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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 muscles in this location are usually innervated by the recurrent branch of the median nerve. They all control movement of the thumb. 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 lateral two lumbrical muscles are the other exception.
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]
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.
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 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]