Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MEDIAN NERVE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

Variations in digital sensory patterns: a study of the ulnar nerve-median nerve palmar communicating branch.

Eighty percent of 50 dissected cadaver palms showed a communicating branch between the fourth and third common digital nerves (ulnar and median origins, respectively). The branch commonly crossed the palm with the superficial arterial arch and usually provided sensory fibers from a branch of the superficial ulnar nerve into the ring finger radial digital nerve. Caution should be taken during carpal tunnel release or other surgery along the axis of the fourth ray to avoid injury to this structure.

Carpal Tunnel Syndrome↗

An unusual ulnar nerve-median nerve communicating branch.

Branching of the ulnar nerve distal to the origin of the dorsal cutaneous branch was investigated in 25 hands in one of which an anatomical variation was observed. This finding may be of importance in the evaluation of certain entrapment phenomena of the ulnar nerve or unexplained sensory loss after trauma or surgical intervention in that particular area.

Humans↗

[Sensory sequelae of injuries to the median nerve].

Median nerve wounds are frequent because of the superficial course of this nerve, especially in the wrist. The sensory sequellae of such lesions, either complete or dissociated, represent a major handicap which may be associated to a motor impairment of the external thenar muscles. The curative procedures such as neurolysis and, above all, sutures or grafts, must be very widely used, even some time after the initial injury and in spite of motor reinnervation. The role of palliative surgery is therefore limited, although it is sometimes useful. There are many procedures, which may be summed up by two techniques: use of sensitive neurovascular skin flaps, the most frequent grafts, neurotization of the median nerve with a transfer of sensory rami from the radial nerve, a less-known technique. The treatment of the sensory sequellae of median nerve lesions is primarily based on a good initial management of the nerve lesions by a good-quality emergent microsurgical suture.

Humans↗

Emergence of radial nerve dominance in median nerve cortex after median nerve transection in an adult squirrel monkey.

Throughout the glabrous representation in Area 3b, electrical stimulation of the dominant (median or ulnar) input produces robust, short-latency excitation, evident as a net extracellular "sink" in the Lamina 4 current source density (CSD) accompanied by action potentials. Stimulation of the collocated nondominant (radial nerve) input produces a subtle short-latency response in the Lamina 4 CSD unaccompanied by action potentials and followed by a clear excitatory response 12-15 ms later. Laminar response profiles for both inputs have a "feedforward" pattern, with initial activation in Lamina 4, followed by extragranular laminae. Such corepresentation of nondominant radial nerve inputs with the dominant (median or ulnar nerve) inputs in the glabrous hand surface representation provides a likely mechanism for reorganization after median nerve section in adult primates. To investigate this, we conducted repeated recordings using an implanted linear multi-electrode array straddling the cortical laminae at a site in "median nerve cortex" (i.e., at a site with a cutaneous receptive field on the volar surface of D2 and thus with its dominant afferent input conveyed by the median nerve) in an adult squirrel monkey. We characterized the baseline responses to median, radial, and ulnar nerve stimulation. We then cut the median nerve and semichronically monitored radial nerve, ulnar nerve and median nerve (proximal stump) evoked responses. The radial nerve response in median nerve cortex changed progressively during the weeks after median nerve transection, ultimately assuming the characteristics of the dominant nerve profile. During this time, median, and ulnar nerve profiles displayed little or no change.

Action Potentials↗

[Carpal tunnel syndrome due to a cavernous hemangioma of the median nerve].

Median nerve hemangiomas causing carpal tunnel syndrome are very rare. The number of reported cases is less than ten, all of which resulted in recurrences. We present a 35-year-old woman who developed median nerve hemangioma in her left wrist. The mass was removed by epineural resection and the patient's complaints disappeared after a while. During a six-year follow-up no recurrences were detected.

Adult↗

Nerve transfer to the median nerve using parts of the ulnar and radial nerves in the rabbit--effects on motor recovery of the median nerve and donor nerve morbidity.

In this study, motor re-innervation of the median nerve by transfer of one-third, one-half, and two-thirds of either the agonistic ulnar nerve or the antagonistic radial nerve was investigated in both extremities of 20 rabbits. Recipient median nerve: Muscle contraction force of the flexor digitorum sublimus muscle after a one-third and a one-half of the ulnar nerve transfer achieved an average of 75 and 97% muscle power respectively as compared to conventional end-to-end neurorrhaphy. Muscle contraction force after one-third or one-half of the radial nerve transfer was significantly lower (36%). Donor nerves: Extensor carpi radialis muscle or flexor carpi ulnaris muscle contraction force 6 months postoperatively demonstrated a significant decrease after a one-half ulnar nerve and a two-thirds ulnar or radial nerve transfer, but not after a one-third transfer of either radial or ulnar nerves. Histologically, the number of axons in the re-innervated median nerve and both donor nerves distal to the coaptation site seemed to follow variable patterns. It was concluded that in the rabbit use of one-third of the agonistic ulnar nerve for re-innervation of the median nerve results in useful motor recovery with negligible donor site morbidity. Clinically, this technique may offer an alternative option for proximal nerve injuries or for free functioning muscle transplantations.

