Analyze the Form and Amplitude of CMAP of Both the Median and Ulnar in a Normal Population, as well as the Anatomical Innervations of Tiny Hand Muscles in Normal Cadavers
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 1456-1463
AbstractAim: To analyze of shape, amplitude of CMAP of both median and ulnar in normal population and to analyze the anatomical innervations of small muscles of hand in normal cadavers.
Methods: This was retrospective observational study Department of Physical Medicine &Rehabilitation (PMR), Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India for 1 year. 100 normal subjects (32 males and 68 females) were include in this study. Motor conduction studies of both median and ulnar nerves were done for the included subjects. NCV machine was used to conduct the tests. Analysis of the shape of CMAP, amplitude and distal latency were performed.
Results: The mean amplitude of median nerve (11.74 mv) was significantly higher than that of the ulnar nerve (10.92 mv).The mean DL of the median nerve (3.92 msec) was significantly longer than that of the ulnar nerve (3.07 msec). Mean DL of median nerve was significantly longer in those with dome shaped CMAP rather than those with double peaked CMAP. Mean DL of ulnar nerve was significantly longer in those with dome shaped CMAP rather than those with double peaked CMAP. The APB received nerve supply from the median nerve in 85% of the specimens and double innervations from both median and ulnar nerves in 15% of the specimens. Flexor pollicis brevis (FPB) received nerve supply from the median nerve alone in 43% of the specimens and from the ulnar nerve alone in 12% of the specimens. FBP received innervations from both nerves median and ulnar in 45% of specimens. Abductor digiti minimi (ADM) muscle received one branch from deep branch of the ulnar nerve in 87% of the specimens and from superficial branches of the ulnar nerve in 13% of the specimens. Simultaneous branches from the deep branch of the ulnar nerve to 3rd lumbrical muscle (77% of the specimens) and to 4th lumbrical muscles (100% of the specimens) and to the palmar interossei in all the specimens.
Conclusion: The configuration of the CMAP of the median nerve is mostly dome, whereas that of the ulnar is mostly double peaked. Variability in the pattern of innervations of the small muscle of the hand could be a possible etiological factor.
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