Median nerve lesions

  • Anatomical position of medial nerve
  1. median nerve images : median-nerve-image-1.jpg (618×936) (mobilephysiotherapyclinic.in)
  2. From axilla to the cubital fossa(between the head of the pronator teres), then down to the wrist(between flexor carpi radialis and palmaris longus), then enters the carpal tunnel, then first and second digits(between flexor pollicis longus and flexor digitorum profundus)
  3. Median Nerve : Anterior lateral side of forearm and hand
    1. Flexor carpi radialis
    2. Palmaris longus
    3. Flexor digitorum superficalis
    4. Flexor digitorum profundus (2nd and 3rd fingers)
    5. Pronator teres
    6. Pronator quadratus
    7. Flexor pollicis longus
    8. Flexor pollicis brevis (superficial head)
    9. Abductor pollicis brevis
    10. Opponeus pollicis
  • Causes of the lesion
  1. Fracture : elbow, wrist and carpal bones
  2. Dislocation : elbow, wrist and carpal bones(lunate and scaphoid)
  3. Compression : Fibrosis and hypertonicity in overused muscles
  4. Trauma
  • Kinds of the median nerve lesions
  1. Pronator teres syndrome
  2. Capla tunnel syndrome
  • Symptoms
  1. Ape hand
  2. Oath hand
  3. Edema, nail changes(ridge) and skin changes(thin, glossy, lanking lines) : d/t autonomic fiber damage
  4. Atropy forarm flexors and thenar muscles
  5. Risk of causalgia
  6. Sensory dysfunction : Palmar surface, lateral 3rd and half fingers

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