This document discusses nerve injuries and their classification. It begins by describing the basic structure and physiology of neurons and nerves. It then classifies nerve injuries based on Seddon's and Sunderland's classifications, ranging from neurapraxia involving a conduction block to neurotmesis with complete nerve disruption. Specific conditions like trigeminal neuralgia, Bell's palsy, and traumatic neuromas are explained. Surgical and medical management strategies are outlined for different nerve injuries and disorders.
PNI with Relevant Anatomy, Etiology, Mechanism of Degenration and Regenration, Saddon's and Sunderland Classifications, Clinical symptoms and Examination (Tests) of Brachial Plexus, Radial & Median Nerve.
PNI with Relevant Anatomy, Etiology, Mechanism of Degenration and Regenration, Saddon's and Sunderland Classifications, Clinical symptoms and Examination (Tests) of Brachial Plexus, Radial & Median Nerve.
Pain in facial area may be due to neurologic or vascularcauses as well as can be due to dental origin.
The main causes can be Temporomandibular joint disorders or trigeminal neuralgia.
Trigeminal neuralgia can cause abrupt,searing pain due to nerve irritation or damage.
It causes pain along the course of the nerve all over the face and will mostly be on one side of the face.It is treated with anti convulsant medicines or a series of surgeries.
TMJ pain can be due to tenderness in the temporo mandibular joint.It can be unilateral or bilateral.IT can cause difficulty in chewing and even in speaking.It can also lead to difficulty in opening of mouth due soreness of joint.It is usually surgically treated.
Dr Sachdeva's Dental clinic and Facial aesthetic centre is one of the leading clinics offering treatment for facial pain in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
u need to download the powerpoint so u can see the motion and explanation of each slide.For any questions please feel free to ask me on mohammedn.omer@yahoo.com
what is RNS and what the techniques to perform this test in the lab. Its significance in the evaluation and diagnosis of NMJ disorders like MG, LEMBS etc..
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
Late response are the most helpful findings in some of the diseases affecting the peripheral nerves, (e.g GBS, Radiculopathies, ). How to assess these responses while performing Nerve Conduction Studies, is the most technical and theoretical consideration.... Here we go with the same things in the stated slides
Pain in facial area may be due to neurologic or vascularcauses as well as can be due to dental origin.
The main causes can be Temporomandibular joint disorders or trigeminal neuralgia.
Trigeminal neuralgia can cause abrupt,searing pain due to nerve irritation or damage.
It causes pain along the course of the nerve all over the face and will mostly be on one side of the face.It is treated with anti convulsant medicines or a series of surgeries.
TMJ pain can be due to tenderness in the temporo mandibular joint.It can be unilateral or bilateral.IT can cause difficulty in chewing and even in speaking.It can also lead to difficulty in opening of mouth due soreness of joint.It is usually surgically treated.
Dr Sachdeva's Dental clinic and Facial aesthetic centre is one of the leading clinics offering treatment for facial pain in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
u need to download the powerpoint so u can see the motion and explanation of each slide.For any questions please feel free to ask me on mohammedn.omer@yahoo.com
what is RNS and what the techniques to perform this test in the lab. Its significance in the evaluation and diagnosis of NMJ disorders like MG, LEMBS etc..
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
Late response are the most helpful findings in some of the diseases affecting the peripheral nerves, (e.g GBS, Radiculopathies, ). How to assess these responses while performing Nerve Conduction Studies, is the most technical and theoretical consideration.... Here we go with the same things in the stated slides
Реализационное проектирование. Особенности технологии. методическое пособие. ...Проектариум Проектариум
Методическое пособие (рекомендации) выпускается в рамках выполнения проекта
«Образовательный цикл реализационного проектирования для гражданских активистов —
представителей городов с активным местным сообществом» отдельной книжкой. При
реализации проекта используются средства государственной поддержки, выделенные в
качестве гранта в соответствии с распоряжением Президента Российской Федерации от
01.04.2015 № 79-рп и на основании конкурса, проведенного Фондом ИСЭПИ.
В пособии представлен методически обобщенный опыт разработки реализационных проектов
согласно авторской технологии проектирования, которая совершенствовалась с 2003 г.
(Бочкарева Т.В., Самарцев С.Е.). В случае данного издания - технология разработки проекта
процедурно излагается по шагам проектирования (с приведением отдельных примеров по
сложным шагам). При этом особо акцентируется итерация как принцип переосмысления после
каждого следующего шага наработанного на предыдущих проектных шагах - в их взаимосвязи.
