Median Nerve - Injury

Injury

Injury of median nerve at different levels cause different syndromes:

Above the elbow

  • Injury of this nerve at a level above the elbow results in loss of pronation and a reduction in flexion of the hand at the wrist.

At the elbow

  • Severing the median nerve at this level or higher (at above the elbow) causes "the Blessed Hand," or "Hand of Benediction."
  • Entrapment at the level of the elbow or the proximal forearm could be due to the pronator teres syndrome.
  • Lesions of compression of the Median Nerve can also leads to Median Nerve Palsy

Within the forearm

  • Injury to the anterior interosseous branch in the forearm causes the anterior interosseous syndrome.

At the wrist

  • Injury by compression at the carpal tunnel causes carpal tunnel syndrome.
  • In the hand, thenar muscles are paralyzed and will atrophy over time.
  • Opposition and flexion of the thumb are lost.
  • Sensory is lost:
Palm - 3 1/2 Fingers
Dorsal - Finger tips
  • The thumb and index finger are arrested in adduction and hyperextension. This appearance of the hand is collectively referred as 'ape hand deformity'.

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