Median nerve - axillary and upper arm lesions

Causes

  • Traumatic/compression:
  • Penetrating trauma
  • Humerus fracture
  • Compression during sleep
  • Compression by aberrant brachialis muscle
  • Iatrogenic
  • Arteriovenous fistula

Symptoms & signs

  • Proximal lesions of musculocutaneous nerve result in sensorimotor deficits in all innervated muscles and all sensory areas.
  • Weakness of forearm pronation.
  • Weakness of radial wrist flexion.
  • Weakness of thumb opposition.
  • Weakness in flexion of the thumb interphalangeal joint.
  • Simian hand because of unopposed actions of extensor pollicis longus and adductor pollicis muscles.
  • Thenar atrophy.
  • Benediction hand because of inability to flex index finger and weakness in flexion of middle finger.