24 Questions
What is the consequence of rupture of vesicles in a nerve?
Fibrillation potential, making the muscle weak
What is the prognosis for patients with lumbar disc prolapse?
Poor, and may require surgical repair
What type of lesion is characterized by local demyelination?
Neurapraxia
What is the purpose of Electromyography (EMG) in nerve damage diagnosis?
To detect fibrillation potentials or positive sharp waves
What type of therapy is used when a muscle is not working?
Passive motion
What is the rate of recovery for patients with nerve damage?
1-4 mm per day
What is the term for nerve degeneration resulting in axonal disruption?
Axonotmesis
What is the primary problem in Neurapraxia?
Local demyelination in the nerve segment
What type of nerve degeneration occurs in Axonotmesis?
Axonal degeneration
What type of therapy is commonly used to aid nerve regeneration?
Laser therapy
What is the primary site of damage in Axonotmesis?
Axon and neurilemmal sheath
What is the term for a condition where the nerve is compressed, resulting in pain, numbness, and muscle weakness?
Peripheral nerve entrapment syndrome
What is the characteristic symptom of Neurapraxia?
Temporary interruption of conduction
What is the term for nerve degeneration that affects both the axon and neurilemmal sheath?
All nerve degeneration
What is the result of complete compression of a nerve in a peripheral nerve entrapment syndrome?
Paralysis in the muscles
What is the term for a condition where the myelin sheath is damaged, resulting in demyelination at the peripheral nerve?
Demyelinating neuropathy
What is the consequence of complete compression in terms of sensation?
Complete loss of sensation
What is the characteristic of NCV across the site of lesion in Axonotmesis?
Lost NCV distal to the site of lesion
What is observed in EMG during maximum voluntary contraction of the affected muscles in Axonotmesis?
No MUP
What is the condition characterized by local demyelination?
Neurapraxia
What is the duration before NCV is lost or decreased in Axonotmesis?
7-10 days
What is observed in EMG at rest in Axonotmesis?
Silence
What is the consequence of denervation in Axonotmesis?
Supersensitivity to ACH
What is the condition characterized by loss of axon?
Axonotmesis
Study Notes
Peripheral Nerve Injury
- Peripheral nerve entrapment syndromes are a common condition in the upper limb, resulting from the persistent application of pressure to a nerve.
- Symptoms include pain, numbness, tingling, muscle weakness, and atrophy.
- The distribution of symptoms depends upon the nerve affected.
Classification of Peripheral Nerve Injury
- Neurapraxia: Temporary interruption of conduction, with a problem at the myelin sheath.
- Axonotmesis: Axonal interruption, with the neurilemmal sheath intact.
- Neurotmesis: All nerve interruption, with both axon and neurilemmal sheath affected.
Clinical Presentation
- Weakness or paralysis in the muscles supplied by the affected nerve.
- Decreased or lost interference pattern.
- Fibrillation potential and positive sharp waves of the affected muscles.
Prognosis
- Neurapraxia: Completely reversible when the cause is removed, with a good rate of recovery (1-4 mm per day).
- Axonotmesis: Poor prognosis and may need surgical repair.
- Neurotmesis: Poor prognosis and may need surgical repair.
Rehabilitation
- Passive motion and active exercises.
- Electrotherapy (ES) according to each nerve.
- Sensory reeducation (if sensation is affected) ± splints.
- Laser therapy (common in all nerve lesions, helps with nerve regeneration).
Electrodiagnostic Tests
- NCV (Nerve Conduction Velocity): Decreased or absent NCV, with normal NCV above and below the site of lesion.
- EMG (Electromyography): At rest, fibrillation potentials or positive sharp waves of the affected muscles.
- Interference Pattern: Decreased or lost during maximum contraction, with silent EMG at rest.
This quiz covers the classification of peripheral nerve injuries, including neurapraxia, axonotmesis, and neurotmesis, and their symptoms.
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