A comprehensive review of motor innervation of the hand: variations and clinical significance

Abstract

The median and ulnar nerves display many anatomical variations, often with significant clinical implications. Awareness about these variations is clinically important when interpreting clinical examination findings, electrophysiological and radiological investigation as well as during management of patients in terms of surgical and anesthetic procedures.

MXtrodes: MXene-infused bioelectronic interfaces for multiscale electrophysiology and stimulation

“…The location with the shortest latency indicates the location of the IZ, which can be seen overlaid on the subject's hand in Fig. 4B, and it is in good agreement with expectations based on anatomical landmarks (74).…”

Use of collision tests to identify physiological differences between the median and ulnar nerves

“…Widely used electrophysiological comparisons between median and ulnar nerves, mainly in the evaluation of carpal tunnel syndrome, must be performed carefully. 2,3 Future studies on the differences between hand nerves are essential for correct diagnosis, mostly of entrapment syndromes, and, consequently, for safe and effective surgical interventions. False positive electrodiagnostic tests in carpal tunnel syndrome are one reason for unnecessary surgical treatment.…”

“…Knowledge of the function of the median and ulnar nerves is basic for reconstructive procedures after nerve injuries. These 2 nerves are often used in comparative electrophysiological studies (e.g., diagnosis of carpal tunnel syndrome), implying that they are functionally and electrophysiologically similar despite well‐known anatomical differences . In animal studies, Barton proved that the ulnar nerve on the elbow–wrist level possessed a larger diameter and quantity of myelinated fibers, with greater myelin area than the median and radial nerves.…”

“…These 2 nerves are often used in comparative electrophysiological studies (e.g., diagnosis of carpal tunnel syndrome), implying that they are functionally and electrophysiologically similar despite wellknown anatomical differences. [1][2][3][4][5][6] In animal studies, Barton 7 proved that the ulnar nerve on the elbowwrist level possessed a larger diameter and quantity of myelinated fibers, with greater myelin area than the median and radial nerves. In ultrasound studies in humans, the data are not fully consistent with Barton's findings, indicating that the median nerve has the largest cross-sectional area at the wrist and forearm.…”

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“…These anastomoses may alter the clinical and electrophysiological manifestations of different neuromuscular diseases of the forearm and hand, may modify the required surgical procedures, and may be a source of iatrogenic nerve injury. [31][32][33][34] Diseases of Riche-Cannieu anastomosis in the palm may be misdiagnosed as severe carpal tunnel syndrome of the median nerve with consequent unneeded performance of a surgery. 35 Anastomoses were also determined between the musculocutaneous nerve and other major nerves in the arm and forearm.…”