UPPER LIMB 1) Superficial

NERVE - deep to brachioradalis

Axillary (C5, C6) - pierces deep fascia (lateral to distal radius)
- quadrangular space (above posterior circumflex of humeral
artery, posterior shoulder joint) 2) Deep
- divides into anterior & posterior branch - wind around neck of radius
- anterior : round humerus surgical neck, deep to deltoid - penetrates supinator (arcade of Frohse)
- posterior : winds around deltoid posterior border - emerges posterior compartment as posterior interosseous
: continue as upper lateral cutaneous nerve of the arm
3) Posterior cutaneous nerve of forearm
Musculocutaneous (C5, C6, C7) - perforates lateral head of triceps
- exits axilla (piercing coracobrachialis) - descends along lateral side of arm
- between biceps brachii & brachialis - posterior aspect of forearm to wrist
- continue as lateral cutaneous nerve of forearm
- lateral to biceps brachii on brachialis (runs with cephalic vein) ARTERY
- descends along lateral border to wrist 1) Subclavian
- inclines anteromedially (posterior to clavicle)
Median (C5, C6, C7, C8, T1) - enters axilla
- lateral & medial roots merge (lateral to axillary artery)
- adjacent to brachial artery 2) Axillary
- medial to artery in cubital fossa - lateral to rib cages
- exits fossa between heads of PT - runs superior to pec minor (1 branch - superior thoracic)
- in fascial plane between FDS & FDP - runs posterior to pec minor (2 branches - thoracoacromial &
- deep to PL tendon lateral thoracic)
- superficial proximal to wrist - runs inferior to pec minor (3 branches - subscapular, anterior &
- passes deep to FR posterior circumflex of humeral artery)
- exits axilla below TM
1) Anterior interosseous
- descends anterior aspect of interosseous membrane with artery 3) Brachial
- between FDP & FPL - runs between bicps brachii & coracobrachialis
- deep to PQ - in medial bicipital groove
- branches of profunda brachii
2) Palmar cutaneous branch - anterior to medial supra-epicondylar ridge & trochlea
- superficial to FR (reach skin of central palm) - between biceps tendon & median nerve in cubital fossa
- branches off to radial & ulnar
Ulnar (C8, T1)
- descends medial arm 4) Ulnar
- posterior to medial epicondyle of humerus - descends inferomedially then inferiorly
- between heads of FCU - between PT-FDS & FDP
- between FCU & FDP - reach medial side of forearm
- superficial in distal forearm - superficial to FR into superficial palmar arch
- superficial to FR - laterally deep to palmar aponeurosis & superficial to FDS
tendon in palm
1) Palmar cutaneous branch - at level of distal border of extended thumb
- anterior to ulnar artery
- perforates deep fascia in distal forearm 5) Radial
- subcutaneous tissue to palmar skin (medial to 4 th digit) - inferolaterally under brachioradialis
- lateral to FCR tendon
2) Dorsal cutaneous branch - winds around lateral aspect of radius
- posteroinferiorly between ulna & FCU - crosses floor of anatomical snuff box
- subcutaneous tissue to dorsal skin (medial to 4th digit) - pierces 1st dorsal interosseous muscle into deep palmar arch
- curves medially & pierces AP (deep to FDP tendon & above
Radial (C5, C6, C7, C8, T1) interosseus muscle)
- exits axilla (posterior to axillary artery) - in contact with bases of metacarpals
- posterior to humerus (radial groove)
- between lateral & medial head of triceps 6) Palmar digital
- perforates lateral IM septum - common : pass distally on lumbricals to webbing of digits
- enters cubital fossa (between brachialis & brachioradialis) - proper :run along sides of 2nd to 5th digits
- anterior to lateral epicondyle
- divides into superficial & deep
LOWER LIMB Gluteal
NERVE 1) Superior (L4, L5, S1)
Sciatic (L4, L5, S1, S2, S3) - enters gluteal region via greater sciatic foramen (superior to
- enters gluteal region via greater sciatic foramen (inferior to piriformis)
