems with tibial and/or peroneal nerve

Question 10

Injuries to the Common Peroneal Nerve (L4-S2)

Answer 10

Causes:
   1. Direct trauma
   2. Leg fractures
   3. Compression
       A. Kneeling
       B. Crossing legs
       C. Orthotics/casts
Clinical picture:
   1. Drop foot
   2. What type of gait pattern would your expect ?

Question 11

Injuries to the Tibial Nerve

L4-S2

Answer 11

Causes of injury:
1. Deep nerve, well protected. Less likely to be injured. Injuries usually occur at the sciatic nerve level.
2. Direct trauma.
Clinical signs:
1. Lack of plantar flexion
A. Knee instability
B. Lack of terminal stance 2. Impaired sensation