Nerve injury

Alaa A. Alibrahim
Medical Student 2013

S
 Outlines

 Definition

 Anatomy of the nerves

 Pathophysiology

 Classification
 Definition

 Injury to a nerve can stop signals to and from the brain, causing
motor, sensory or autonomic function loss in the injured area.
 Peripheral nerve anatomy

 Neurons

 Glial cells

 Connective tissue

 Nerve topography
Neuron
Motor and Sensory Neurons
Sympathetic neuron
Glial cells
Connective tissue
 Nerve topography

 Monofascicular: e.g. terminal skin branch, pure motor or

sensory.

 Oligofascicular: e.g. common digital nerve, pure motor or

sensory, or mixed

 Polyfascicular: e.g. radial nerve, contains fiber for variety of

functions.
 Pathophysiology of the nerve
injury

 Wallerian degeneration

 Nerve regeneration
Pathophysiology
 Nerve regeneration

 Nerve growth factor by target cells and Schwan cells

 Macrophages produce interleukins

 Schwan cells produce adhesion molecules

 Axonal sprouts from the proximal cut must inter the distal tract

 Prior to regeneration, 15 to 30 days

 Growth initiation
Seddon Classification
 Seddon Classification
Type of Structure Cause Patho- EMG-conduction
injury s involved physiology study

Neurpraxia none Compression or none normal compound

ischemia motor action
potential

Axonotmesis axon Stretch or Wallerian Fibrillation and

contusion degeneration denervation

Neurotmesis CT loss Laceration or Axonal Denervation

Peri and local anesthetic regeneration
endo toxicity causes
neurium Neuroma
Sunderland classification
 References

 Michigan Manual of plastic surgery, David Brown and Gregory

Borschel

 www.uptodate.com

 www.wikipedia.com