Median Nerve

By - Kritika Singh ( 58 )
-It is a Mixed Nerve ( contains motor and sensory fibres)

-Root Value- C 5,6,7,8 and T1

-Runs in the median plane of the forearm , so it's called

Median nerve.
Arises in the axillary by 2 roots ( lateral and medial ):
1) Lateral root : from the Lateral cord of the brachial
plexus.
2) Medial root : from the medial cord of the brachial
plexus.

▪️In Axilla : - Median nerve is formed by Lateral root from

Lateral cord and medial root from medial cord of brachial
plexus.
– Median nerve runs Lateral side of axillary artery.
In Arm -
▪️Median nerve continues to run on the Lateral side of brachial artery till the
middle of the arm, where it crosses infront of the artery and passes anterior
to the elbow joint into forearm.
In Forearm-
▪️Enters to the forearm between two heads of pronator teres.

▪️Then deep to fibrous arch of flexor digitorum superficialis, in proximal third.

▪️In mid forearm,descends between flexor digitorum superficialis and flexor

digitorum profundus .

▪About 5 cm above wrist,it comes to lie on lateral side of the flexor digitorum
superficialis, becomes superficial just above wrist .️
In Hand -
▪️Nerve passes deep to the flexor retinaculum and enters the palm .

▪️Muscular branches supply muscles of the thenar eminence ( abductor

pollicis brevis, opponens pollicis and flexor pollicis brevis ).

▪️Finally divides into 4 to 5 Palmar digital branches supplying lateral three and
half digit and their nail beds.

▪️Also, motor branches are given to the first and second lumbrical muscles.
 Branches
▪️In Arm : Vascular branches to the brachial.

▪️In the forearm: Muscular branches to all superficial flexor muscles.

▪️Anterior Interosseous , which comes off the median nerve supplies lateral
half of flexor digitorum profundus, flexor pollicis longus and pronator
quadrature.

▪️Articular branches supply the elbow joint and proximal ulner joint.

▪️Palmer cutaneous branch supply skin over thenar eminence and central part
of palm.
 Injury to median nerve-
▪️Median nerve is most commonly injured near wrist or high up in the
forearm.

▪Muscles supplied by median nerve affected according to the level of median

nerve injury -

1. High median nerve palsy

2. Low median nerve palsy️
 Median nerve compression
Three separate syndromes are recognized
▪️

1. Carpal tunnel syndrome

2. Pronator syndrome
3. Anterior interosseous syndrome
Physical Examination
▪️Phalen’s maneuver
▪️Tinel’s sign
▪️Carpal compression test -