NERVES OF UPPER LIMB

NERVES OF UPPER LIMB

Axillarynerve
Musculocutaneous nerve
Median nerve
Ulnar nerve
Radial nerve
AXILLARY NERVE
 The axillary nerve arises from the
posterior cord of the brachial plexus in
the axilla.

 Itpasses backward and enters the

quadrangular space with the posterior
circumflex humeral artery.

 As the nerve passes through the space,

it comes into close relationship with the
inferior aspect of the capsule of the
shoulder joint and with the medial side
of the surgical neck of the humerus.

 Itterminates by dividing into anterior

and posterior branches.
BRANCHES
An articular branch: To the
shoulder joint

An Anterior terminal

branch: To deltoid and
overlying skin.

A Posterior terminal
branch: To teres minor and
posterior part of deltoid.
MUSCULOCUTANEOUS NERVE
The origin of the Musculocutaneous nerve
from the lateral cord of the brachial plexus
(C5, 6, and 7) in the axilla.

Itruns downward and laterally, pierces the

coracobrachialis muscle, and then passes
downward between the biceps and
brachialis muscles.

Itappears at the lateral margin of the biceps

tendon just above the elbow.

Itruns down the lateral aspect of the

forearm as the lateral cutaneous nerve of the
forearm.
BRANCHES
MUSCULAR:
Coracobrachialis
Biceps brachii
Brachialis

CUTANEOUS:
Skin of the front and lateral
aspects of the forearm down
as far as the root of the
thumb.

ARTICULAR:
Elbow joint
 MEDIAN NERVE (C5-C8,T1)

The origin of the median

nerve is from the medial
and lateral cords of the
brachial plexus in the
axilla.

Itruns downward on the

lateral side of the brachial
artery.
COURSE IN ARM

Halfway down the upper arm, it

crosses the brachial artery and
continues downward on its
medial side.

The median nerve has no

branches in the upper arm,
except for a small vasomotor
nerve to the brachial artery.

Pass anterior to elbow joint into

the forearm
COURSE IN FOREARM
The median nerve enters the
forearm by passing between the
two heads of the pronator teres.

Itcontinues downward behind

b/w flexor digitorum superficialis
and flexor digitorum profundus.

At the wrist, the median nerve

emerges from the lateral border of
the flexor digitorum superficialis
muscle.

Itenters the palm by passing

behind the flexor retinaculum.
BRANCHES IN FOREARM

Muscular branches:
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor digitorum superficialis.

Articular branches: To the Elbow joint

Anterior interosseous nerve

Palmar cutaneous branch. This arises in

the lower part of the forearm and is
distributed to the skin over the lateral part
of the palm.
COURSE IN PALM
 The median nerve enters the palm by
passing behind the flexor retinaculum
and through the carpal tunnel.

 It immediately divides into lateral and

medial branches.

Muscular branches:
 Muscles of thenar eminence
 1st and 2nd lumbrical muscle.

Cutaneous branches:
 Palmar aspect of the lateral three and a
half fingers
 Skin of distal phalanges on dorsum.
 ULNAR NERVE
 The ulnar nerve (C8 and T1)
arises from the medial cord
of the brachial plexus and
descends in the interval
between the axillary artery
and vein.

 Theulnar nerve gives off no

branches in the axilla.
COURSE IN ARM
 Itruns downward on the
medial side of the brachial
artery as far as the middle of
the arm.

 The nerve enters the posterior

compartment of the arm and
passes behind the medial
epicondyle of the humerus.

 Itenters the front of the

forearm by passing between
the two heads of the flexor
carpi ulnaris.
COURSE IN FOREARM

It then runs down the forearm

between the flexor carpi ulnaris
and the flexor digitorum
profundus muscles.

BRANCHES IN FOREARM:

Muscular branches:
 Flexor carpi ulnaris
 Medial half of the flexor
digitorum profundus

Articular branches: Elbow joint

COURSE IN PALM

The ulnar nerve enters the

palm anterior to the
flexor retinaculum.
As it crosses the
retinaculum, it divides
into a superficial and a
deep terminal branch.
Superficial Branch of the Ulnar Nerve
The superficial branch of the ulnar nerve
descends into the palm, between the
pisiform bone and hamate. The ulnar
artery is on its lateral side. Here, the nerve
and artery may lie in a fibro-osseous
tunnel, the tunnel of Guyon.

Branches:

Muscular branches:
Palmaris brevis

Cutaneous branches:

Palmar aspect of the little finger and the

adjacent sides of ring finger.
Distal half of the dorsal aspect of these
fingers.
 Deep Branch of the Ulnar Nerve

The deep branch of the ulnar nerve runs

backward between the abductor digiti minimi
and the flexor digiti minimi.

Muscular branches:
Three muscles of the hypothenar eminence
(abductor digiti minimi, flexor digiti minimi,
and opponens digiti minimi).

Allthe palmar and dorsal interossei

3rd and 4th lumbrical muscles
Both heads of the adductor pollicis muscle.
 RADIAL NERVE (C5-C8, T1)
The radial nerve is the largest branch of the
brachial plexus and lies behind the axillary
artery.

The origin of the radial nerve is from the

posterior cord of the brachial plexus in the
axilla.

Itgives posterior cutaneous nerve in axilla.

Branches are given to the long and medial
heads of the triceps

On leaving the axilla, the radial nerve

immediately enters the posterior
compartment of the arm.
COURSE IN ARM
The nerve winds around the
back of the arm in the spiral
groove on the back of the
humerus between the heads of
the triceps.

Itpierces the lateral fascial

septum above the elbow and
continues downward into the
cubital fossa in front of the
elbow, between the brachialis
and Brachioradialis muscles.
 BRANCHES IN ARM
In the spiral groove:
Lateral and medial heads of the triceps
Anconeus.

Lower lateral cutaneous nerve of the arm:

skin over the lateral and anterior aspects of
the lower part of the arm.

Anterior compartment of the arm:

Branches to the brachialis, Brachioradialis,
and Extensor carpi radialis longus muscles.

Articular branches: Elbow joint.

At the level of the lateral
epicondyle, it divides into
superficial and deep branches.

Superficialbranch enter into

lateral compartment

Deep branch enter into front

of forearm
 Superficial Branch of the
Radial Nerve

 Itreaches the posterior surface of the

wrist, where it divides into terminal
branches.

BRANCHES:

 Skin on lateral two thirds of the

posterior surface of the hand
 posterior surface over the proximal
phalanges of the lateral three and a
half fingers.
Deep Branch of the Radial Nerve

Branches:
Muscular branches:
Extensor carpi radialis brevis
Supinator
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis

Articular branches: To the wrist and carpal

joints
THE END…!!