Median nerve Formation Medial and lateral roots Front

Median nerve

Formation • Medial and lateral roots • Front of axillary artery • Root value. Ventral branches of ventral rami of C 5, 6, 7, 8 and T 1

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

• In the forearm

Branches • • • Muscular Cutaneous Articular Vascular Communicating

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

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

Applied anatomy 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 thumb, difficulty in buttoning the shirt/blouse.

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

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