In the human body - a large number of nerves, they are responsible for the movement of legs, arms and other functions. So, for example, in a person’s hand there are three main: the radial, median, ulnar nerves. Squeezing or trauma to the median nerve or any other can lead to serious problems with arm movements. It’s about him that we’ll talk today, learn about its functions, location, basic pathologies.
Anatomy
The median nerve is one of the largest nerves of the brachial plexus. It originates from the bundles of the brachial plexus, or rather, from the lateral and medial. In the shoulder area, it is conveniently located in the groove of the biceps muscle among all other nerves. Then it descends along the front of the hand through the fossa in the elbow to the forearm, where it is very conveniently located between the flexors of the fingers - deep and superficial. Further, it passes into the lower section along the median sulcus and already through the carpal canal falls into the palm of the hand. In the region of the palmar aponeurosis, it is divided into three terminal branches, which then create seven separate digital nerves.
The median nerve in the forearm area innervates not only two of the pronators, but all the flexors. An exception is the ulnar flexor of the wrist and half of the deep flexor, which is responsible for the motor function of the fingers. As for the brush, here he is responsible for the muscles of the thumb and both vermiform, the middle of the palm and the palmar side of I-III and half of the IV fingers.
Nerve function
Each of the nerves in the human body is responsible for certain functions. So, the median nerve provides flexion and extension of three fingers on the hand: large, index and middle. In addition, he is responsible for contrasting the thumb and pronation of the forearm.
Muscle atrophy in case of injury is most often expressed in the area of the tenor. As a result of this, flattening of the palm occurs, and bringing the thumb makes the brush very similar to a monkey's paw. In order to independently detect damage to this nerve, it will be enough to detect anesthesia of the terminal phalanges of two of the fingers - the index and middle.
Very often, patients turn to the doctor complaining that several fingers on their hand do not obey. They feel discomfort in the hand, and they reveal neuropathy of the median nerve or neuritis, as well as damage to the nerve. But what are these pathologies, what causes and symptoms do they have?
Median Nerve: Injury
Nerve damage is a fairly common pathology that is caused by a complete or partial interruption of the nerve trunk. Closed injuries can occur due to compression of soft tissues with a foreign object, for example, if a person is under the rubble, when struck with a blunt object. Tumors, bone fragments during a fracture can also injure a nerve. Open injuries can occur if a person is cut or injured in a hand.
Nerve tissue regenerates very poorly, and with such injuries in the distal part of the nerve Waller degeneration can develop very quickly - this is a process during which the resorption of nerve tissue occurs, and it is replaced by scar tissue. That is why to guarantee that the outcome of treatment will be favorable, no one can, in the end the patient receives a disability.
Nerve Damage: Classes
The median nerve of the hand, depending on how damaged it can be, can provoke several pathologies:
- Concussion. In this case, morphological and anatomical abnormalities were not noticed. Sensitivity and movement functions return 15 minutes after injury.
- Injury. This condition is due to the fact that the anatomical continuity of the nerve trunk is preserved, but the epineural membranes are torn and blood enters the nerve. With such damage, motor function is restored only after a month.
- Compression With this pathology, the severity of the disorder is observed, and it depends on the severity and duration of compression, minor disturbances can be observed, but there are serious cases requiring only the intervention of a surgeon.
- Partial damage manifests itself in the form of loss of individual functions. In this case, the functions are not restored on their own, only an operation is needed.
- Complete break - in this condition, the nerve is stratified into two separate ends - peripheral and central. If serious measures are not taken, then in this case the middle fragment is replaced by a small part of the scar tissue. The functions themselves will not be restored, muscle atrophy will increase every day, trophic disorders are observed further. In this case, only the operation can help, but it also does not always give the desired results.
Neuropathy or neuritis of the median nerve can be diagnosed at the initial stage, and if appropriate measures are taken, then this pathology can be cured without any consequences.
Causes of Neuropathy
A lot of people in the world are faced with such a problem as neuropathy of the hands. Very often it is associated with fatigue, lack of sleep, and if you have a good rest, get enough sleep, then everything will pass, but in fact everything is completely wrong.
