User:Syedm191/sandbox

Article Evaluation

Annotated Bibliography.

Everything in this article is relevant and the article is fairly neutral, but there were places where it sounded like the writer was leaning towards one style of annotated bibliography. One of the reference sources went to "Page 404 not found" of Purdue University. There is some information that is outdated but nothing too concerning. It article was related and had relevant information throughout. It is very detailed and structured to the point where I had difficulty trying to find a flaw in it.

Encyclopedia.

The article had several broken links with some of them mentioning “dead link.” Most of the links were very dated, but were working. One of the references took me to a blog post where one wrote about their opinion, which is what is supposed to be avoided on Wikipedia. Besides that the article was very brief. I personally disliked that because I am sure there is a lot more to write about from researching. The article is definitely not caring about the 20^th and 21^st century information. Overall, it is difficult to overlook the length of this article and a lot more can be added.

Axonotmesis Article Selection (4/26/2017)

Axonotmesis of a nerve

The Seddon Classification of Nerve Injury classifies Axonotmesis as the second-degree nerve injury. Axonotmesis is an injury to the peripheral nerve of one of the extremities of the body. It occurs when there is a disruption in the axon and the myelin sheath. This myelin sheath in the peripheal nerves is made up of Schwann cells, which are left intact along with endoneurium. Axonotmesis occurs when a limb is crushed severely to the point where the lamella of the myelin shealth ruptures and the axon of the nerve is exposed. Motor and sensory functions distal to the point of injury are completely lost over time leading to Wallerian Degenration due to ischemia, or loss of blood supply. Denervation begins after 3 weeks if left untreated.

Axonotmesis mainly follows a stretch injury. These stretch injuries can either dislocate joins or fracture a limb, due to which peripehral nerves are severed. If the sharp pain from the exposed axon of the nerve is not observed, one can identify a nerve injury from abnormal sensations in their limb. A doctor may ask for a Nerve Conduction Velocity (NCV) test to completely diagnose the issue. If diagnosed as nerve injury, Electromyography preformed after 3 to 4 weeks shows signs of denervations and fibrillations, or irregular connections and contractions of muscles.

Classification:

Seddon	Sunderland
Neurapraxia	Grade I
Axonotmesis	Grade II
Axonotmesis	Grade III
Axonotmesis	Grade IV
Neurotmesis	Grade V

Sunderland's Stage II Classification

• Endoneurial tube remains intact

• Emergence of Wallerian Degeneration
• Can be detected with Tinel's sign

Sunderland's Stage III Classification

• Endoneurial tube is damaged
• Perineurium remains intact
• Scarring occurs
• Intrafascicular fibrosis occurs due to edema

Sunderland's Stage IV Classification

• Perineurium is damaged
• Epineurium remains intact
• Neuroma could occur
• Surgery is required for treatment

Treatment:

Schwann cells provide the nerve with protection throught the production of Nerve Growth Factors, and because these cells are intact this kind of nerve injury can be cured and normal feeling and sensations can be restored. Surgery can be done in order to help the nerve heal. The surgery will help with nerve regeneration, providing guidance to the nerve sprouts on where to attach on the proximal side of the injury. Damaged nerve axons can reattach themselves after surgery, and the rate of growth can go up to 1 inch per month.Complete recovery can take anywhere from 6 months to a year.

Article Selection (4/19/2017)

Median Nerve Palsy: The article gives a lot of information on the anatomy, and diagnosis of disorders related to the median nerve. I intend to add more on the anatomy of the hand while adding more pictures. I want to add more on Claw Hand deformity, which is not addressed in this article at all, and I also will be adding more on Ape Hand deformity and explain the Sign of Benediction, 3. of which are medically related to median nerve palsy.

Sources: https://www.youtube.com/watch?v=0AAligXLJ1A

http://emedicine.medscape.com/article/1242387-overview

Things that need to be added:

1. Eye of the Hand
2. Anterior interosseus nerve (AIN) syndrome (AINS)

1. Eye of the Hand

The median nerve provides controls the majority of the muscles in the forearm. It controls abduction of the thumb, flexion of hand at wrist, flexion of digital phalanx of the fingers, is the sensory nerve for the first three fingers, etc. Because of this major role of the median nerve, it is called the eye of the hand.

2. Anterior Interosseus Nerve Syndrome

The Anterior Interosseus Nerve, a branch of the median nerve, only accounts for the movement of the fingers in hand and does not have any sensory capabilities. Therefore, this syndrome is purely neuropathic. AINS is considered as an extremely rare condition because it accounts for less than 1% of neuroathies in the upper limb. Patients suffering from this syndrome have impaired distal interphalangeal joint, because of which they are unable to pinch anything or make and "OK" sign with their index finger and thumb. The syndrome can either happen from pinched nerve, or even dislocation of the elbow.

1. Better structure (Add paragraphs)
2. Diagnosis
3. Healing and Treatment