В этом проявляется сила рефлексивного осознания, дающая возможность выявить
дополнительную суть каждого шага и скрытые взаимосвязи между шагами и, вместе с тем,
задать системную целостность разрабатываемого проекта.
Те
хнология реализационного проектирования работает много лет в самых разных городах
России, а в 2016 году апробирована в ходе образовательных семинаров в рамках гранта: в
Москве и Самаре (36 часовой курс), на проектном интенсиве в Красноярске (в рамках
образовательной сессии «Формула города»), представлена на мастер-классах, проведенных в
То
льятти, на форсайт-флоте-2016 АСИ (корабль «Общество»), на форумах Живых гор�
Nerve injuries /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
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This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Ethnobotany and Ethnopharmacology:
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Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
10. SUNDERLAND’S CLASSIFICATION
First Degree- Neurapraxia
Second Degree- Axonotmesis
Third Degree- Endoneurotmesis
Fourth Degree- Perineurotmesis
Fifth Degree- Neurotmesis
11.
12. First degree/ neurapraxia
Localised conduction block in the nerve
Nerve fibres respond to electrical stimuli proximal and
distal to the lesion
No conduction across the injured segment
Axonal continuity is preserved
No wallerian degeneration
Usually complete recovery
CAUSES:- biochemical lesion caused by concussion /
shock like injuries to nerve
Compression/ blows to the nerve
13. Second degree/ axonotmesis
Disruption of axon into proximal and distal portion
interrupted axoplasmic flow
Loss of relative continuity of axon and its covering of
myelin but preservation of connective tissue
Wallerian degeneration occur within 24 hrs in distal
portion & a slight degree in proximal portion
Intact connective tissue
Axon may regenerate at rate of 1mm/day
Potential for complete recovery
14. Third degree/ endoneurotmesis
Endoneurium and axon are injured
Perineurium remains intact
Wallerian degeneration occurs
Axons may regenerate but may be blocked by scar
tissue――――› partial re-innervation
Incomplete recovery
15. Fourth degree/ perineurotmesis
Only epineurium remains intact
Axon, endoneurium & perineurium are disrupted
Wallerian degeneration occur
Greater chance of abberent degeneration
Incomplete recovery
16. Fifth degree/ neurotmesis
Complete disruption of nerval continuity
Most severe & occur on severe contusion, stretch &
lacerations
Not only axon but also connective tissue lose their
continuity
Extreme degree is transection- complete loss of
sensory,motor and autonomic function
Without carefull repair, no chance of regeneration and
recovery
Axonal sprouts may escape into nerve sheaths and
produce painful neuromas
17. TRAUMATIC NEUROMA/
AMPUTATION NEUROMA
Reaction of peripheral nerves to local injury
Painful submucosal bump
Cutting of a peripheral nerve
during surgical/ traumatic episodes
During subsequent regeneration
Axons canot find their way into
severed nerve sheath
Forms a painful disorganized mass
in area of injury
18. H/P
Presence of a jumble of small peripheral
nerve fibre
T/T
Surgical excision
19. NEURITIS
Inflammation of a peripheral
nerve accompanied by
degenerative changes in nervous
tissue
TYPES- localized and
multiple/polyneuritis
polyneuritis – affects many
peripheral nerves symmetrically
at the same time
20. AETIOLOGY-
1. LOCALIZED
Exposure to cold
Blows & wounds to nerve
Stretching of nerve
Extension of inflammation
Vascular reasons- occlusion of blood
vessel/ hemorrhage
22. SIGNS AND SYMPTOMS
Pain of boring character along the
course of the nerve
Redness/ oedema along the course
of nerve
Muscle pain , numbness,
impairement of tactile sensation
Finally muscular atrophy &
degenerative changes
23. FACIAL NERVE INJURY
FACIAL PALSY/ BELL’S PALSY
CLINICAL FEATURES
Characteristic features- impaired blinking,
sagging cheek, flattening of nasolabial
crease
Alterd lacrimal secretion
Altered salivary secretion
Impairement of taste perception
Weakness of all facial muscles
Impaired eye closure
25. DIAGONOSIS
Basic functions are examined
1. Raising the eyebrows to test frontalis
corrugator
2. Tightly closing the eyes for orbicularis
oculi
3. Ask pt. to grin to examine retractor
muscles on angle of mouth
4. Taste may also be tested
26. Assesing the degree of voluntary involvement
House classification
Grade Degree Description
I normal Normal facial movements
II slight Mild deformity, slight assymetry
III moderate Obivious Facial weakness, forhead motion
present, good eye closure, asymmetry, bells
palsy
IV moderately Obivious facial weakness, no forhead motion
V severe Very obivious facial paralysis, some tone
present,cannot close eye
VI total Complete facial paralysis, absent tone
27. MANAGEMENT
MEDICAL MANAGEMENT
EYE CARE- to prevent exposure keratitis
lacrilube ointment in eye
tapping of eyelids during sleep
Use of a moisture chamber
28. SURGICAL MANAGEMENT
2 types- primary & secondary
1. PRIMARY MANAGEMENT
Neurorrhaphy
Indication- sharp precise lacerations of facial
nerve
Technique- by skilled microsurgeon
Identification of nerve
Suturing of nerve- identified nerves are
carefully trimmed & direct simple perineural
sutures are used
Nylone/ prolene sutures are used
Surgeons knot with 2 square throws are
adequate
29. GRAFT NEURORRHAPHY
Indications-avulsive type of injuries
Common donor site-greater auricular nerve, sural
nerve, antebrachial cutaneous nerve
GREATER AURICULAR NERVE
Identified in relation to external jugular vein
Surface marking- a perpendicular at the midpoint
of a line drawn from mastoid to angle of
mandible.
