![]() In the rare case of a supracondylar spur resulting in a ligament of Struthers entrapment, one looks for a bone spur arising from the medial distal humerus. When assessing vascular structures, the color and/or power Doppler must be used. In addition, one of the major advantages of ultrasound is its ability to visualize structural lesions, including ganglion cysts, scarring, aneurysms, vascular anomalies/injuries, and tumors ( Fig. As in other entrapment neuropathies, the proximal median nerve should be assessed for its size, echogencity, and fascicular structure. When assessing for proximal median neuropathy, after scanning the median nerve at the wrist, the ultrasound probe should be used to scan from the mid-forearm to mid-arm. In others, the median nerve is more medial, located over the proximal edge of the PT. In most individuals, the median nerve and brachial artery are immediately adjacent to each other. As it nears the surface, it runs under the lacertus fibrosus accompanied by the brachial artery, which is just lateral. It then runs between the two heads of the PT with the large humeral head above it and the small ulnar head below ( Fig. The nerve is deepest at this location and more difficult to visualize. It then moves proximally through the FDS, where it exits under the tendinous arch of the sublimis bridge. As the probe is moved proximally, the median nerve is joined by the ulnar artery. Recall that in the mid-forearm, the median nerve is easily visualized with ultrasound as it runs in the fascial plane between the FDS and FDP. Preston MD, in Electromyography and Neuromuscular Disorders, 2021 Proximal Median Nerve ![]() Recovery occurred within 3–6 weeks post-season.David C. Conclusions In this natural experiment, impaired median nerve conduction developed during 22 days of repetitive industrial work with moderate wrist postures and limited force exertion. Symptom and disability scores showed corresponding changes. Three to six weeks post-season, the changes had reverted to normal. At end-season, mean distal motor latency (DML) had increased 0.41 ms (P<0.001), mean sensory nerve conduction velocity (SNCV) digit 2 had decreased 6.3 m/s (P=0.004), and mean SNCV digit 3 had decreased 6.2 m/s (P=0.01) 9 mink skinners had decreases in nerve conduction, 5 fulfilled electrodiagnostic criteria and 4 fulfilled electrodiagnostic and clinical criteria (a positive Katz hand diagram) for carpal tunnel syndrome (CTS). Mink skinning was characterized by a median angle of wrist flexion/extension of 16° extension, a median velocity of wrist flexion/extension of 22 °/s, and force exertions of 11% of maximal voluntary electrical activity. Results The study comprised 11 male mink skinners with normal median nerve conduction at pre-season (mean age 35.7 years, mean number of seasons with skinning 8.9 years). Questionnaire information on symptoms, disability, and lifestyle factors was obtained. For a subgroup, we used goniometry and surface electromyography to characterize occupational mechanical exposures. Methods Using nerve conduction studies (NCS), we examined median nerve conduction before, during, and after engaging in 22 days of mink skinning. ![]() We hypothesized that at end-season, median nerve conduction would be impaired and then recover within weeks. Objectives The aim of this study was to evaluate the development of impaired median nerve function in relation to hand-intensive seasonal work.
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