Abstract. After exiting the carpal tunnel the median nerve enters the hand, thumb, and fingers where it terminates. To perform the test, simply tap over the carpal tunnel with your finger. The median nerve is one of these large nerves that travels from the shoulder down the arm, past the elbow joint, into the forearm, and ultimately across the wrist and into the hand. It innervates many of the muscles in the forearm and controls muscles in the hand. Numbness ; Weakness It happens when there is increased pressure within the wrist on a nerve called the median nerve. If the patient develops tingling in the thumb and radial two and a half fingers this is suggestive of median nerve compression. There are specific tests for detecting nerve weakness 1 (motor function) for each of the three nerves of the hand i.e. Tinel’s test is used to identify median nerve compression and can be useful in the diagnosis of carpal tunnel syndrome. Radial, Median and Ulnar nerve. There are various signs and tests used in routine practice when examining nerve function of the hand. Special Tests for Median Nerve Injury Pen Test. This nerve provides sensation to the thumb, index, and … Interpretation. The nerve has a motor and sensory function through the forearm and parts of the hand. Carpal tunnel syndrome is a common condition that causes pain, numbness, tingling, and weakness in the hand and wrist. However, in the case of a traumatic event, such as a wrist injury from a fall, nerve damage can occur right away. Palmar interossei muscles innervated by the ulnar nerve 1 Symptoms of nerve damage in the hand, wrist or elbow . Other nerves that function similarly in the upper extremity include the ulnar nerve and the radial nerve . Median nerve damage most commonly occurs in association with carpal tunnel syndrome, where swollen tissue causes increased pressure on the nerve as it passes through a channel called the carpal tunnel, on the inside of the wrist. Carpal tunnel syndrome causes pain, tingling, and numbness in your hand from pressure on the median nerve in your wrist. Sensory: Test the dorsal webspace between the thumb and index finger; Median (C5-T1): Motor: Recurrent motor branch of the median nerve: Have the patient attempt opposition (bringing the thumb tip across to the small finger tip) The median nerve runs along the arm and through the wrist to supply some of the muscle movement and skin sensation in the hand. Figure 1.Muscles innervated by the median nerve (blue) and the radial nerve (red) 1 Figure 2. The highest percentage of patients discharged with median nerve injuries in 2006 were between the ages of 18–44. Test- Patient keeps his/her hand flat on the table and at the same time, examiner brings a … For example, carpal tunnel syndrome arises from too much pressure on the median nerve in the hand and can slowly damage the median nerve in the hand. But there is no one specific test to detect weakness of all three nerves. This can impair the function of the thenar muscles. Ape hand is usually the result of median nerve palsy, which is commonly caused by deep injury to the wrist or forearm. Median nerve injuries were the least likely to be admitted to the emergency room out of all peripheral nerve injuries (median nerve 68.89%, ulnar nerve 71.3% and radial nerve 77.06%). The median nerve is the only one that travels through the carpal tunnel. When assessing the distal peripheral nerve motor functions of the hand, try using this mnemonic: “Rock, Paper, Scissors”. Tenderness and paraesthesia at region of ulnar nerve distribution signifies median nerve entrapment in carpal tunnel leading to carpal tunnel syndrome.