The median nerve forms in the axilla from the lateral and medial roots of the brachial plexus, then travels through the arm. A proximal injury to the median nerve near the elbow results in an inability to flex the index and middle fingers, known as the "hand of benediction" posture, due to loss of lateral lumbrical function while the fingers are extended by unopposed radial nerve action. This lesion also causes loss of opposition of the thumb, resembling an ape hand. Examination of the median nerve involves testing muscles like the flexor pollicis longus and sensation over the nerve's distribution.

1. MEDIANMEDIAN
NERVENERVE
Anatomy , surgical importanceAnatomy , surgical importance
and examination.and examination.

2. Formed in axilla by union of lat. Root and med. Root
of brachial plexus.

8. Thenar wasting
Injury at or above elbow
“benediction attitude”

9. Pope's Blessing / Hand of Benediction
Nerve: Median
Lesion Location: Proximal (near the elbow) [1]
Deficiency: When the patient tries to make a fist,
they are unable to flex the index and middle fingers
due to loss of lateral lumbrical action, leading to
the hand of benediction. The fingers are extended
due to unopposed radial nerve action on the finger
extensors.

10. This lesion is also related to ape hand due to the fact
that loss of opponens pollicis means one has an
unopposable thumb (like an ape). It seems some also
believe the term ape hand refers to the thenar
atrophy.

11. Examination of
flexor pollicis longus
flexor digitorum profundus
flexor carpi radialis
abductor pollicis brevis
pronator teres
Sensation over the distribution of the nerve.