Peripheral Nerve Injury PDF
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Kurdistan Higher Council of Medical Specialties
Dr.Sarkawt S.Kakai
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Summary
This presentation details peripheral nerve injuries, covering various aspects, including mechanism of injury, classification, diagnosis, and treatment, along with different clinical evaluations for upper and lower limbs. Medical professionals and students in orthopedics and related fields will find this presentation to be valuable.
Full Transcript
Peripheral Nerve Injury Dr.Sarkawt S.Kakai KHCMS (Ortho. & Trauma) Introduction Mechanism of Injury Objectives Classification Diagnosis Treatment Peripheral nerve injuries encompass a range of reversible and irreversible impairments determined by injury level, axonal disruption, and time to...
Peripheral Nerve Injury Dr.Sarkawt S.Kakai KHCMS (Ortho. & Trauma) Introduction Mechanism of Injury Objectives Classification Diagnosis Treatment Peripheral nerve injuries encompass a range of reversible and irreversible impairments determined by injury level, axonal disruption, and time to treatment. Introduction Male>Females Mechanism of injury Stretching injury Compression/crush Laceration Classification Seddon Symptoms Neurapraxia pain no muscle wasting muscle weakness numbness proprioception issues Axonotmesis pain muscle wasting complete motor, sensory, and sympathetic function loss Neurotmesis no pain (anesthesia) muscle wasting complete motor, sensory, and sympathetic unction loss Diagnosis • NCS • EMG TREATMENT Diagnosis & Treatment Nonoperative • Observation with sequential EMG Operative • • • • Direct muscular neurotization Nerve grafting Nerve transfer Tendon transfer Sensory exam MCS Score Description 0 No contraction 1 Flicker or trace of contraction 2 Active movement, with gravity eliminated 3 Active movement against gravity 4 Active movement against gravity and resistance 5 Normal power A. History B. Clinical Examination Step1 Assessment of the Peripheral Nerves • Look Step 2 • Quick screen of nerves Step 3 • Feel Step 4 • Move Step 5 • (Provocation tests if necessary) Nerve examination Upper limb Axillary nerve • Shoulder abduction Musculocutaneous nerve • Elbow flexion Median nerve • Proximal to wrist…….FCR • Distal to wrist……APB and opponens pollicis (OK sign) AIN • Finger Flexion Nerve examination Upper limb Radial nerve • Wrist Extension PIN • Finger Extension Ulnar nerve • Finger abduction + Interossoeus Nerve examination Lower Limbs Sciatic nerve • Hip extension • Knee Flexion Femoral nerve • Knee Extension Superficial peroneal • Ankle eversion Deep peroneal • Ankle dorsiflexion Tibial nerve • Ankle planter flexion Upper limb dermatomes Lower limb dermatomes
