| Recurrent branch of the median nerve | |
|---|---|
 Superficial palmar nerves. (Recurrent branch labeled at center left as "Muscular to abductor, opponens, and flexor brevis pollicis.") | |
| Details | |
| From | median nerve |
| Anatomical terms of neuroanatomy | |
The recurrent branch of the median nerve is the branch of the median nerve which supplies the thenar muscles. [1] It is also occasionally referred to as the thenar branch of the median nerve, or the thenar muscular branch of the median nerve.
An earlier branch of the median nerve also supplies the lumbricals 1 & 2. All other intrinsic muscles of the hand receive their motor innervation from branches of the ulnar nerve. It usually passes distal to the transverse carpal ligament. [2] It ends in the opponens pollicis. [3]
In the thenar eminence, the recurrent branch of the median nerve provides motor innervation to:
The recurrent branch of the median nerve may be affected in carpal tunnel syndrome, or from its own separate peripheral neuropathies. [5]
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 possibility of injury to this nerve is even greater when it runs through the ligament without any curling at the distal part of the ligament. [6]
Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. Symptoms typically start gradually and during the night. Pain may extend up the arm. Weak grip strength may occur, and after a long period of time the muscles at the base of the thumb may waste away. In most cases, both hands are affected.
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 thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb. The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex. The word thenar comes from Greek θέναρ (thenar) 'palm of the hand'.
In human anatomy, the ulnar nerve is a nerve that runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest in the human body unprotected by muscle or bone, so injury is common. This nerve is directly connected to the little finger, and the adjacent half of the ring finger, innervating the palmar aspect of these fingers, including both front and back of the tips, perhaps as far back as the fingernail beds.
The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.
The flexor pollicis brevis is a muscle in the hand that flexes the thumb. It is one of three thenar muscles. It has both a superficial part and a deep part.
The palmaris longus is a muscle visible as a small tendon located between the flexor carpi radialis and the flexor carpi ulnaris, although it is not always present. It is absent in about 14 percent of the population; however, this number can vary in African, Asian, and Native American populations. Absence of the palmaris longus does not have an effect on grip strength. However, the lack of palmaris longus muscle results in decreased pinch strength in fourth and fifth fingers. The absence of palmaris longus muscle is more prevalent in females than males.
The opponens digiti minimi is a muscle in the hand. It is of a triangular form, and placed immediately beneath the palmaris brevis, abductor digiti minimi and flexor digiti minimi brevis. It is one of the three hypothenar muscles that control the little finger.
The opponens pollicis is a small, triangular muscle in the hand, which functions to oppose the thumb. It is one of the three thenar muscles. It lies deep to the abductor pollicis brevis and lateral to the flexor pollicis brevis.
The hypothenar muscles are a group of three muscles of the palm that control the motion of the little finger.
The anterior interosseous nerve is a branch of the median nerve that supplies the deep muscles on the anterior of the forearm, except the ulnar (medial) half of the flexor digitorum profundus. Its nerve roots come from C8 and T1.
The posterior compartment of the forearm contains twelve muscles which are chiefly responsible for extension of the wrist and digits, and supination of the forearm. It is separated from the anterior compartment by the interosseous membrane between the radius and ulna.
In the human body, the carpal tunnel or carpal canal is the passageway on the palmar side of the wrist that connects the forearm to the hand.
The cervical spinal nerve 8 (C8) is a spinal nerve of the cervical segment.
The muscles of the hand are the skeletal muscles responsible for the movement of the hand and fingers. The muscles of the hand can be subdivided into two groups: the extrinsic and intrinsic muscle groups. The extrinsic muscle groups are the long flexors and extensors. They are called extrinsic because the muscle belly is located on the forearm. The intrinsic group are the smaller muscles located within the hand itself. The muscles of the hand are innervated by the radial, median, and ulnar nerves from the brachial plexus.
Ape hand deformity is a deformity in humans who cannot move the thumb away from the rest of the hand. It is an inability to abduct the thumb. Abduction of the thumb refers to the specific capacity to orient the thumb perpendicularly to the ventral (palmar) surface of the hand. Opposition refers specifically the ability to "swing" the first metacarpal such that the tip of the thumb may touch the distal end of the 5th phalanx and if we put the hand on the table as the palm upward the thumb can not point to the sky. The Ape Hand Deformity is caused by damage to the distal median nerve, and subsequent loss of opponens pollicis muscle function. The name "ape hand deformity" is misleading, as some apes do not have opposable thumbs.
Injuries to the arm, forearm or wrist area can lead to various nerve disorders. One such disorder is median nerve palsy. The median nerve controls the majority of the muscles in the forearm. It controls abduction of the thumb, flexion of hand at wrist, flexion of digital phalanx of the fingers, is the sensory nerve for the first three fingers, etc. Because of this major role of the median nerve, it is also called the eye of the hand. If the median nerve is damaged, the ability to abduct and oppose the thumb may be lost due to paralysis of the thenar muscles. Various other symptoms can occur which may be repaired through surgery and tendon transfers. Tendon transfers have been very successful in restoring motor function and improving functional outcomes in patients with median nerve palsy.
The muscles of the thumb are nine skeletal muscles located in the hand and forearm. The muscles allow for flexion, extension, adduction, abduction and opposition of the thumb. The muscles acting on the thumb can be divided into two groups: The extrinsic hand muscles, with their muscle bellies located in the forearm, and the intrinsic hand muscles, with their muscles bellies located in the hand proper.
Palmaris profundus is a rare anatomical variant in the anterior compartment of forearm. It was first described in 1908. It is usually found incidentally in cadaveric dissection or surgery.