Median nerve

1. Median nerve

2. Formation
• Medial and
lateral roots
• Front of axillary
artery
• Root value-
Ventral
branches of
ventral rami of
C5,6,7,8 and T1

3. Course
• In the arm
• In the cubital
fossa
Median
nerve
Branches to pronator
teres & vascular branches
Median
nerve
Coracobrachialis
Pronator
teres
Brachialis

4. • In the
forearm

5. Branches
• Muscular
• Cutaneous
• Articular
• Vascular
• Communicating

6. Branching in the palm
• Lateral and
medial
branches
Passes deep
to the
flexor
retinaculum
medial
lateral
Proper palmar
digital nerve
Common palmar
digital nerve

7. In the palm
Passes deep
to the
flexor
retinaculum
*
*
* *
*

8. Lesions of the median nerve:- 2 places
• Forearm and wrist.
• Common site- while passing through carpal tunnel.
• Carpal tunnel syndrome- fluid retention, infection
and excessive exercise of the fingers causing
swelling of the tendons /synovial sheaths causes
paresthesia (tingling), hypoesthesia (diminished
sensation), anesthesia (loss of sensation).
• Progressive loss of coordination and strength in
the thumb-unable to oppose the thumb, difficulty
in buttoning the shirt/blouse.
Applied anatomy

9. Laceration of the wrist:
• Attempt 4 suicide by wrist slashing- paralysis
of thenar muscles & 1st 2 lumbricals
Median nerve injury at elbow level-
• loss of flexion of the proximal & distal
interphalangeal joint of the 2nd &3rd digits +
no flexion at the metacarpophalangeal joint
(1st & 2nd Lumbricals)

10. Applied anatomy
Cutaneous loss
Ape hand (thumb movements
Limited to flexion & extension)