Median Nerve

 MEDIAN NERVE ANATOMY 

Median nerve

Median Nerve | Median Nerve Course, Branches, Muscle Supply, Test & Palsy


Median nerve comes from lateral cord of brachial plexus. Median Nerve supply most long muscle in front of forearm so it’s also called ” Labourer’s Nerve ”  it also called ” eye of the hand ”


    ROOT VALUE OF MEDIAN NERVE :

    Root value of Median nerve is C6, C7, C8, T1


    COURSE OF MEDIAN NERVE : 


    => Median nerve closely to brachial artery.  


    => in upper part median nerve run to lateral side of brachial artery 


    => in lower part median nerve cross the brachial artery from laterl to medial 


    => in cubital fossa median nerve lie medial to brachial plexus 


    => Then median nerve enter in forearm and it lie between flexor digitorum superficialis and flexor difgitorum profundus


    => in last median nerve pass to  flexor ratinaculum through carpal tunnel and thn enter in palm 


    BRANCHES OF MEDIAN NERVE : 


    =>Anterior interosseous branch : supply to deep muscle of anterior forearm


    =>palmar cutaneous branch : supply to lateral skin


    MEDIAN NERVE SUPPLY : 

    Motor supply


    median nerve
    Median Nerve


    IN  FOREARM : In forearm Median Nerve supply All muscle except Flexor Carpi Ulnaris  and Median part of the Flexor Digitorum Profundus


    median nerve supply in forearm :


    Superficial muscle of forearm


    • Pronator Teres 
    • Flexor Carpi Ulnaris 
    • Palmaris Longus 
    • Medial 1/2 of Flexor Digitorum Profundus (lateral 1/2 supply by ulnar nerve) 
    • Flexor Digitorum Superficialis 
    • Pronator Quadratus


    Deep muscle of forearm


    • Flexor Digitorum Profundus
    • Flexor Policis Longus
    • Pronator Qyadratus


    IN HAND : In forearm median nerve supply all thenar muscle and 1st & 2nd lumbrical


    • Abductor pollicis brevis
    • Flexor Pollicis Brevis
    • Opponens Pollicis
    • 1st & 2nd lumbrical

    Sensory    

    => Median nerve supply medial half of hand from medial half of middle finger. Palmar aspect of thumb, second, third and fourth (radial half) fingers. 

    MEDIAN NERVE INJURY / MEDIAN NERVE PALSY : 


    => Median nerve injury occure due to any trauma or neuropathy Read More about Median Nerve 


    => Carpal Tunnel Syndrom (CTS) : it cause by Compression on median nerve at space of carpal tunnel Read More



    MEDIAN NERVE TEST : 


    1. Froment’s sign / Book holding test : 

    If the patient is not able to holding book or pen then the sign is positive. 

    2. Paper holding test :
    If the patient is not able to holding book or pen then the test is positive.

    3. Pen test for Median Nerve :

    This Pen test for testing abductor policis muscle which supply the Median Nerve. first ask to patient to lie hand on flat surface. therapist held pen above palm and ask to patient to touch the pen with thumb.
     


    QUICK REVISION OF MEDIAN NERVE :


    => In the forearm Proximal 1/3: All flexor muscles of the forearm (except the flexor carpi ulnaris and medial half of the flexor digitorum profundus). 


    => In the forearm Distal 1/3 : Nil. In the hand: Flexor pollicis brevis, opponens pollicis, abductor pollicis, first two lumbricals. 


    => Sensory distribution: Palmar aspect of thumb, second, third and fourth (radial half) fingers. 


    => Clinical features: In hand (loss of thumb opposition, flexion and abduction).

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