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Neuro > Peripheral Nerves/Injuries > Flashcards

Peripheral Nerves/Injuries Flashcards

1
Q

Neuropraxia (Least Severe)

A
  • Demyelination
  • Reversible conduction block
  • Myelin sheath is compressed but axon and endoneurium are intact
  • example: Radial nerve compression - Writers drop
    • Waking up at night
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2
Q

Axonotmesis (Demyelination and axon lost)

A
  • Segment lost but endoneurium is intact
  • Neuron can grow back inside the endoneurium sheath
  • Wallerian degeneration
    - Distal end dies off before the grow back
  • Example: Crash injuries and disposed bone
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3
Q

Neurotmesis (demyelination + axonal lost +one of the following)

A
  • Endoneurium involvement: fair growth
  • Perineurium involvement: poor growth
  • Epineurium involvement: no growth
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4
Q

1st degree injury (neuropraxia)

A

Minimal structural disruption - complete recovery

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5
Q

2nd degree (axonotmesis)

A

Complete axonal disruption - usually complete recovery

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6
Q

3rd degree (may be either axonotmesis or neurotmesis)

A

Disruption of axon and endoneurium - poor prognosis without surgery

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7
Q

4th degree (neurotmesis)

A

Disruption of axon, endoneurium, and perineurium - poor prognosis without surgery

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8
Q

5th degree (neurotmesis)

A

Complete structural disruption - poor prognosis without microsurgery

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9
Q

Recovery from Nerve Injury

A

Depends on:
Nature and level of injury
Timing and technique of repair
Age and motivation of patient

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10
Q

Sympathetic
(PNS also part of ANS)

A

T1-L3
Fight or flight
Increase HR, BP, pupil size, bronchodilation

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11
Q

Parasympathetic
(PNS also part of ANS)

A
  • Cranial nerves & S2-S4
  • Rest/digest
  • Increase gastric secretion, decrease HR and pupil size
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12
Q

What controls Sympathetic and Parasympathetic?

A

BOTH are controlled by hypothalamus, limbic system, and afferent sensory information from the periphery

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13
Q

Musculocutaneous Nerve

A

From Lateral Cord

Motor: flexion of arm at elbow + supination of forearm

Sensory: lateral forearm

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14
Q

Axillary Nerve

A
  • Posterior cord
  • Injury: dislocation of shoulder and surgical neck fracture of the humerus
  • Motor: abduction (>15 degrees) and lateral rotation of shoulder
  • Sensory: shoulder
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15
Q

Radial Nerve

A
  • Posterior cord
  • Injury: compression, fracture of body of humerus
  • Motor: extension at all arm, wrist, proximal finger joint + forearm supination + thumb abduction
  • Sensory: posterior arm and forearm + below the fingertips of the three and one-half fingers
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16
Q

Median Nerve

A
  • Medial and lateral cords
  • Injury: hypertrophy of pronator teres of muscle or entrapment
  • Motor: forearm pronation + wrist flexion and abduction + thumb flexion and opposition + flexion of digit 2 and 3
  • Sensory: lateral three and one-half fingers - palmar surface and superior dorsal aspect
17
Q

Ulnar Nerve

A
  • Medial cord
  • Injury: at the elbow and other sites
  • Motor: wrist flexion and adduction + finger adduction and abduction other than the thumb + thumb adduction + flexion of digits 4 and 5
  • Sensory: dorsal and palmar aspect of hand for medial 1 1/2 fingers
18
Q

Femoral Nerve

A
  • 3 posterior divisions of lumbar plexus
  • Injury: trauma or pressure
  • Motor: hip flexion + knee extension
  • Sensory: anteromedial thigh + medial side of foot and leg
19
Q

Obturator Nerve

A
  • 3 anterior divisions of the lumbar plexus
  • Isolated injury is rare - uterine pressure or damage during labor
  • Motor: adduction and external rotation at the thigh
  • Sensory: medial skin over adductors
20
Q

Sciatic Nerve

A
  • Sacral plexus
  • Injury: piriformis syndrome, hip dislocation or reduction
  • Knee flexion
  • Component parts - tibial and common peroneal nerves
21
Q

Tibial Nerve

A
  • Injury: entrapment
  • Motor: foot plantar flexion and inversion + toe flexion
  • Sensory: sole of the foot
22
Q

Superficial Peroneal Nerve (from Common Peroneal Nerve)

A
  • Motor: foot eversion
  • Sensory: skin of the anterolateral leg, and dorsum of the foot (except skin between the first and second toes)
23
Q

Deep Peroneal Nerve (from Common Peroneal Nerve)

A
  • Motor: foot dorsiflexion + toe extension
  • Sensory: skin between the first and second toes

Neuro (4 decks)

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