basic science

Peripheral Nerve Injury and Regeneration

intermediate

6 min

28 marks

6 questions

Clinical Scenario

A 32-year-old male sustains a deep laceration to the medial aspect of his elbow from broken glass. He presents with numbness in the small finger and ring finger (ulnar half), weakness of finger abduction, and a positive Froment's sign. Examination reveals absent sensation in the ulnar nerve distribution and weakness of intrinsic muscles. The wound is clean and explored, revealing complete transection of the ulnar nerve.

Intraoperative photograph is provided.

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Clinical image for Peripheral Nerve Injury and Regeneration

Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License

Questions

Question 1 (4 marks)

Describe the anatomy of a peripheral nerve. What are the connective tissue layers?

Question 2 (5 marks)

Classify peripheral nerve injuries. Describe the Seddon and Sunderland classifications.

Question 3 (6 marks)

Describe the pathophysiology of nerve degeneration and regeneration. What is Wallerian degeneration?

Question 4 (5 marks)

What factors affect nerve regeneration? How do you assess nerve recovery?

Question 5 (4 marks)

Describe the surgical options for nerve repair. What are the principles of nerve repair?

Question 6 (4 marks)

What is the expected outcome for this patient's ulnar nerve repair?