1. PERIPHERAL NERVE INJURIES Mansoor khan

2. A N A T O M Y Connective tissue (epineurium, perineurium, endoneurium) Nerve tissue (axon, schwann cell)

3. A N A T O M Y EPINEURIUM PERINEURIUM ENDONEURIUM VESSELS

4. PERRIPHERAL NERVE INJUIES NERVE INJURIES Acute injury Chronic injury

5. N e u r o p r a x i a Mildest form, reversible conduction block (function loss), for hours or days due to direct mechanical compression, ischemia, mild burn trauma or stretch

6. A x o n t m e s i s

7. N e u r o t m e s i s

9. C l i n i c a l S i g n s Motor function, Tinel’s sign (positive-sensory function negative (after 4-6weeks)-total interruption, Sweating-sympathetic fiber, Sensory function

10. Muscle atrophy start : post-injury 1 month peak : 3rd - 4th month

11. C h r o n i c N e r v e E n t r a p m e n t Paresthesia Loss of function Pain

12. P a t h o p h y s i o l o g y Direct compression Segmental demyelination Wallerian degeneration(distal) Ischemia Swelling of nerve Microcompartment SD

13. C a r p a l T u n n e l S y n d r o m e

14. PREGNANCY TYPE WRITING

15. PAIN & PARASTHESIA DISTRIBUSION

16. RELEASE SURGERY

17. SUPRA-CONDYLAR FRACTURE anterior displacement M E D I A N N E R V E

18. Radial Nerve Entrapment Posterior Interosseous Nerve Syndrome

19. Radial Nerve Entrapment Posterior Interosseous Nerve Syndrome

20. RADIAL NERVE INJURY Fracture of shaft of humrus

21. RADIAL NERVE INJURY WRIST DROP

22. GUYON’S CANNAL SYNDROME U L N A R N E R V E

23. CUBITAL TUNNEL SYNDROME U L N A R N E R V E

24. Benediction posture CLAWING OF RING & LITTLE FINGER U L N A R N E R V E

25. FROMENT’S SIGN Flexior pollicus longus (median nerve) compensates for a weak adductor pollicis (ulnar nerve) U L N A R N E R V E

26. CUBITAL TUNNEL SYNDROME Ulnar nerve Release surgery U L N A R N E R V E

27. COMMON PERONEAL Fracture of the head of fibula

28. PERONEAL NERVE INJURY SYMPTOMS Decreased sensation, Slapping gait, foot drop, toes drag

29. FACIAL NERVE Anatomy

30. FACIAL NERVE Anatomy

31. FACIAL NERVE PALSY LOSS OF FRONING, DROOPING, EYEBROW DROP

32. C o n s e r v a t i v e t r e a t m e n t Indications Short history, mild-moderate, intermittent, reversible cause (pregnancy, oral contraceptive, endocrine abnormalities, type writer) Method Non-steroidal anti-inflammatory drugs, splint

33. T r e a t m e n t Time of operation Open injury Closed injury Early intervention Delayed intervention Delayed intervention

34. S u r g i c l I n d i c a t i o n s

35. E p i n e u r a l R e p a i r

36. F a s c i c u l a r R e p a i r

37. N e r v e G r a f t