Editing Upper limb (section)

=== '''Median nerve''' ===

** Origin
*** Medial root and lateral       root combine to form main nerve
*** C5-T1
** Course
*** Runs down arm with brachial       artery
*** Through ACF into forearm,       between pronator teres and biceps tendon
*** Central route down forearm.       Travels between the layers of FDS and FDP. At the wrist, found ulnar to       the tendon of FCR, between the tendons of FPL and FDP.
*** Main branch passes through       carpal tunnel and gives off digital nerves. Supplies cutaneous       innervation to distal phalanges of index and middle fingers.
*** Branches
**** Palmar cutaneous nerve        arises in the mid-forearm. This penetrates the deep fascia at the wrist        and supplies the skin over the thenar eminence.
**** Anterior interosseous
**** Deep palmar cutaneous
**** '''Recurrent        muscular branch'''        ('million dollar nerve') - to thenar muscles
***** This nerve is the reason         for not straying radially during CTR
***** 50% take-off distal to         flexor retinaculum
***** 30% branch within (then         still recurrent to thenar muscles)
***** 20% pass through the         retinaculum (non-recurrent)
**** Digital cutaneous branch
** Supplies:
*** Most of the flexor muscles       of the forearm - all of anterior compartment except FCU and medial parts       of FDP
**** Wrist and finger flexors
**** Pronator teres and        quadratus
*** LOAF muscles in hand
**** Lateral two lumbricals
**** Opponens pollicis
**** Abductor pollicis brevis
**** Flexor pollicis brevis
*** Cutaneous to the flexor       surfaces of 3.5 radial digits and palm
** Injuries
*** Most commonly injured at       the wrist - lacerations, compression in carpal tunnel
*** Sensory loss radial 3.5       fingers of palm
*** Weakness and eventually       wasting of thenar eminence
*** High lesion
**** Wasting of front of        forearm because the long flexors (except FCU and half of FDP) and the        pronators are paralysed
**** Hand of benediction - on        attempted finger flexion, held with the index/middle finger straight,        with all other fingers flexed
****
**** Test FPL and finger        flexors by pinching together pads of thumb and index finger
*** Lesion at the wrist
**** Test abductor pollicis        brevis (not flexor because of uncertain nerve supply)