Typically, mononeuropathy is damage to one of the nerve fibers, most often due to the compression of the nerve in the place where it passes superficially under the skin itself or in the narrow canals of the bone. There may be several causes of neuropathy:
- a surgical procedure, in the place where the operation was performed, over time, the blood stops circulating correctly, which ultimately leads to swelling and muscle atrophy, as well as to the fact that the nerves are compressed;
- injury to the arm, during which puffiness developed, leading to compression of the nerve;
- frequent hypothermia;
- irradiation;
- heavy loads on the muscles of the hands;
- endocrine pathologies, this also applies to diabetics;
- intoxication of the body;
- lack of B vitamins;
- tumors;
- previous infections: herpes, malaria, diphtheria, tuberculosis and even HIV;
- long-term use of drugs that contain phenytoin and chloroquine.
Symptoms of Neuropathy
Few patients go to the hospital with the first symptoms of pathology, most often they try to use folk remedies. They use ointments, make compresses, but it is not always possible to cure the median nerve in this way, the symptoms can appear again and be even more acute. Pathology manifests itself in the form of burning pain that accompanies the patient throughout the day, numbness of the fingers, hands and even completely hands appears. In addition, other symptoms may appear:
- edema;
- cramping and cramping;
- sensation of goosebumps on the skin;
- decrease in temperature sensitivity;
- lack of coordination;
- difficulty moving hands.
When visiting a doctor or on his own, at home, it is possible to determine by motor impairment whether the patient has neuritis, neuropathy of the median nerve, or not.
Definition of motor disorder of the median nerve
To determine motor disorders during compression or any other lesion of the median nerve, the doctor may recommend such tests:
- if you clench your fist, then at this moment the index, as well as partially the thumb and middle fingers remain extended, and the other two fingers on the hand are pressed so hard that it can be difficult even to open them later;
- if the median nerve is affected, then the patient, when crossing his fingers, is not able to quickly rotate the affected hand with his thumb around the thumb, healthy, this test is called a "mill";
- the patient will not be able to scratch the index finger on the table, he can only get the friction of the distal phalanx of the finger, or he simply knocks it, at that moment the brush lies on the table;
- if two palms are folded together, then the index finger of a damaged hand cannot scratch a healthy one;
- the patient is unable to retract the thumb so that he can form a right angle with the index finger.
If after a visual inspection there are such malfunctions in the movement of the fingers, then it is recommended to undergo a comprehensive examination.
Diagnosis of the disease
Before choosing the right treatment method, you need to undergo a full examination by a neurologist who will evaluate reflexes, muscle strength, conduct special tests and tests.
Of the instrumental diagnostic methods are best suited:
- electroneuromyography;
- X-ray examination;
- magnetic tomography.
These studies will detect where the nerve was damaged, find out what is the cause of the pathology, and identify the degree of malfunction in conduction. If necessary, the patient will be advised to undergo laboratory tests, only after that it is possible to accurately diagnose and select the most effective therapy.
Disease treatment
Treatment of the median nerve is selected individually for each patient, because the causes of the disease can be different and the degree of damage for each is different. During treatment, the doctor may resort to etiotropic therapy. This treatment includes taking antibiotics, antiviral and vascular agents.
In addition, the doctor prescribes the use of anti-inflammatory and decongestant drugs, physiotherapy, massage and exercise therapy also give good results.
In those cases, if it was found that the nerve is compressed, the cause must be eliminated. In this case, a powerful absorbable therapy is needed, but in order to carry it out, you need to start with various enzymes, as well as take absorbable and softening scar tissue funds. There are such cases that manual therapy and massage help to quickly recover from all the symptoms.
In order for the treatment to be effective, it is necessary to carry out restoration procedures, which ones are suitable in a particular case, the resuscitator decides.
If the median nerve is injured, then in this case you need to determine exactly which of the treatment methods will be effective - conservative or surgical. To do this, it is recommended to conduct needle myography, it is with its help that you can accurately determine the degree of damage.
Prevention
The defeat of the median nerve is a serious condition, if you do not take any measures, then it will be impossible to restore the motor function of the fingers. As preventive measures, methods are used that help to normalize metabolic processes, it is also very important to treat infectious pathologies on time. In addition, you need to regularly do gymnastics for the hands, especially if the patient's activity is associated with constant work with his hands (seamstresses, programmers and others).
Conclusion
Summing up the above, we can say for sure that any even the slightest damage to the median nerve can lead to irreparable consequences. Therefore, if you suddenly notice that your fingers are bent badly, often they cramp or you can’t clench your fist, then it’s best to consult a doctor. In case of hand injury, the advice of a doctor and examination is very important. It is better to cure minor changes than to undergo an operation, which also does not give the desired results in severe cases.