median nerve | Anatomy2Medicine
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median nerve

  • Median Nerve (C5–T1)
  • Median nerve arises from the medial & lateral cords of the brachial plexus
  • It is also known as labourer’s nerve (MCQ)
      • Runs down the anteromedial aspect of the arm
      • at the elbow, it lies medial to the brachial artery on the brachialis muscle
      • it has no muscular branches in the arm
      • Passes through the cubital fossa, deep to the bicipital aponeurosis and medial to the brachial artery(MCQ)
      • Enters the forearm between the humeral and ulnar heads of the pronator teres muscle, passes between the flexor digitorum superficialis and the flexor digitorum profundus muscles, and then becomes superficial by passing between the tendons of the flexor digitorum superficialis and flexor carpi radialis near the wrist.

 

  • In the cubital fossa, it gives rise to the anterior interosseous nerve

 

        • supply three muscles (MCQ)

 

  • flexor digitorum profundus
  • flexor pollicis longus

 

          • pronator quadratus
        • supply sensory “twigs” to the wrist joint.
      • Innervates all of the anterior muscles of the forearm except the flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus (MCQ)
      • Enters the palm of the hand through the carpal tunnel deep to the flexor retinaculum (MCQ)
        • gives off a muscular branch (recurrent branch) to the thenar muscles

 

  • Abductor pollicis brevis (MCQ)
  • Flexor pollicis brevis
  • Opponens pollicis

 

        • terminates by dividing into three common palmar digital nerves, which then divide into the palmar digital branches.
      • Motor Supply in Palm

 

  • lateral two lumbricals
  • First two lumbricals are paralysed, so when the patient is asked to make a fist slowly, the index and middle fingers tend to lag behind the ring & little fingers.

 

      • Sensory Supply in Palm
        • the skin of the lateral side of the palm
        • the palmar side of the lateral three and one-half fingers
        • the dorsal side of the index finger, middle finger, and one-half of the ring finger.
      • Injury to the median nerve
        • may be caused by

 

  • supracondylar fracture of the humerus

 

          • a compression in the carpal tunnel.
        • It results in loss of

 

  • Pronation

 

          • opposition of the thumb

 

  • flexion of the lateral two interphalangeal joints and impairment of the medial two interphalangeal joints

 

      • It also produces a characteristic flattening of the thenar eminence, often referred to as the ape hand.