Peripheral Nerve Problems COPY Flashcards
Seddon’s Classification - PN (3)
- neuropraxia
- axonotmesis
- neurotmesis
Neuropraxia
injury - mild
recovery
Axonotmesis
injury - severe
regeneration - 1mm/day
recovery
Neurotmesis
injury
degeneration
neuroma formation
Sunderland’s Classification PN - Degree 1
structures remain intact
local conduction block and dymyelination
Sunderland’s Classification PN - Degree 2
axonal disruption with distal (Wallerian) degeneration
Sunderland’s Classification PN - Degree 3
disruption of axons and endoneurial tubes
fascicles remain intact
Sunderland’s Classification PN - Degree 4
disruption of axons, endoneurial tubes
only epineurium intact
loss of fascicular integrity
Sunderland’s Classification PN - Degree 5
complete nerve transection
Radial Nerve Palsy
most commonly injured peripheral nerve
fx of humerus (1:10 have radial nerve complications)
elbow dislocation
Monteggia fx-dislocation
High Radial Nerve (4)
- triceps
- anconeus
- brachioradialis
- ECRL
Low Radial Nerve (9)
- ECRB
- supinator
- EDC
- EDM
- ECU
- APL
- EPL
- EPB
- EIP
High Median Nerve (7)
- PT
- FCR
- PL
- FDS
- FDP (index and long)
- FPL
- PQ
Low Median Nerve (4)
- OP
- FPB (superficial head)
- APB
- Lumbricals (index and long)
High Ulnar Nerve (2)
- FCU
2. FDP (ring and small)
Low Ulnar Nerve (8)
- ADM
- ODM
- FDM
- Lumbricals (4 and 3)
- 3 palmar interossei
- 4 dorsal interossei
- FPB (deep head)
- Add Pol
ape hand deformity
median nerve injury
claw hand deformity
ulnar nerve injury
wrist drop deformity
radial nerve injury
anterior interosseous syndrome
entrapment of motor branch of median nerve
unable to make “ok” sign
Froment’s sign
flexion of the IP with lateral pinch
FPL attempts to compensate for paralyzed or weak adductor pollicis and FPB
ulnar nerve
Wartenberg’s sign
unable to adduct the 5th finger due to weak interosseous muscle
ulnar nerve
elbow flexion test
provocative test for ulnar nerve compression
elbow flexed and wrist in neutral for up to 5 minutes
Wallerian degeneration
breakdown of the axon distal to the site of injury
occurs 48-96 hours after injury