Nerves of the upper limbs

Dr. M Koruji, PhD, Anatomical Sciences Department, TUMS

Brachial plexus

Roots Anterior rami of C5

to C8, and most of T1 Gray rami

communicantes from the sympathetic trunk: postganglionic

sympathetic fibers

Trunks The superior trunk :

C5 and C6 roots; The middle trunk :

C7 root; The inferior trunk

C8 and T1 roots.

Divisions & Cords Divisions

Anterior and a posterior division

The three anterior divisions : anterior compartments of the arm and forearm;

The three posterior divisions: the posterior compartments.

Cords Lateral cord Medial cord Posterior cord

Dorsal scapular Originates from the

C5 root Pierce the middle

scalene muscle Innervates the

rhomboid major and minor muscles

Long thoracic Originates from C5 to

C7; Down the axilla to

supply the serratus anterior muscle

Lies on the superficial aspect of muscle

Suprascapular nerve

Nerve to subclavius muscle

Cords Lateral cord(C5-C7)

Lateral pectoral, Musculocutaneous nerve, Lateral root of median

Medial cord(C8-T1) Medial pectoral, Medial cutaneous of forearm, Medial cutaneous of arm, Medial root of Median nerve Ulnar nerve

Posterior cord(C5-T1) Upper subscapular, Thoracodorsal, Lower subscapular Axillary nerve Radial nerve

Muscolocutaneous nerve Motor innervation to

all muscles in the anterior compartment of the arm; and

Sensory innervation to skin on the lateral surface of the forearm.

Muscolocutaneous nerve

Median nerve

Median nerve

Vasomotor to brachial artery

Medial cord1. The medial pectoral nerve

major muscle.

2. The medial cutaneous nerve of arm (medial brachial cutaneous nerve)

3. The medial cutaneous nerve of forearm (medial antebrachial cutaneous nerve)

4. The medial root of median nerve

5. The ulnar nerve

Ulnar nerve

Posterior cord 1. The superior

subscapular nerve; 2. The thoracodorsal

nerve; 3. The inferior

subscapular nerve;, 4. The axillary nerve; 5. The radial nerve

Axillary nerve Deltoid Teres minor Upper lateral

cutaneous nerve of the arm

Axillary nerve

Radial nerve All muscles in the

posterior compartments of the arm and forearm;

The skin on the posterior aspect of the arm and forearm, the lower lateral surface of the arm,

The dorsal lateral surface of the hand.

Radial nerve

Radial nerve In Axilla

Med head, post cut arm, long head

Radial nerve In Arm

Lat. head Med. head Lower lat. Cut. arm Post. Cut. forearm

Radial nerve injury in the arm Wrist drop (due to

denervation of the extensor muscles)

sensory changes over the dorsum of the hand

Wrist drop

1- Hard TissueThe upper limb skeleton (32)

2-Soft tissueMusclesVesselsNerves

1- Shoulder Girdle2- Arm (Brachium)3- Forearm (Anti brachium)4- Hand

Upper limb

Nerves of forearm1.Musculocutaneous nerve (lat.Cutaneous nerve

of forearm)2.Median nerve3.Radial nerve4.Ulnar nerve

Muscolocutaneous nerve

Median nerve

Nerves of the Anterior Forearm

Median nerve

musclucutaneous

Anterior interosseous nerve

Ape hand

Ulnar nerve

Ulnar nerve Muscular branches Two small cutaneous

branches Palmar branch

supply skin on the medial side of the palm;

The larger dorsal branch Posterior surfaces of

the medial one and one-half digits.

1

Ulnar nerve

Ulnar nerve injury Clawed-hand

Metacarpophalangeal joints are hyperextended and the interphalangeal joints are flexed

Damage to the ulnar nerve at the wrist : dorsal branch

Radial nerve

Superficial terminal branch

Deep terminal branch(post. interosseous

Radial nerveBrachialis-Joint

AxiAxiRT2

Cutaneous nerves of forearm and hand

Nerves of the Hand

Cutaneous Nerves and Superficial Veins of the Hand, Posterior View