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MSK > peripheral nerve injuries > Flashcards

peripheral nerve injuries Flashcards

1
Q

What is another name for motor root

A

ventral root

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2
Q

What is another name for a sensory root

A

dorsal root

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3
Q

Where do the cell bodies of motor units lie

A

The grey matter of the spinal cord

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4
Q

Where do the cell bodies of sensory units lie

A

dorsal root ganglia

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5
Q

What forms a spinal nerve

A

Ventral and dorsal root combining

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6
Q

Where do the spinal nerves leave the spine

A

Intervertebral foramen

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7
Q

What surrounds peripheral nerves

A

schwann cells

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8
Q

Describe the structure of a peripheral nerve

A

Axons that are covered in endoneurium - grouped into fascicles (nerve bundles) which are covered in perineurium - these are grouped into nerves which are covered in epineurium

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9
Q

What is the fastest type of neuron fibre

A

Alpha

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10
Q

What is the slowest type of nerve fiber

A

C

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11
Q

What is the correlation between size and speed of transmission

A

the larger the fibre, the faster the speed of transmission

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12
Q

What can compress nerves and give examples

A

Entrapment
Carpal tunnel syndrome - median nerve compression
Sciatica - intervertebral disc compresses sciatic nerve
Morotons neuroma - digital nerves in web space are compressed

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13
Q

What is neurapraxia

A

Reversible conduction block caused by trauma which causes local ischaemia and demyelination which then leads to the neurapraxia

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14
Q

What is wallerian degeneration

A

Degeneration of the distal end of an axon

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15
Q

Does the tube remain intact in axonotmesis

A

Yes because the endoneurium is intact

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16
Q

What happens in neurotmesis

A

division of the nerve

17
Q

What are closed nerve injuries associated with

A

the nerve is still continuous and intact
Neuropraxis and axonotmesis

18
Q

When is surgery indicated in closed nerve injuries

A

If no recovery has been identified after 3 months

19
Q

What nerves commonly get damaged with closed nerve injuries

A

Brachial plexus and radial nerve

20
Q

What type of injury are Open nerve injuries associated with

A

Associated with nerve division - neurotemesis

21
Q

What is a common cause of open nerve injury

A

Accidental cut of the hands with knife

22
Q

What is the treatment for open nerve injury

A

Early surgical intervention

23
Q

What are the sensory clinical features of nerve injury

A

Dysaethesiae - disordered sensation - anaesthetic, hypo and hyper-aesthetic or paraesthesia(pins and needles)

24
Q

What are the motor clinical features of nerve injury

A

Paresis - weakness
Dry skin - nerve not stimulating sweat glands in skin
Diminished or Absent reflexes due to no preipheral nerve

25
Q

How fast is the regeneration of a nerve

A

1mm/day

26
Q

What is the first function to return in nerves

A

pain

27
Q

Does a pure or mixed nerve have better recovery and why

A

Pure because it is all one type of nerve (sensory or motor) so they all regenerate back to one end plate

28
Q

Is nerve healing better for a distal or proximal injury

A

distal - due to degeneration of the end plates when it is further which is why proximal is not as fast at healing

29
Q

What is tinnel’s sign

A

Tap over sign and paresthesia will be felt as far distally as regeneration has progressed

30
Q

How can nerve injury be assessed and healing can be monitored

A

Electrophysiological nerve conduction studies

31
Q

What injuries require direct repair

A

laceration
no loss of nerve tissue

32
Q

When is nerve grafting done

A

When there is nerve loss - due to damage or retraction where the nerve endings cannot be pulled together

33
Q

What happens in nerve grafting

A

unuseful nerve such as the sural nerve is used and stitched at either end to the nerve endings - provides a passage for the axons to grow down

34
Q

What is the rule of three

A

The surgical timings of traumatic peripheral nerve injury

35
Q

Describe the rule of three

A

Immediate surgery within 3 days for clean and sharp injuries

Early surgery within 3 weeks for blunt/contusion injuries

Delayed surgery within 3 months for closed injuries

36
Q

What are the signs in upper motor neuron lesions (central)

A

Still have peripheral nerves therefore

decreased strength
Increased tone and deep tendon reflex

present clonus and babinski

no atrophy

37
Q

What are the signs in lower motor neuron lesions (peripheral nerve)

A

decreased strength, tone and deep tendon reflex

Absent clonus and babinski

Atrophy is present

MSK (36 decks)

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