Nerve injury

Rationale

Peripheral nerve injuries often occur as part of more extensive trauma and often go unrecognized. These injuries need to be evaluated with accurate knowledge of the anatomy and functions of the specific nerves involved.

Causal Conditions

(list not exhaustive)

1. Compression and/or stretch
2. Contusion
3. Laceration
4. Vasculitis-induced ischemia

Key Objectives

Given a patient with a possible nerve injury, the candidate will confirm the diagnosis, cause, severity, and complications, and initiate an appropriate management plan. In particular, the candidate will identify the peripheral nerves involved, as well as the level and type of involvement.

Enabling Objectives

Given a patient with a possible nerve injury, the candidate will

1. list and interpret critical clinical findings, including those based on
   1. an occupational history and physical examination that can help determine whether a peripheral nerve injury has occurred in the setting of other trauma, and
   2. identification of the specific nerve involved, framed within a differential diagnosis that distinguishes a nerve injury from other neurologic disorders (e.g., nontraumatic neuropathies, central lesions), and consideration of vasculitic neuropathy if more than one nerve is affected;
2. list the critical investigations and interpret the results of the investigations, including
   1. tests used to detect the presence of a traumatic peripheral neuropathy, and
   2. tests to screen for vasculitis;
3. construct an effective initial management plan, including listing indications for specialized care.