PNI Flashcards
Neuropraxia
Mild
Motor sensory loses
No sign of wallerian degeneration
Axonal integrity is preserved
Food prognosis
Axonotmesis
Impaired atonal integrity
Axon and myelin destruction
Nerve sheath integrity is preserved
Wallerian degeneration present
Surrounding tissues partially or completely intact
Neurotmesis
Affect axon, myelin sheath and connective tissue
Complete nerve rupture
Formation of scar tissue
Impossible axonal regeneration
Only surgery can help
Wallerian degeneration
Damage to peripheral nerve axon due to trauma, severe pressure etc
Distal to where axon is interrupted
Phagocytosed by macrophages
Proximal part of axon and peripheral nerve cell body remain intact
Axonal degeneration
Damage to axon, cell body or peripheral nerve
Due to metabolic and toxics
Can regain if the cause is removed without destroying axonal integrity
Degmental demyelination
Damage to surrounding schwann cell and or myelin sheath without any damage to peripheral nerve axon
Segmental demyelination can be caused by
Hereditary neuropathies
Acquired neuropathies
Hereditary neuropathies
Demyelination along entire nerve
Acquired neuropathies
Specific nerve segment is affected
Guillain barre
Chronic inflammatory demyelinating polyneuropathy
Nerve regeneration
Collateral sprouting of axons and axonal regeneration
Sign of regeneration
Voluntary muscle contractions
Autonomic nervous system
Tunnel sign
Electrical stimulation but not conclusive
Causes of radial nerve injury
Saturday night palsy
Crutch paralysis
Triceps injections
Symptoms of RNI
Extension paralysis
Supination paralysis
Wrist drop
Triceps areflexia
Brachioradialis jerk
Muscles in RNI
Triceps
Brachioradialis
Wrist extensors
Ed
Epl
Ulnar nerve injury causes
C7-T1
Entrapment at cubital tunnel
Anaesthesia
Sign and symptoms of UNI
Wrist radial deviation
Claw hand
Paraesthesia
Sensory loss
Muscles in UNi
Flexor carpi ulnaris
Abductor disgiti minimi
Interrosei
Abductor pollicis
Egawas test
Test for interossei, abductors of middle finger
Card test
Test for interrosei adductors of fingers
Froment sign and book test
Test for adductor pollicis
Causes of Medial nerve injury
Sleep paralysis
Shoulder dislocation
Crutch compression
Supracondylar fracture of humerus
Signs and symptoms of MNI
Atrophy of thenar
Simian or ape hand
Benediction hand
Pointing index
Muscles of MNI
Fdl
Fds and lateral half of fdp
For
Abd pb and opponens pollisis(thenar muscles)
Pen test used for
Abd pb
Examination of denervated muscle contractions
Nerve conduction velocity
Galvanic test
Faradic test
Strength duration curve
Galvanic tetanic ratio
Accommodation ration
Sympathetic activation assessment
Vasomotor changes
Sudomotor changes
Plyomotor changes
Trophic changes
Electrical stimulation functions
Prevents atrophy
Accelerate regeneration
Muscles re-education in post op
Therapeutic US
Provides arterial dilation
New artery formation
⬆️ nerve fiber density
Activation of schwann cells
Remove chemicals and chemotoxins mediators
Orthotics
Protects denervated muscles from overtension
Prevents joint contracture
Prevents compensatory pattern
Positioning
Early phase of sensory education
Moving touch
Continuous touch
Pressure
Touch localization
Desensitization training
Late phase of sensory education
Facilitate the tactile sense
Compensation training
Ways to support regenerations
Electrotherapy
DLA training
Proximal segment stabilization
Body awareness
Stabilization
