[The gliding tissue of the median nerve in the carpal tunnel]

Passive movement of nerves is possible because the epifascicular epineurium is connected to the surrounding tissue by a loose connective tissue. In the carpal tunnel tendon sheaths have been developed to facilitate gliding of tendons produced by muscle contraction. By cadaveric dissection and by intraoperative examination of the carpal tunnel, a special gliding tissue of the median nerve could be demonstrated. Injection of fluid into the tissue revealed a sheath-like structure with a space between the layers limited both proximally and distally. Intraoperatively a parietal layer of loose connective tissue and several layers surrounding the median nerve could be demonstrated.