this doesnt apply to me but it's interesting
The median
nerve can get entrapped at several distinct anatomical sites
from the upper arm up to the carpal tunnel as
comprehensively documented by Birch et al. and
Bilecenoglu et al. The nerve becomes compressed and
remains tethered to the structures forming the tunnel and
loses its mobility. Any movement in a nearby joint stretches
the nerve. Longstanding entrapments of the median nerve
characteristically result in neuropathies, muscle weakness
and wasting (Birch et al.; Green et al., 1999). On account of
close proximity of the brachial artery to the median nerve,
entrapment of the median nerve usually accompanies
concomitant compression of the brachial artery. Compression
of the artery is aggravated by spasm in the additional fibres
of the muscles or by their hypertrophy. A compromise in
vascularity of the forelimb by compression of the brachial
artery produces claudicating pain in the upper limb. The case
presented in this study is quite rare to come across as it
exhibits: (1) bilateral occurrence of the musculo - aponeurotic
tunnel, since bilateral arm and forearm muscle variations
have been reported very rarely (Nakatani et al.,1998)
specially with such long tunnels that trap the neurovasculature,
(2) unusually long tunnels for the neurovascular
bundles, (3) additional origins of the biceps brachii muscle
in both the arms, (4) additional fibres of origin descending
from the lower part of the left tunnel and the medial intermuscular
septa, crossing across the elbow towards the superficial
group of forearm flexors (suggesting higher origin
of the common flexors in the arm). Additional origins of
forearm muscles may be explained as evolutionary remnants
as suggested by Wood (1867). It is therefore important to be
aware of entrapment situations occuring bilaterally in an individual
as reported here with additional origins of muscles
in the vicinity of the neuro-vascular structures. Vascular and
nerve entrapment symptoms can easily be treated with the
release of these entities from the offending structures.
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last felt my fingertips august 2010 .
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