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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]
Cutaneous innervation of the upper limbs is the nerve supply to areas of the skin of the upper limbs (including the arm, forearm, and hand) which are supplied by specific cutaneous nerves. Modern texts are in agreement about which areas of the skin are served by which cutaneous nerves, but there are minor variations in some of the details.
In the palm of the hand the median nerve is covered by the skin and the palmar aponeurosis, and rests on the tendons of the flexor muscles.Immediately after emerging from under the transverse carpal ligament the median nerve becomes enlarged and flattened and splits into a smaller, lateral, and a larger, medial portion.
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]
In the palm of the hand, the median nerve is covered by the skin and the palmar aponeurosis, and rests on the tendons of the Flexor muscles.Immediately after emerging from under the transverse carpal ligament the median nerve becomes enlarged and flattened and splits into a smaller, lateral, and a larger, medial portion.
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 ulnar nerve, origin C8-T1, is a continuation of the medial cord of the brachial plexus. This nerve passes in the same plane as the median nerve, between the biceps and triceps muscles. At the elbow, this nerve travels posterior to the medial epicondyle of the humerus. This means that condylar fractures can cause lesion to this nerve.