Questions
1–2 questions in university exams
Difficulty
Medium
Importance
Core topic for clinical physiotherapy and neurology exams
Overview
Peripheral nerve injuries involve damage to the nerves outside the brain and spinal cord, leading to sensory and motor deficits. Mastering the Seddon classification and specific nerve palsy syndromes is essential for clinical assessment in BPT and neuro-rehabilitation exams.
Seddon Classification of Nerve Injury
This classification system categorizes nerve injuries based on the severity of damage to the nerve structure and its ability to recover. It is the gold standard for clinical description of nerve trauma in examination answers.
- Neurapraxia: Conduction block without structural disruption
- Axonotmesis: Disruption of the axon with intact connective tissue
- Neurotmesis: Complete transection of the nerve and sheath
- Neurapraxia has the best prognosis for full recovery
- Neurotmesis requires surgical intervention for functional return
Common Upper Limb Nerve Palsies
Injuries to the brachial plexus or specific peripheral nerves cause classic clinical presentations that examiners frequently test. Understanding the specific muscle weakness and sensory loss is critical for practical viva questions.
- Erb's Palsy: C5-C6 injury causing 'waiter's tip' deformity
- Klumpke's Palsy: C8-T1 injury causing 'claw hand' deformity
- Radial Nerve Injury: Results in 'wrist drop' due to extensor paralysis
- Ulnar Nerve Injury: Leads to 'ulnar claw' due to intrinsic muscle wasting
- Median Nerve Injury: Causes 'ape hand' deformity
Common Lower Limb Nerve Palsies
Lower limb nerve injuries significantly impact gait and stability, making them vital topics for orthopaedic and neurological assessment. Focus on the dermatomal and myotomal distributions associated with these nerves.
- Common Peroneal Nerve: Causes 'foot drop' and steppage gait
- Sciatic Nerve: Results in gluteal and posterior thigh muscle weakness
- Femoral Nerve: Leads to difficulty in knee extension and loss of knee jerk
- Tibial Nerve: Causes inability to plantarflex and toe clawing
Exam Tip
Always draw the classic hand deformities (Wrist Drop, Ape Hand, Claw Hand) as simple line diagrams to instantly boost your marks.
Common Mistakes
- Confusing the sensory loss distribution between Radial, Ulnar, and Median nerve injuries.
- Failing to mention the structural integrity of the nerve sheath when defining Axonotmesis.
- Mixing up the specific clawing patterns between Klumpke's palsy and Ulnar nerve lesions.
More Revision Notes
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