KnotesFree Orthopaedic & FRCS notes, viva stations and higher order SBAs

Median nerve in the hand

High YieldHand & WristthinKbox SBA

Motor supply

The recurrent motor branch supplies:

  • Abductor pollicis brevis
  • Opponens pollicis
  • Superficial head of flexor pollicis brevis

Median nerve also supplies the first and second lumbricals.

Sensory supply

  • Palmar aspect of thumb, index, middle and radial half of ring finger
  • Nail beds / dorsal distal phalanges of the same digits

Clinical relevance

  • Carpal tunnel syndrome
  • Recurrent motor branch injury causing thenar weakness
  • High median nerve injury versus isolated recurrent branch lesion

Signs

  • Thenar wasting
  • Weak thumb abduction and opposition
  • Sensory loss in radial three-and-a-half digits

Diagram

Median nerve in the hand

Written/reviewed by Kishore Puthezhath

Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon

FRCS (Tr & Orth) revision resource

Reviewed: September 2026