1. By

2. Nerve supply of muscles of upper limb
Ms. of front of arm
Ms. of Back of arm & forearmMs. of front of forearm
Musculocutaneous N.
All the Ms. except medial
11/2Ms
Median Nerve
Ulnar N. Radial N.

3. Cutaneous innervation of upper limb

5. Thenar
eminenceHypothenar
eminence

6. The muscles of the hand are
supplied by ulnar & median nerves
A- All thenar muscles are supplied by median
except “ adductor pollicis” by ulnar N.
B- All hypothenar muscles by ulnar N.
C. Lumbrical muscles:
1-1st
& 2nd
by median nerve
2-3rd
& 4th
by ulnar nerve
D. Palmar & Dorsal interossei by ulnar nerve

8. )Fig. 32 ) Lumbrical muscles

10. Palmar
Interossei
)Adductors)
)Abductors)

11. Ulnar nerve

12. )Fig.37)Musculocutaneous, median & ulnar nerves
in the axilla & arm

14. Ulnar nerve in forearm & hand

15. Deep branch of ulnar N. passes with deep
palmar arch in front of interossei muscles

16. Deep branch of ulnar N. supplies
the interossei muscles

20. Injury to the ulnar nerve
Cause : a fracture of the medial epicondyle, or wound in the wrist . It
results in a claw hand (Fig.43( .
The lesion above the elbow : ( partial claw hand(
1-The ring and little fingers : a- loss of flexion of terminal phalanges ( due
to paralysis of flexor digitorum profundus(
b- hyperextension of the metacarpo-phalangeal joints with flexion of the
proximal interphalangeal joints due to paralysis of interossei & the 2
medial lumbrical muscles
2-loss of abduction and adduction of the fingers.
3-Wasted hypothenar eminence and loss of adduction of the thumb due
to paralysis of the adductor pollicis muscle
The lesion at wrist : leads to paralysis of the muscles of hand
(complete claw(
**The lesion above the elbow leads to less or partial clawing due to
paralysis of medial 12 of flexor digitorum profundus.
.

21. (Fig.79(Fracture of medial epicondyle
causing injury of ulnar nerve

22. Ulnar nerve lesion “ Claw hand”
Dorsal view Palmar view

23. Ulnar tunnel syndrome

24. Ulnar Nerve injury

25. Median nerve

27. axilla
arm
forearm
hand

28. )Fig.37)Musculocutaneous, median & ulnar nerves
in the axilla & arm

29. Median nerve in forearm & hand

30. Ulnar & median nerves

32. Median nerve lesion
“Ape hand“

33. Colles’fracture. Fracture of the
distal end of the radius causing a
“silver fork” deformity.

34. Flexor retinaculum

36. Carpal tunnel syndrome

37. Release of carpal tunnel

38. Carpal tunnel syndrome
( neglected(

39. Radial Nerve

40. )Fig.40 )Radial nerve in axilla & arm
In axilla
In posterior arm

43. N.B. Brachial artery ,Median nerve,
radial & ulnar nerves

44. Radial nerve in axilla , spiral groove , ant. arm
1-In axilla : A- long H. of triceps
B-Post. Cut. N. of arm
2-In spiral groove:
A-Lat.& Med. Hs. of triceps & anconeus
B-Lower lat. Cut. N. of arm
C-Post. Cut. N. of forearm
3-Lower lat. Of front of arm:
A- Lat. Part of brachialis
B- Brachioradialis & Ext. carpi radialis longus
C-Articular branch to elbow joint.
4-In front of lateral epicondyle:
superficial & deep terminal branches

45. Superficial muscles of posterior forearm
They are arranged from lateral to medial side
: 7 Ms.
1-Brachioradialis
2-Extensor carpi radialis longus
3-Extensor carpi radialis brevis
1,2&3lie in the lateral side of forearm
4-Extensor digitorum
5-Extensor digiti minimi
6-Extensor carpi ulnaris
7-Anconeus
All are supplied by radial nerve & its deep
branch.

46. Deep muscles of posterior forearm
They are 5 muscles arranged from above
downwards:
1-Supinator
2-Abductor pollicis longus
3-Extensor pollicis brevis
4-Extensor pollicis longus
5-Extensor indicis
All are supplied by deep branch of radial
nerve ( posterior interosseous nerve( .

47. Radial nerve in forearm & hand
Front of forearm
Back of forearm
In hand

51. Radial nerve lesion
“ Wrist drop& fingers drop”

52. Radial Nerve injury

53. Fracture
of the
shaft of
the
humerus
may
damage
nearby
nerves.

54. Radial Nerve injury
•In the upper part of the arm.
)penetrating injury, stab wound, gun shot
injury or traction injury(
•In the mid arm.
)fracture humerus, iatrogenic, stab w., …(
•At the elbow.
)fracture or dislocation of the head of the
radius(

55. )Fig.43) Lesion of ulnar, median & radial nerves
Ulnar nerve lesion
“Claw hand“
Median nerve lesion
“Ape hand“
Radial nerve lesion
“Wrist & finger drop“

56. Axillary Nerve

57. Lesion of Axillary Nerve

58. Musculocutaneous Nerve

60. Upper trunk lesion “ Erb’s Palsy”

62. Nerve to serratus anterior Lesion
“ Winged scapula“

63. Distributed by
University Book Centre
Mr. Sayed Mahmoud