PERIPHERAL NERVE

INJURIES
Sneha Lakshmi
Roll no 78
INTRODUCTION
Peripheral nerves are formed from nerves arising from
the spinal cord
There are 31 pairs of spinal nerves in the body
Each spinal nerves has 3 components: Sympathetic,
motor, sensory
These either through a direct branching or through a
network of nerves (plexus), give rise to Peripheral
nerves.
ANATOMY

Structure Of Peripheral Nerve

An individual nerve fibre is enclosed in a
collagen connective tissue known as
endoneurium.
A bundle of such nerve fibres are further bound
together by fibrous tissue known as
perineurium. (Faciculus)
A number of fasciculi are bound together by a
fibrous tissue sheath known as epineurium.
AETIOPATHOGENESIS

Fractures and dislocation are the commonest causes of peripheral nerve injuries
Direct injury-cut, laceration
Infection- leprosy
Mechanical injury-compression, friction
Cooling and freezing
Thermal injury
Ischemic injury
Electrical injury
Radiation
CLASSIFICATION
Seddon’s Classification
1 Neuropraxia
2 Axonotmesis
3 Neurotmesis

• Neuropraxia:physiological disruption of conduction in the nerve

fibre.
No structural changes occur.
Recovery occurs spontaneously within a few weeks, and is complete.
• Axonotmesis:Axons are damaged but the
Internal architecture of the nerve is preserved
Wallerian degeneration occurs.
Recovery may occur spontaneously but may take many months.
Complete recovery may not occur
• Neurotmesis: The structure of a nerve is damaged by actual cutting or
scarring of a segment.
Wallerian degeneration occurs.
Spontaneous recovery is not possible, and nerve repair is required.
Incidence of Peripheral nerve injury
Radial nerve ------ commonly injuried
Ulnar nerve ------- 30%
Median nerve ----- 15%
Lumbosacral plexus ---- 3%
CLINICAL FEATURES

PAIN
LOSS OF SENSATION TO TOUCH, TEMPERATURE
LOSS OF MOTION
LOSS OF POWER
LOSS OF REFLEXES
MUSCLE WASTING
TROPHIC CHANGES
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