Peripheral Nerve Injuries
Sustained pressure that is applied externally onto a peripheral nerve that results in ischemia of the nerve (no longer getting blood flow that it needs to support normal cell function to transmit signals).
Compression
- Segmental demyelination
- AP slowed or blocked at point of demyelination, but normal above and below
- Muscle does not atrophy, temporary sensation symptoms
- Results from mild ischemia from compression or traction
- Recovery is usually complete
Neuropraxia
Strain, Sprain, subluxation, dislocation and rupture
Stops early and abruptly with a rebound from hyperactivated muscles. Usually accompanied by pain.
The amount of oxygen consumed by the heart
Myocardial oxygen consumption
Cut (sever) the nerve (i.e. from a knife, surgical complication, injection, GSW, etc.)
Laceration
- loss of atonal continuity but CT coverings remain intact
- Wallerian degeneration distal to lesion
- Muscle fiber atrophy and loss of sensation
- d/t prolonged compression or stretch causing infarction and necrosis
- Recovery is incomplete, may require surgical intervention
Axonotmesis
This grade of soft tissue injury is classified as mild pain at the time of injury or within the first 24 hours. Mild swelling, local tenderness, and pain occur when the tissue is stressed.
Grade 1
It can be felt with chronic conditions like adhesive capsulitis or in acute inflammatory situations. The normal end feel is described as “stretching old leather”, this end feel has the same leathery quality, but with less ROM.
Capsular
Measure of the bodies capacity to use oxygen, measured in O2 consumed per minute when an individual has reached their all out max effort
VO2 Max
Excessively stretch or place tension on a nerve, creating micro tears from too much traction/ tensile/ stretching force
Stretch
- Complete severance of nerve fiber with disruption of CT coverings
- Wallerian degeneration distal to lesion
- Muscular fiber atrophy and sensory loss
- d/t GSW, Stab wounds, avulsion or rupture
- No recovery w/o surgery
Neurotmesis
This grade of soft tissue injury is classified as near-complete or complete tear or avulsion of the tissue (tendon or ligament) with severe pain. Stress to the tissue is usually painless; palpation may reveal the defect. A torn ligament results in instability of the joint.
Grade 3
Involves a soft, spongy quality, usually from excessive swelling in and around a joint.
Boggy
Ability to work for prolonged periods of time/ resist fatigue
Endurance
Caused by exposure to radiation therapy
Radiation
What is the timeline for regeneration of nerves in the body?
1 inch per day. However, rates of 0.5-9.0mm have also been reported.
This grade of soft tissue injury is classified as moderate pain that requires stopping the activity. Stress and palpation of the tissue greatly increase the pain. When the injury is to ligaments, some of the fibers are torn, resulting in some increased joint mobility.
Grade 2
D/t the internal derangement of the joint. Usually Occurring in articulations that contain menisci or articulation discs, this end feel involves a pronounced rebound effect at the end of movement.
Spring block end-feel
Planned/ structured activity designed to improve/ maintain physical fitness
Exercise
Lightening strike or being electrocuted from an outlet
Electrical
Definition: Cardiovascular and MSK systems ability to adapt to the training stimulus over time
Adaptation
Length of healing time in:
1. Grade 1 Muscle Injury
2. Grade 2 Muscle Injury
3. Grade 3 Muscle Injury
1. 0-5 weeks
2. 3 weeks - 3 months
3. 5 weeks - 6 months
Occurs when the movement stops d/t the significant pain that the pt feels.
Empty
Any bodily movement produced by skeletal muscle contraction
Physical Activity