The median nerve of a person: a description, anatomy and structural features. Symptoms of involvement of the median nerve

In the human body - a large number of nerves, they are responsible for the movement of legs, hands and other functions. So, for example, in the human hand there are three main ones: radial, medial, ulnar nerves. The squeezing or trauma of the median nerve or any other can lead to serious problems with the movements of the hand. We will talk about it today, learn about its functions, location, and basic pathologies.

Anatomy

The median nerve is one of the largest nerves of the brachial plexus. It originates from bundles of the brachial plexus, more precisely, from the lateral and medial plexuses. In the shoulder area, it is conveniently located in the boson of the biceps muscle among all the other nerves. Then it descends along the front of the arm through the pit in the region of the elbow to the forearm, where it is very conveniently located between the flexors of the fingers - deep and shallow. Further, it passes into the lower section along the median sulcus and passes through the wrist canal into the palm. In the region of the palmar aponeurosis is divided into three terminal branches, which then create seven separate digital nerves.

The median nerve in the forearm region innervates not only two of the pronators, but all the flexors. The 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 it is responsible for the muscles of the thumb and both wormlike, the middle of the palm and palm side I-III and half of the IV fingers.

Nerve function

Each of the nerves in the human body is responsible for certain functions. Thus, the median nerve provides flexion and extension of three fingers on the arm: large, index and medium. In addition, he is responsible for opposing the thumb and pronation of the forearm.

Atrophy of muscles in case of his injury is most often expressed in the field of a tenor. As a result, the palm is flattened, and the reduction of the thumb makes the brush very similar to the monkey's paw. To independently detect the damage of this nerve, it will be enough to detect anesthesia of the terminal phalanx of two of the fingers - the index and the middle finger.

Very often patients turn to the doctor with complaints that several fingers on their hand do not obey. They feel discomfort in the hand, and they have neuropathy of the median nerve or neuritis, as well as nerve damage. But what are these pathologies, what causes and symptoms do they have?

Median nerve: trauma

Nerve damage is a common pathology that is caused by a complete or partial break in the nerve trunk. Closed injuries can occur due to the compression of soft tissues with a foreign object, for example, if a person is under a blockage, when a blunt object hits. Tumors, bone fragments during a fracture can also injure the nerve. Open injuries can happen if a person cuts or has a gunshot wound in the arm.

Nerve tissues are very poorly regenerated, and with this kind of damage in the distal nerve, Waller degeneration can very quickly develop - this is a process during which the nerve tissue dissolves, and it is replaced by scar connective 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 much it was damaged, can provoke several pathologies:

• Shake. In this case, no morphological and anatomical abnormalities were observed. Sensitivity and movement functions are returned after 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 ruptured, and blood enters the nerve. With such damage, the motor function is restored only after a month.
• Compression. With this pathology, the severity of the disorders is observed, and it depends on the severity and duration of the squeezing, there may be minor disturbances, but there are also serious cases requiring only surgeon intervention.

• Partial damage is manifested in the form of loss of individual functions. In this case, the functions themselves are not restored, only the operation is needed.
• Full break - for this condition, the nerve is divided into two separate ends - peripheral and central. If you do not take serious measures, then in this case the median fragment is replaced by a small part of the scar tissue. Independently, the functions will not be restored, muscle atrophy will grow with each passing 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

Very many people in the world face such a problem as hand neuropathy. Very often it is associated with fatigue, lack of sleep, and if it's a good time to rest, sleep, everything will go away, but in reality it's not at all like that.

Usually mononeuropathy - damage to one of the fibers of the nerve, most often develops due to the fact that the nerve is clamped in the place where it passes superficially under the skin itself or in the narrow channels of the bone. There may be several reasons for neuropathy:

• The surgical intervention suffered in the place where the operation was performed, eventually the blood ceases to circulate correctly, which eventually leads to edema and muscle atrophy, and also to the compression of the nerves;
• Trauma to the hand, during which the 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;
• The transmitted infections: herpes, malaria, diphtheria, tuberculosis and even HIV;
• Long-term use of drugs, which include phenytoin and chloroquine.

