Between ulnar and humeral heads of pronator teres.Bicipital aponeurosis or lacertus fibrosus.About 5 cm proximal to the medial epicondyle.On the anteromedial aspect of the humerus.The palmar nerves also give off branches to supply the two lateral lumbrical muscles. In the hand, the nerve divides into a muscular branch and a palmar digital branch The flexor retinaculum forms the roof of the canal. The carpal tunnel is formed by the carpal bones and the pronator quadratus on the inferior and side borders of the carpal tunnel. The palmar cutaneous branch just above the wrist and supplies the thenar eminence and central palm.Īfter branching, the median nerve continues into the hand via the carpal tunnel anterior and lateral to the tendons of the flexor digitorum superficialis. The median nerve continues its course in the distal forearm, under the flexor digitorum superficialis, and on the flexor digitorum profundus. Further, it gives branches to the pronator teres, the flexor carpi radialis, the palmaris longus, and the flexor digitorum superficialis.Ī significant branch is the anterior interosseous nerve, which is given off within the pronator teres and supplies the flexor pollicis longus, the pronator quadratus, and the lateral half of the flexor digitorum profundus. It enters the cubical fossa lateral to the brachialis tendon.Īfter that, the median nerve passes between the two heads of the pronator teres. In its course to elbow, the nerve lies close to the brachial artery, crossing it anteriorly to medially. In the axilla, it lies in the vicinity of the artery. It has contributions from has roots in C5, C6, C7, C8, and T1. The median nerve is formed in the axilla by the lateral and medial cords of the brachial plexus. It has been associated with well-developed forearm muscles as in weightlifters. Pronator syndrome is more common in women, especially in the fifth decade.
Other two compression neuropathies of median nerve are anterior interosseous nerve and carpal tunnel syndrome which are described separately. It is one the compression neuropathies of the median nerve. Pronator syndrome or pronator teres syndrome results in a predominantly sensory alteration in the median nerve distribution of the hand and the palmar cutaneous distribution of the thenar eminence. The median nerve, one of the three major nerves of the upper limb mainly supplies the hand and is also known as the eye of the hand. Pronator syndrome is a compressive neuropathy of the median nerve at the level of the elbow.
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