TECHNIQUE: elevation of platysma
6-8 cm of nerve length
Nerve is isolated posterior to jugular vein and
dissected to its entrance in to parotid
30. SURAL NERVE
Branch of tibial nerve in popliteal fossa
Supplies skin on the lower half of back of leg and
whole of the lateral border of foot up to tip of
little toe
ADVANTAGE-abundant length up to 40cm,diameter
approx. to most of cranial nerve, used in multiple
facial nerve defects
ANTEBRACHIAL CUTANEOUS NERVE
Originates from brachial plexus
Located adjacent to basilar vein near antecubital
fossa
Most useful for facial nerve reconstruction.
31. CROSS-FACIAL NERVE
GRAFTING
Use of normal facial nerve on the uninjured side.
Buccal branch of normal facial nerve is sacrificed
32. NERVE TRANSPOSITION
Used in 2 situations.
1. When there is isolated segmental injury to a
crucial branch of facial nerve.
In such cases less critical segment of facial
nerve(frontal,cervical) is accomplished.
2. When extreme proximal facial nerve is injured.
Hypoglossal nerve is transposed and sutured to trunk
of distal facial nerve
Drawback is mass movement of face
34. STATIC SUSPENSION
Oldest methods reconstruct nasolabial
fold and labial commisure
Fascia lata is used
NEUROMUSCULAR TRANSFER
Gracilis muscle
FACIAL REANIMATION
Using hypoglossal/ contralateral facial
nerve/ surgical redirection of accessory
cranial nerve into the degenerate 7th
nerve which help in restoring some facial
muscle function
35. NEURALGIA
TRIGEMINAL NEURALGIA
Facial pain syndrome characterized by sharp,
lancinating pain in the face
Etiology- tumors , vascular defects, compression by
superior cerebellar artery
Clinical features-
1. Medical care
2. Surgical care- a) peripheral procedures
b) ganglion procedures
c) open operation
d) central procedures
36. MEDICAL CARE
Carbamazepine( tegretol)
Phenytoin
Baclofen
Clonazepam
Amitryptaline
Gabapentin
lamotrigine
37. SURGICAL MANAGEMENT
1. Peripheral procedures-
cryotherapy, laser, neurectomy
2. Ganglion procedures-
thermocoagulation, glycerol
injection, ballon
compression,radio surgery
3. Open operations- microvascular
decompression, trigeminal root
resection
4. Central procedures- tractotomy
38. Anaesthesia dolorosa
Following injury to trigeminal nerve ,painful area
of numbness may develop
Severe, constant, Burning, gnawing or stinging
type of pain
t/t:- often ineffective
medications often not relieve pain
Surgical methods have limited success
39. Geniculate neuralgia
Nervous intermedius neuralgia
Severe pain deep in the ear
Sharp shooting/gnawing type of pain
May spread to ear canal, outer ear, mastoid
or eye regions
T/t:- not with medications
Surgical- microvascular decompression of 5th 9th
and 10th cranial nerve
40. Sphenopalatine/ sludgers
neuralgia
Unilateral headache behind the eyes with
pain in the upper jaw or soft palate
Assosiated with nasal/ sinus congestion,
swelling/redness of face
Longer duration of pain with inflamed
nasal mucosa on involved side
