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The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, [1] and has contributions from ventral roots of C6-C7 (lateral cord) and C8 and T1 (medial cord). [1] [2]
The median nerve innervates the flexors of the wrist and digits, the abductors and opponens of the thumb, the first and second lumbricals. The ulnar nerve innervates the remaining intrinsic muscles of the hand. [3] [4] All muscles of the hand are innervated by the brachial plexus (C5–T1) and can be classified by innervation: [1] [4] [5]
The ulnar nerve is exclusively responsible for the innervations of the hypothenar eminence. Both nerves contribute to the innervations of the midpalmar group. [8] The innervation of these muscles by the median nerve is unusual, as most of the intrinsic muscles on the palm of the hand are supplied by the ulnar nerve.
The recurrent branch of the median nerve is also colloquially called the "Million Dollar Nerve", because injury to this nerve during carpal tunnel surgery can lead to a million dollar lawsuit. Injury to this nerve can lead to loss of function of the thumb. Such injury can happen if the flexor retinaculum is transected too radially. The ...
It is innervated by the ulnar nerve in 50% of people and by both the median and ulnar nerves in 15%. The opponens pollicis originates on the tubercle of the trapezium and the flexor retinaculum. It is inserted onto the radial side of the first metacarpal. It opposes the thumb and assists in adduction. It is innervated by the median nerve. [6]
Unlike most of the median nerve innervation of the hand, the palmar branch travels superficial to the Flexor retinaculum of the hand. Therefore, this portion of the median nerve usually remains functioning during carpal tunnel syndrome. [1]
The anterior interosseous nerve is a branch of the median nerve, with a large sensory branch to the wrist bones, which arises just below the elbow. It passes distally, anteriorly along the interosseous membrane and innervates flexor pollicis longus, flexor digitorum profundus to index and middle finger as well as pronator quadratus, and supplies sensory feedback from the wrist bones, i.e. the ...
The third and fourth lumbricals (most ulnar two) are innervated by the deep branch of ulnar nerve. [5] This is the usual innervation of the lumbricals (occurring in 60% of individuals). However 1:3 (median:ulnar - 20% of individuals) and 3:1 (median:ulnar - 20% of individuals) also exist.