Laceration Nerve

Nerve agents are hazardous through any route of exposure including inhalation, exposure of the skin and eye, ingestion, and broken, abraded, or lacerated skin (e.g., penetration of skin by debris). 

Infiltration anesthesia. The drug is injected directly into the selected tissue, allowing it to diffuse to sensory nerve endings within that tissue. This technique saturates an area such as a skin laceration for performing surgical repair (suturing). 

Administration of an orbital nerve block requires intimate familiarity with both the anatomic locations of the sensory nerve fibers of the orbit (Figure 19-5) and the sensory distribution of these nerve branches (Figure 19-6). A description of orbital nerve blocks and distribution of regional anesthesia associated with these injections is included in Table 19-1. Care must be taken to avoid nerve laceration that may manifest as severe pain or paresthesias during needle insertion. 

A local anesthetic (see chart) blocks pain at the site where the medication is administered without affecting the patient s consciousness. It is commonly used for dental procedures, suturing of skin lacerations, short-term suigeiy at a localized area, spinal anesthesia by blocking nerve impulses (nerve block) below the insertion of the anesthetic, and diagnostic procedures such as lumbar punctures. 

Injury to the body due to a blunt external force from an object, or a fall or bump. Usually accompanied by swelling and black and blue mark due to rupture of veins. Severity may vary from a small bruise to severe underlying damage to bones, vessels, and nerves. Severe contusions may be accompanied by lacerations as well. 

Local Anesthesia Temporary pharmacological inhibition of nerve impulses to a specific body part, typically used to treat small lacerations or perform minor surgery. 

Local anesthetics are used to locally anesthetize a wide range of specific body parts or areas to allow painless surgery. Local anesthetics are most commonly used for dental procedures and repair of lacerations. They can also be used to provide neural blockade for larger, more painful procedures. Sites of LA application include localized injection, peripheral nerve blocks as well as central nerve blockade. The only safe agents which can be utilized for intravenous regional anesthesia (Bier block) are lidocaine and prilocaine. Other typical indications are outlined in Table 64.1. 

Taras, JS, and Jacoby, SM. 2008. Repair of lacerated peripheral nerves with nerve conduits. Tech Hand Upper Extremity Surg 12(2) 100-106. 

In the cubital fossa, the median nerve courses behind the lacer tus fibrosus and superficial to the brachialis... 

Fig. 14.88a-c. Complete tear of the common peroneal nerve in a patient with previous knee dislocation, a Long-axis 12-5 MHz US image over the peroneal nerve in the popliteal fossa. The nerve has a wavy course and is characterized by abnormal thickened (arrowheads) and thinned (arrows) segments related to the interruption and laceration of the fascicles, b Transverse oblique 12-5 MHz US image over the lateral knee with c lateral radiographic correlation demonstrates abnormal hypoechoic tissue related to the avulsion of the biceps femoris tendon (arrows) from its insertion (open arrowhead) into the fibular head (FHj.Note the close relationship of the ruptured biceps with the torn nerve (white arrowheads). On the radiograph, a small fleck of bone (curved arrow) appears retracted proximally with the torn biceps tendon... 

Contusions, bruises Concussions and internal injuries Open wounds, including cuts, lacerations, abrasions, severed tendons, nerves and blood vessels Amputations Open fractures Closed fractures Dislocations... 

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