Podział urazów nerwów obwodowych
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Podział urazów nerwów obwodowych

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Urazy nerwów obwodowych dzielą się na otwarte i zamknięte oraz całkowite lub częściowe. Czym się charakteryzują?

Urazy nerwów obwodowych otwarte charakteryzują się przerwaniem ciągłości powłok. Dochodzi do nich w wyniku zranienia ostrym przedmiotem. Ten wnikając w ciało może właśnie uszkodzić również nerwy.

Urazy nerwów obwodowych zamknięte natomiast to urazy z zachowaną ciągłością skóry. Tworzą się przez działanie tępych urazów przyciskających gwałtownie nerw do kości, naciągnięcia nerwu bądź zranienia przez ostrą krawędź złamanej kości.

Urazy nerwów obwodowych całkowite to urazy, które są źródłem zupełnego braku czynności ruchowych, współczulnych oraz czuciowych w obszarze zaopatrywanym przez nerw.

Urazy nerwów obwodowych częściowe są urazami, podczas których zachowane zostają niektóre czynności nerwów.

Urazowe uszkodzenia nerwu obwodowego dzielą się natomiast na przecięcie, zdławienie i naciągnięcie

Do przecięcia dochodzi w sytuacji, kiedy ostry przedmiot przerywa ciągłość całego pnia nerwu lub jego części.

Zdławienie to uszkodzenie nerwu, charakteryzujące się silnym dociśnięciem pnia nerwu do twardego, zazwyczaj kostnego podłoża. Dochodzi do niego w wyniku tępego urazu, zakleszczenia między odłamami złamanej kości, jatrogennym uciśnięciem narzędziami operacyjnymi czy wszczepianymi częściami metalowymi.

Natomiast naciągnięcie powstaje pod wpływem siły działającej wzdłuż nerwu, która przekracza granice jego sprężystości i prowadzi do różnego rodzaju uszkodzenia struktury pnia nerwu. Wówczas dochodzi do uszkodzenia splotu ramiennego, którego źródłem jest pociągnięcie za kończynę górną, bądź urazu nerwu strzałkowego, spowodowanego zwichnięciem stawu kolanowego.

Źródło: Noszczyk W., Trojanowski T., Chirurgia, Wydawnictwo Lekarskie PZWL Warszawa, s. 295

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