Lesson 5: Median Nerve Injury

Median Nerve Injury

• Rarity: Median nerve injury is uncommon.

• Etiologies:

  • Intravenous (IV) placement in the antecubital (AC) space
  • Carpal tunnel syndrome
  • Elbow hyperextension
  • Forced extension during positioning after neuromuscular blockers.

• Anatomy: Median nerve is located near the basilic and median cubital veins in the cubital fossa.

Presentation

• Sensory Loss: Reduced sensation over the palmar surface of:

  • Thumb
  • Index finger
  • Middle finger
  • Lateral aspect of the ring finger.

• Motor Dysfunction:

  • Inability to oppose the thumb.
  • High median nerve injury results in 'hand of benediction' when commanded to make a fist.

• Chronic Consequence: Can lead to ape hand deformity.