Upper limb: median nerve: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Upper limb: median nerve

Sample item

A woman has nocturnal tingling of the thumb, index and middle fingers and weakness of thumb abduction. Sensation over the thenar eminence is normal. Which anatomical fact explains the sparing of the thenar skin?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. The palmar cutaneous branch arises proximal to the flexor retinaculum and passes superficial to it

In carpal tunnel syndrome the median nerve is compressed beneath the flexor retinaculum. The palmar cutaneous branch leaves the nerve above the retinaculum and runs superficial to it, so thenar sensation is preserved while the digital branches are affected.

Option by option

  • A. The recurrent motor branch supplies the skin of the thenar eminence

    The recurrent branch is purely motor to the thenar muscles and supplies no skin.

  • B. The thenar skin is supplied by the ulnar nerve

    The ulnar nerve supplies the medial palm and the medial one and a half digits, not the thenar skin.

  • C. The anterior interosseous nerve supplies the thenar skin

    The anterior interosseous nerve is a deep motor branch with no cutaneous territory in the palm.

  • D. The palmar cutaneous branch arises proximal to the flexor retinaculum and passes superficial to it (correct)

    Correct. The branch bypasses the carpal tunnel, so it is not compressed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, The palmar cutaneous branch arises proximal to the flexor retinaculum and passes superficial to it. In carpal tunnel syndrome the median nerve is compressed beneath the flexor retinaculum.

Why is "The recurrent motor branch supplies the skin of the thenar eminence" not the answer?

The recurrent branch is purely motor to the thenar muscles and supplies no skin.

Why is "The thenar skin is supplied by the ulnar nerve" not the answer?

The ulnar nerve supplies the medial palm and the medial one and a half digits, not the thenar skin.

Why is "The anterior interosseous nerve supplies the thenar skin" not the answer?

The anterior interosseous nerve is a deep motor branch with no cutaneous territory in the palm.

What concept does this question test?

It tests Upper limb: median nerve in Anatomy. The palmar cutaneous branch leaves the nerve above the retinaculum and runs superficial to it, so thenar sensation is preserved while the digital branches are affected.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Upper limb: median nerve?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.