Anatomic relations between the median nerve and flexor tendons in the carpal tunnel: MR evaluation in normal volunteers

Zeiss, Jacob; Skie, Martin; Ebraheim, Nabil A.; Jackson, William T.

doi:10.2214/ajr.153.3.533

Cited by 63 publications

(41 citation statements)

References 10 publications

(3 reference statements)

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“…MRIs in normal persons have demonstrated changes in the size of the carpal tunnel, the shape of the tunnel, and the alignment of the contents with wrist flexion and extension (116,117). The median nerve migrates during these movements, and the tendons slide over a curved surface.…”

Section: Pathogenesis Of Carpal Tunnel Syndromementioning

confidence: 99%

Occupational Ergonomics: Principles and Applications

Bhattacharya¹,

Talbott²,

Kincl³

2012

Patty's Toxicology

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This chapter provides the basic principles that underlie the field of ergonomics and their application to some of the current issues of importance in the workplace. Sections 2–4 deal with the physiology of muscles; biomechanics; cellular responses to tissue, nerve, and joint injuries as they relate to cumulative trauma disorders; and common types of overuse syndromes. The remaining sections deal with applications of the principles to workplace ergonomic issues and proposed ergonomic regulations. The word “ergonomics” is made up of two Greek words, “ergo” meaning work and “nomas” meaning laws. The field of ergonomics is highly interdisciplinary. It applies principles from engineering, physiology, medicine, and psychology to the understanding of the interaction of humans with their workplace. The interaction of humans with their workplace may consist of identifying the relationship between job physical risk factors and physiological responses. For example, a specific ergonomic problem of paramount importance in the occupational health and safety is the issue of work‐related musculoskeletal disorders (WMD). Some of these issues are discussed further in this chapter. The specific areas of application relevant to the field of ergonomics are defined and briefly explained. Activities that involve repetitive stress have effects that are extremely complicated. Adding internal or external forces to the body can, as described, alter bone, joints, ligaments, tendons, nerves, and muscles. Belief that a repetitive motion will result in an isolated nerve injury without affecting surrounding joints, ligaments, muscles, or tendons is likely to inhibit appropriate care and control of exposed individuals. Additional research is needed to further characterize changes that occur, and current approaches to recognizing, managing, and preventing repetitive injuries must address all tissues in the involved area.

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Section: Pathogenesis Of Carpal Tunnel Syndromementioning

confidence: 99%

Occupational Ergonomics: Principles and Applications

Bhattacharya¹,

Talbott²,

Kincl³

2012

Patty's Toxicology

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“…The median nerve is located between the flexor retianculum and the tendons of the middle finger flexor digitorum superficialis muscle in wrist extension (sublimis 2) (45). Flexion produces an anterior shift of the tendons toward the flexor retinaculum.…”

Section: The Median Nervementioning

confidence: 99%

Anatomic variations of the median nerve in the carpal tunnel: a brief review of the literature

Demirçay¹,

Çivelek²,

Cansever³

et al. 2011

Turkish Neurosurgery

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Carpal tunnel syndrome (CTS) is a common focal peripheral neuropathy. Increased pressure in the carpal tunnel results in median nerve compression and impaired nerve perfusion, leading to discomfort and paresthesia in the affected hand. Surgical division of the transverse carpal ligament is preferred in severe cases of CTS and should be considered when conservative measures fail. A through knowledge of the normal and variant anatomy of the median nerve in the wrist is fundamental in avoiding complications during carpal tunnel release. This paper aims to briefly review the anatomic variations of the median nerve in the carpal tunnel and its implications in carpal tunnel surgery. KeywOrds: Median nerve, Anatomic variation, Carpal tunnel, Transverse carpal ligament ÖZKarpal tünel sendromu (KTS) sık görülen bir periferik nöropatidir. Karpal tünel basıncının artması median sinirin sıkışmasına ve kanlanmasının bozulmasına yol açar. Ağır vakalarda ve konservatif tedavinin yeterli olmadığı durumlarda cerrahi olarak transvers karpal ligamanın kesilmesi tercih edilir. Karpal tünelin gevşetilmesi sırasında komplikasyonlardan kaçınmak için median sinirin bu bölgedeki ayrıntılı anatomisinin ve varyasyonlarının iyi bilinmesi gereklidir. Bu derleme median sinirin karpal tüneldeki olası anatomik varyasyonlarını ve bunun karpal tünel cerrahisine etkilerini kısaca gözden geçirmek amacıyla yazılmıştır.

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“…The contents of the tunnel are not static. The nerve moves transversely within the tunnel, and relative to the tendons, when the extrinsic finger flexors are activated isometrically (Nakamichi and Tachibana, 1992), when the fingers are flexed or extended (Ham et al, 1996), and when the wrist is flexed or extended (Zeiss et al, 1989), and change in the nerve's location seems to be somewhat variable from one person to the next. The extrinsic finger flexor tendons slide proximally with finger flexion and distally with finger extension.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

“…The median nerve takes on an oval or somewhat flattened shape within the carpal tunnel (Robbins, 1963;Zeiss et al, 1989). In a study of cadaver hands (donor health history unknown), Armstrong et al (1984) observed increased subsynovial and adjacent connective tissue densities, increased synovial hyperplasia, and arteriole and venule muscular hypertrophy, with changes being most pronounced near the distal wrist crease.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%