piriformis, deep to gluteus maximus) - lateral between gluteus medius & minimus towards tensor fascia
- posterior thigh, deep to biceps femoris latae
- bifurcates into tibial & common fibular nerve (popliteal fossa 2) Inferior (L5, S1, S2)
apex)
- enters gluteal region via greater sciatic foramen (inferior to
piriformis, deep to inferior gluteus maximus)
Tibial (L4, L5, S1, S2, S3)
- divides into branches
- descends through popliteal fossa, lies on popliteus
- on tibialis posterior with posterior tibial vessels ARTERY
- branches off medial sural cutaneous 1) Common iliac
- divides into medial & lateral plantar - descends medial of psoas
- media plantar : distally in foot between abductor hallucis & FDB - divides into external & internal iliac (anterior of sacroiliac joint)
: divides into muscular & cutaneous
- lateral plantar : laterally in foot between quadratus plantae & 1) Internal
FDB - branches into gluteal & obturator
: divides into superficial & deep 2) External
- changes into femoral (posterior to inguinal ligament)
Common fibular (L4, L5, S1, S2)
- follows medial border of biceps femoris & its tendon 2) Femoral
- passes over posterior of fibula head - descends through femoral triangle, through adductor canal
- winds around the neck of fibula deep to fibularis longus - transverses adductor hiatus (anterior towards posterior)
- branches off lateral sural cutaneous
- divides into superficial & deep fibular 3) Popliteal
- superficial fibular : arises between fibularis longus & neck of - passes through popliteal fossa
fibula - ends at lower border of popliteus
: lateral compartment of leg - divides into anterior & posterior tibial
: pierces deep crural fascia at distal third of
leg 4) Tibial
: branches into medial & intermediate dorsal 1) Anterior
cutaneous - between tibia & fibula into anterior (through gap in superior
- deep fibular : arises between fibularis longus & neck of fibula interosseous membrane)
: passes through EDL & descends on interosseous - along membrane between tibialis anterior & EDL
membrane - through inferior ER into dorsalis pedis (anteromedially pierces
: crosses distal end of tibia, anterior tarsal tunnel 1st interosseous space) & divides into deep plantar arch &
: branches into lateral & medial terminal branch arcuate
- anastomoses with lateral dorsal
Sural (S1, S2)
- distal third of middle gastrocnemius 2) Posterior
- descends superficially posterolateral - posterior compartment of leg
- posterior to lateral malleolus - terminates distal to FR
- deep to fibularis tendon sheath - divides into medial & lateral plantar
- medial : superficial plantar arch
Femoral (L2, L3, L4) - lateral : deep plantar arch
- descends lateral to psoas major
- enters thigh posterior to inguinal ligament Obturator
- passes lateral to femoral artery (femoral triangle) - enters medial compartment of thigh through obturator foramen
- divides into anterior, anteromedial & posterior divisions - divides into posterior & anterior (sides of adductor brevis)
- posterior : forms saphenous - posterior : branches off acetabular branch to fovea ligament of
femur head
Saphenous (L3, L4)
- descends with femoral vessels through femoral triangle & Gluteal
adductor canal 1) Superior
- descends with great saphenous vein - enters gluteal region via greater sciatic foramen (superior to
- anterior to medial malleolus, ends on medial of foot piriformis)
- divides into superficial & deep
Obturator (L5, S1, S2) - anastomoses with inferior gluteal & medial circumflex humeral
- passes along medial edge of psoas & over sacroiliac joint arteries
- through obturator foramen anterior to obturator externus 2) Inferior
- divides into anterior & posterior divisions - enters gluteal region via greater sciatic foramen (inferior to
- anterior : between adductor longus & brevis piriformis), medial of sciatic nerve
- posterior : between adductor magnus &brevis - anastomosis (profunda femoris, medial & lateral circumflex)