VARIATIONS IN THE FORMATION AND RELATION OF MEDIAN NERVE

Background: The variations related to the formation of median nerve by more than two roots are relatively less common as compared to the other types of variations of median nerve. The relation of its relation with brachial artery may have potential clinical implications especially during surgeries and nerve blocks. Materials and Methods: The routine dissection of 10 adult cadavers including 7 males and 3 females in the Department of Anatomy during undergraduate training was carried out to detect the variations in the structure, formation and relation of Median nerve. Results and main findings: There was a variation observed in the formation of median nerve and its relation with the brachial artery in two adult cadavers. In one male cadaver(C1), there was variation in the formation of the median nerve by more than two roots and in second female cadaver (C2), there was a variation in both formation and its relation with the brachial artery. However, in each of these cadavers the distribution of the median nerve was normal in arm, forearm and palm. There was normal pattern of formation, relation and course of Median nerve in rest of the cadavers. The arterial pattern in the arm (axillary and brachial arteries) was also found to be normal. In each case the opposite upper limb was also dissected completely to exclude bilateral abnormality. In both the cadavers, the anomaly was unilateral. Photographs of abnormalities were taken for proper documentation of the variations. Conclusions: There variations have been explained by some embryological flats available. These variations of formation and relation of median nerve are clinically important for physicians, surgeons and anesthetists because symptoms of median nerve compression due to these variations are often confused with radiculopathy and carpal tunnel syndrome. The knowledge of these variations of median nerve is important to the surgeons and anesthetists’ for carrying out surgical procedures and nerve blocks in axilla and arm.