Animals↗

Posterior tibial nerve and median nerve somatosensory evoked potential monitoring during carotid endarterectomy.

PURPOSE: Somatosensory evoked potential (SSEP) monitoring using the median nerve (MN) modality during carotid endarterectomy is well established. This study assessed the usefulness of monitoring the posterior tibial nerve (PTN) SSEP as an adjunct to MNSSEP for detection of cerebral ischemia and as an indicator for the insertion of a shunt in patients undergoing a carotid endarterectomy. METHODS: All patients undergoing carotid endarterectomy during three years who had routine bilateral MNSSEP were also monitored with bilateral PTNSSEP. Patients received a shunt if there was a significant change (> 50% decrease in amplitude of cortical peak (N20) in the MNSSEP after cross clamping. The incidence, timing, and duration of all PTNSSEP changes were compared to MNSSEP changes. RESULTS: One hundred fifty-three patients were studied. Significant changes in MNSSEP after cross clamp lead to insertion of a shunt in six patients. Changes in PTNSSEP occurred at almost the same time in three patients, four minutes before MNSSEP in one, three minutes later in one and no change in one patient. Good quality baseline tracings were obtained in 99% MNSSEP as compared to 88% PTNSSEP (P < 0.05). New postoperative neurological deficits occurred in four patients (2.6%), only one had significant evoked potential changes. CONCLUSION: Monitoring of PTNSSEP is feasible and may be considered for an adjunct to MNSSEP or as an alternative modality if there are difficulties with MNSSEP. However, there may be a greater incidence of poor quality baseline tracings for PTNSSEP.

Aged↗

Communication of the musculocutaneous nerve with the median nerve.

OBJECTIVE: To study the frequency of occurrence as well as the course and variations in the communicating branch of the musculocutaneous nerve and the relationship of the communicating branch to other structures in the upper arms of Zimbabwean subjects. DESIGN: Cross sectional anatomical dissections. SETTING: Department of Anatomy,University of Zimbabwe Medical School, Harare, Zimbabwe. SUBJECTS: Twenty four upper limbs from twelve preserved cadavers of both sexes. RESULTS: Eight instances of communication from musculocutaneous nerve to the median nerve were observed. Bilateral communication was observed in two cadavers. The communicating branch arose either before or after it pierced the coracobrachialis muscle. In one instance the whole musculocutaneous nerve joined the median nerve. In two instances, the musculocutaneous nerve did not pierce the coracobrachialis muscle. In two instances the communicating branch arose after the origin of the muscular branch to the biceps brachii. CONCLUSIONS: The communicating branch was present in 33% of the cases. The communicating branch when present varied considerably in respect of its origin and its union with the median nerve. In one extreme case, the whole musculocutaneous nerve joined the median nerve and the muscular branches to the biceps brachii and brachilis arose from the median nerve. The clinician or surgeon should be aware of the presence of communicating branch and its variations in origin, course and relationships in the upper arm.

Female↗

The effect of the median nerve compression test on median nerve conduction across the carpal tunnel.

INTRODUCTION: We conducted an experimental, single-blind research study to determine the efficacy of using the median nerve compression test (MNCT) to improve the sensitivity and specificity of median nerve motor and sensory latencies for the diagnosis of carpal tunnel syndrome (CTS). We expected post-MNCT latencies to be prolonged in the CTS group. METHODS: A convenience sample of 18 subjects aged 18-65 was enrolled in this study. The CTS group consisted of 9 subjects with 14 hands tested having clinical signs and symptoms of CTS and normal baseline latency measures. The control group consisted of 9 gender- and age-matched (+/- 3 years) subjects with 14 hands tested. Three standard distal sensory latencies (DSL) and one distal motor latency (DML) were obtained, then repeated after application of the MNCT. RESULTS: No significant differences in latencies were found between groups (p = 0.76) or within subjects (p = 0.74) after application of the MNCT. There was less than 10% increase in sensitivities of post-MNCT latencies. DISCUSSION AND CONCLUSION: We found that the MNCT did not cause a meaningful increase in sensitivity or specificity of latencies for the diagnosis of CTS. The use of the MNCT as a method to prolong standard latencies is not recommended.

Adolescent↗

Median nerve palsy after operative treatment of olecranon fracture.

Olecranon fracture is not an uncommon fracture in clinical practice. Simple olecranon fracture usually heals quite well without any types of iatrogenic complications. Despite close proximity of the fracture to the nerve, median nerve palsy after operative treatment of olecranon fracture is a rare complication. To the authors' knowledge, this complication has not been previously reported in the Thai or English literature. The authors present a patient who had median nerve palsy after tension-band wiring for olecranon fixation. Intraoperative finding revealed that the median nerve was injured by the tip of K-wire. While this complication is uncommon on a per-person basis, it may results in serious complication, such as nerve palsy or limb ischemia. Orthopedic surgeons must remain vigilant with regard to any type of internal fixation in the upper extremity because the risk of neurovascular injury is high.

