Unusual course of median nerve in arm and forearm

Rajani SINGH, Munish WADHWAN

Abstract

Median nerve is formed by two roots, one medial root of medial cord and other- lateral root of lateral cord in front/lateral to third part of axillary artery. Then it crosses brachial artery anteriorly from lateral to medial side. In cubital fossa, it remains medial to brachial artery. In forearm, it lays medial to radial artery. We observed unusual formation and course of median nerve during dissection of right upper limb of female cadaver aged 70 years, fixed in 10% formalin in the Department of Anatomy, AIIMS Rishikesh, India. Scanty literature is available describing such variant course of median nerve in arm and forearm. Variations in the course of median nerve are clinically important to avoid injury to it as it may be injured during endoscopic surgery in this region, post traumatic evaluations and peripheral nerve repair. Knowledge of variant course of median nerve is also imperative for radiologists for proper interpretation of radiographs, for anesthesiologists for introducing anesthesia and for anatomists for rare variations.