竞聘演讲-银行竞聘上岗演讲稿.ppt

PERIPHERAL NERVE INJURIES  MHD BASHAR ALBOSHI Tinel sign Peripheral tingling or dysaesthesia provoked by percussing the nerve A positive Tinel sign is presumptive evidence that regenerating axonal sprouts that have not obtained complete myelinization are progressing along the endoneurial tube. @- neuropraxia(sunderland1) -------negative Tinel sign. @- axonotmesis (sunderland2,3) -------positive Tinel sign. (sunderland4-------- negative Tinel sign ) @- neurotmesis (sunderland 5) ------- negative Tinel sign. The radial nerve, a continuation of the posterior cord of the brachial plexus, consists of fibers from C6, C7, and C8 and sometimes T1.. It is primarily a motor nerve that innervates the triceps, the supinators of the forearm, and the extensors of the wrist, fingers, and thumb. This nerve is injured most often by: -fractures of the humeral shaft. -Gunshot wounds are the second most common cause of radial nerve injury. Other causes include lacerations of the arm and proximal forearm, - injection injuries, - and prolonged local pressure. ExaminationThe following muscles supplied by the radial nerve can be tested accurately because their bellies or tendons or both can be palpated: - the triceps brachii, - brachioradialis, - extensors carpi radialis, -extensor digitorum communis, -extensor carpi ulnaris, - abductor pollicis longus, and - extensor pollicis longus. @ Injury to this nerve results in inability to extend the elbow or supinate the forearm and in a typical wristdrop Entrapment syndromes of the radial nerve @Nerve compression impaires epineural blood flow and axonal conduction --------numbness, paraethesia ,weakness -symptoms are intermittent,sometimes related to specific posture. -prolong compression------segmental demyelination(tinel sign),target muscle atrophy,nerve fibrosis. -peripheral neuropathy(diab