Symptoms of Neuropathy

Few of the patients turn to the hospital at the first symptoms of pathology, most often try to use folk remedies. Use ointments, make compresses, but it is not always possible to cure the median nerve in this way, the symptoms may reappear and be even more acute. There is a pathology in the form of burning pain that accompanies the patient throughout the day, also numbness of the fingers, hands and even completely hands appears. In addition, other symptoms may appear:

• edema;
• Spasms and convulsions;
• Sensation of goosebumps;
• Decrease in temperature sensitivity;
• Lack of coordination;
• Obstructed movement with hands.

When you visit a doctor or yourself, at home, you can tell by motor impairments whether the patient has neuritis, neuropathy of the median nerve, or not.

Determination of motor impairment of the median nerve

To determine motor disorders when squeezing or any other lesion of the median nerve, the doctor may recommend conducting such tests:

• If you clench your fist, then at that moment the index finger, as well as the partially large and middle fingers remain unbent, and the other two fingers on the arm are so tightly pressed that it can be difficult to unclench;
• If the median nerve is affected, the patient, when crossing the fingers, is not able to quickly rotate the thumb of the affected hand around the thumb, healthy, this test is called a "mill";
• The patient can not scratch his index finger on the table, he can only get friction with the distal phalanx of the finger, or he just knocks it, at that moment the brush lies on the table;
• If two palms are folded together, the index finger of the injured hand can not scratch the healthy one;
• The patient can not withdraw his thumb so that he can form a right angle with the index finger.

If after a visual inspection there are such failures in the movement of the fingers, then it is recommended to undergo a comprehensive examination.

Diagnosis of the disease

Before choosing the right method of treatment, you need to undergo a complete examination with a neurologist who will evaluate the reflexes, the strength of the muscles, conduct special tests and tests.

Of the instrumental methods of diagnosis are best suited:

• Electroneuromyography;
• X-ray examination;
• Magnetic tomography.

These studies will allow to find out where the nerve was damaged, find out what the cause of the pathology is, and reveal the degree of conduction failure. If necessary, the patient will be advised to undergo laboratory tests, only after this it is possible to accurately diagnose and select the most effective therapy.

Treatment of the disease

Treatment of the median nerve is selected individually for each patient, because the causes of the disease can be different and each person has a degree of damage. During treatment, the doctor may resort to etiotropic therapy. This treatment includes the administration of antibiotics, antiviral and vascular agents.

In addition, the doctor prescribes the use of anti-inflammatory and decongestants, physiotherapy, massage and exercise therapy also give good results.

In those cases, if it was found that the nerve is compressed, you need to eliminate the cause. In this case, the most powerful dissipative therapy is needed, but in order to conduct it, one must start with various enzymes, and also take resorptive and softening scar tissue of the remedy. There are cases where manual therapy and massage help to quickly cure all the symptoms.

In order for the treatment to be effective, it is necessary to carry out restorative procedures, which ones are suitable in a particular case, the resuscitator decides.

If the median nerve is injured, then in this case it is necessary to determine exactly which of the methods of treatment will be effective - conservative or operative. For this purpose it is recommended to carry out needle myography, precisely with its help it is possible to accurately determine the extent of the lesion.

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 a preventive measure, methods are used to help 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 by hands (seamstresses, programmers and others).

Conclusion

Summing up the aforesaid, it is possible to say for sure that any even the slightest damage to the median nerve can lead to irreparable consequences. Therefore, if you suddenly noticed that your fingers do not bend well, they often make a cramp or you can not clench your fist, then it's better to consult a doctor. With a hand injury, the doctor's advice and examination is very important. It is better to cure minor changes than to do an operation later, which, moreover, does not give the desired results in severe cases.