Adult↗

Sensory nerve recovery following median nerve provocation in carpal tunnel syndrome.

The purpose of this study was to evaluate the recovery of median nerve sensory nerve action potentials (SNAP) following median nerve provocation in hands with carpal tunnel syndrome (CTS). Repeated nerve conduction measurements were performed before and after wrist flexion combined with resisted finger flexion in 35 hands with a clinical diagnosis of CTS and in 25 asymptomatic control hands. Orthodromic sensory median nerve potentials were recorded over an 8 cm segment between the palm and wrist. Hands with CTS had significant reductions in nerve potential amplitude and latency following median nerve provocation. Hands with mild to moderate CTS, had the greatest reductions in nerve potential amplitude and the longest amplitude recovery times following median nerve provocation. Determination of changes in amplitude and amplitude recovery time of the median nerve SNAP following median nerve provocation has the potential to improve the accuracy of the electrophysiological diagnosis of CTS.

Action Potentials↗

A variation in the formation of the median nerve: communicating branch between the musculocutaneous and median nerves in man.

We encountered variation in the formation of the median nerve in a 66-year-old male cadaver during dissection of the upper extremity of 20 adult cadavers. The dissections were made at the Department of Cellular Biology and Anatomy, Louisiana State University Medical Center. The median nerve was formed by fusion of four branches, three of them coming from the lateral cord and one from the medial cord. The normal radix from the lateral cord followed a very close oblique course over the axillary artery. The first unusual radix to the median nerve had an anastomoses from the musculocutaneous nerve to the median nerve in the proximal part of the left arm. The second unusual radix also came from the musculocutaneous nerve after it had pierced the coracobrachialis muscle and then joined with the median nerve. These kinds of variations are vulnerable to damage in radical neck dissection and other surgical operations of the axilla and upper arm. The communicating branch can be explained on the basis of its embryologic development and also ought to be distinguished from the other nerve variations in the upper extremity. The aim of this paper is to provide additional information for the classification of previously found communications between the musculocutaneous and median nerves.

Adult↗

A connecting branch between the musculocutaneous nerve and the median nerve.

We report here a connecting branch between the musculocutaneous and the median nerves in a 42 years old male cadaver. The connecting branch was 8 cm in length and 3 mm in width. One of the brachial veins and the brachial artery were located between the roots of the median nerve and the second brachial vein was present between the connecting branch and the median nerve. These kinds of variations may effect the venous return and may cause edema in the upper extremities. Additionally, variations of these nerves have an importance during operations of this region.

Adult↗

Modification of median nerve somatic evoked potentials by prior median nerve, peroneal nerve, and auditory stimulation.

In a recovery function design, changes were measured in the somatic evoked potential (SEP) to right median nerve (RMN) shocks preceded by stimulation of: the same nerve (RMN-RMN); the left median nerve having primary input to the homologous sensory area in the contralateral hemisphere (LMN-RMN); the right peroneal nerve having primary input to a different region of the same hemisphere (RPN-RMN); and the auditory nerve with primary input to a different sensory modality (AUD-RMN). Eight inter-stimulus intervals ranged from zero (simultaneous) to 2.5 sec. It was assumed that the degree of interaction between evoked potentials would be related to the degree to which common neural structures are activated or modulated in response to the stimuli. Results were: (a) the primary somatosensory response N20-P30 was little influenced by other somatic or auditory stimulation, interaction occurring predominantly in the RMN-RMN condition; (b) with increasing latency, components showed increasing interaction across modalities; (c) preceding homolateral stimulation (RPN-RMN) showed no greater interaction than preceding contralateral stimulation (LMN-RMN); (d) N55-P100 differed from the primary somatosensory response N20-P30 by showing greater interaction with other somatic stimuli; and (e) N140-P190 showed similarly shaped recovery functions across stimulus pairs but significant differences in magnitude of interaction. These results show that components with similar wave form and topographical characteristics can have different neurophysiological properties.

Acoustic Stimulation↗

[Compression syndromes of the ulnar nerve and median nerve in the area of the hand].

Carpal tunnel syndrome occurs very frequently and results from synovial tissue proliferation caused by a variety of events. Morbidity can be determined by detailed neurological examination and treatment depends on the extent of the distal latency. During the operation it is important to pay close attention to the various nerves and to proceed as carefully as the individual situation requires. The success rate also depends on adequate aftercare and follow-up. In the case of Guyon syndrome, operation is always indicated, with the goal being decompression and to search for the cause of the compression. The results are also excellent.

Carpal Tunnel Syndrome↗