The recurrent branch of the median nerve is the branch of the

median nerve 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 median nerve originates from the lateral and medial cords of the brachial plexus, and has cont ...

which supplies the

thenar muscles 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 w ...

. It is also occasionally referred to as the thenar branch of the median nerve, or the thenar muscular branch of the median nerve.

Anatomy

Course

It usually passes to the

transverse carpal ligament The flexor retinaculum (transverse carpal ligament or anterior annular ligament) is a fibrous band on the palmar side of the hand near the wrist. It arches over the carpal bones of the hands, covering them and forming the carpal tunnel. Structur ...

. It ends in the

opponens pollicis 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. Structure The ...

Distribution

In the

thenar eminence 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 w ...

, the recurrent branch of the median nerve provides motor innervation to: *

opponens pollicis muscle 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. Structure The o ...

abductor pollicis brevis muscle The abductor pollicis brevis is a muscle in the hand that functions as an abductor of the thumb. Structure The abductor pollicis brevis is a flat, thin muscle located just under the skin. It is a thenar muscle, and therefore contributes to th ...

* superficial part of

flexor pollicis brevis muscle 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. Origin and insertion The muscle's superficial head arises from the distal edge of the f ...

A separate, more proximal branch of the median nerve additionally provides motor innervation to the 1st and 2nd

lumbricals of the hand The lumbricals are intrinsic muscles of the hand that flexion, flex the metacarpophalangeal joints, and extension (kinesiology), extend the Interphalangeal articulations of hand, interphalangeal joints. p. 97 The lumbrical muscle of the foot, lu ...

. All other intrinsic muscles of the hand receive motor innervation via the

ulnar nerve The ulnar nerve is a nerve that runs near the ulna, one of the two long bones in the forearm. 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 ...

Clinical significance

The recurrent branch of the median nerve may be affected in

carpal tunnel syndrome Carpal tunnel syndrome (CTS) is a nerve compression syndrome associated with the collected signs and symptoms of Pathophysiology of nerve entrapment#Compression, compression of the median nerve at the carpal tunnel in the wrist. Carpal tunn ...

, or from its own separate peripheral neuropathies.

Surgery

The recurrent branch of the median nerve is also

colloquially Colloquialism (also called ''colloquial language'', ''colloquial speech'', ''everyday language'', or ''general parlance'') is the linguistic style used for casual and informal communication. It is the most common form of speech in conversation am ...

called the "Million Dollar Nerve", because injury to this nerve during carpal tunnel surgery can lead to a million dollar

lawsuit A lawsuit is a proceeding by one or more parties (the plaintiff or claimant) against one or more parties (the defendant) in a civil court of law. The archaic term "suit in law" is found in only a small number of laws still in effect today ...

. Injury to this nerve can lead to loss of function of the

thumb The thumb is the first digit of the hand, next to the index finger. When a person is standing in the medical anatomical position (where the palm is facing to the front), the thumb is the outermost digit. The Medical Latin English noun for 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.

References

External links

* {{Brachial plexus Nerves of the upper limb