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Dr.AkramJaffar
Applied Anatomy of Nerve Injuries in the Upper LimbApplied Anatomy of Nerve Injuries in the Upper Limb
Radial nerveRadial nerve
Akram Jaffar, Ph.D.
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References and suggested reading
• Ellis H (2006): Clinical anatomy, A revision and applied anatomy for clinical students.
11th
Ed. Blackwell Publishing. Massachusetts
• Moore KL & Dalley AF (2006): Clinically oriented anatomy. 5th
ed. Lippincott Williams
& Wilkins. Baltimore
• Brust JCM (2007): Current Diagnosis & Treatment in Neurology. 2nd
ed. McGraw-Hill
Professional.
Dr.AkramJaffar
Objectives
After completion of this session, students should be able to discuss, identify, and describe:
– The anatomical factors predisposing to nerve injuries.
– The anatomy of deformity, weakness and sensory loss following the nerve injury.
– The applied anatomy of clinical examination for specific nerves.
– Surgical anatomy of treating nerve injuries.
Dr.AkramJaffar
Radial nerve
• Arises from the posterior cord of the brachial
plexus
• Is the nerve of the extensor compartments of the
upper limb
• Gives its branches some distance to the part to
be innervated
• Branches in the axilla
– Motor: triceps
– Sensory: posterior cutaneous of arm
• Branches in the spiral groove
– Motor: Triceps
– Sensory: lower lateral cutaneous n. of arm
and posterior cutaneous n. of forearm
• Testing: Resisted extension at the elbow at 90o
.
Radial n.
Testing triceps: resisted extension at the elbow
Dr.AkramJaffar
Radial nerve
• Branches at the elbow:
• Motor: Supplies ALL the muscles in
the extensor compartment of the
forearm.
• Sensory : superficial branch to dorsum
of the hand.
• Testing
• Extension of the wrist against
resistance
Testing extensors of forearm
Superficial br.
Post. Interosseous n.
Dr.AkramJaffar
Radial nerve injury
• Common sites of injury
• Axilla: pressure of the upper end of a badly fitting
crutch (crutch palsy). Crutches should NOT be
thrust high into the axilla
• Spiral groove:
• Fracture of the shaft of the humerus.
• Improper IM injection.
• Improper positioning of the arm on the operating
table.
• Posterior interosseous nerve in fractures of the
proximal end of the radius
Dr.AkramJaffar
Radial nerve injury
• Wrist drop results from paralysis of the extensors of the
wrist
• Inability to extend the fingers at the metacarpophalangeal
joints.
• Interphalangeal joints can still be extended by the intrinsic
muscles.
• Muscle wasting.
• Loss of skin sensation over the back of the arm, forearm,
and dorsum of the hand.
Extensor muscle wastingInability to extend metacarpophalangeal joint
but interphalangeal joints can be extended
Wrist drop
Sensory loss

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Applied anatomy radial nerve injury

  • 1. Dr.AkramJaffar Applied Anatomy of Nerve Injuries in the Upper LimbApplied Anatomy of Nerve Injuries in the Upper Limb Radial nerveRadial nerve Akram Jaffar, Ph.D. Subscribe to Human Anatomy Education Channel https://www.youtube.com/user/akramjfr Human Anatomy Education platforms by Akram Jaffar Follow @AkramJaffar Like Human Anatomy Education Page https://www.facebook.com/AnatomyEducation
  • 2. Dr.AkramJaffar References and suggested reading • Ellis H (2006): Clinical anatomy, A revision and applied anatomy for clinical students. 11th Ed. Blackwell Publishing. Massachusetts • Moore KL & Dalley AF (2006): Clinically oriented anatomy. 5th ed. Lippincott Williams & Wilkins. Baltimore • Brust JCM (2007): Current Diagnosis & Treatment in Neurology. 2nd ed. McGraw-Hill Professional.
  • 3. Dr.AkramJaffar Objectives After completion of this session, students should be able to discuss, identify, and describe: – The anatomical factors predisposing to nerve injuries. – The anatomy of deformity, weakness and sensory loss following the nerve injury. – The applied anatomy of clinical examination for specific nerves. – Surgical anatomy of treating nerve injuries.
  • 4. Dr.AkramJaffar Radial nerve • Arises from the posterior cord of the brachial plexus • Is the nerve of the extensor compartments of the upper limb • Gives its branches some distance to the part to be innervated • Branches in the axilla – Motor: triceps – Sensory: posterior cutaneous of arm • Branches in the spiral groove – Motor: Triceps – Sensory: lower lateral cutaneous n. of arm and posterior cutaneous n. of forearm • Testing: Resisted extension at the elbow at 90o . Radial n. Testing triceps: resisted extension at the elbow
  • 5. Dr.AkramJaffar Radial nerve • Branches at the elbow: • Motor: Supplies ALL the muscles in the extensor compartment of the forearm. • Sensory : superficial branch to dorsum of the hand. • Testing • Extension of the wrist against resistance Testing extensors of forearm Superficial br. Post. Interosseous n.
  • 6. Dr.AkramJaffar Radial nerve injury • Common sites of injury • Axilla: pressure of the upper end of a badly fitting crutch (crutch palsy). Crutches should NOT be thrust high into the axilla • Spiral groove: • Fracture of the shaft of the humerus. • Improper IM injection. • Improper positioning of the arm on the operating table. • Posterior interosseous nerve in fractures of the proximal end of the radius
  • 7. Dr.AkramJaffar Radial nerve injury • Wrist drop results from paralysis of the extensors of the wrist • Inability to extend the fingers at the metacarpophalangeal joints. • Interphalangeal joints can still be extended by the intrinsic muscles. • Muscle wasting. • Loss of skin sensation over the back of the arm, forearm, and dorsum of the hand. Extensor muscle wastingInability to extend metacarpophalangeal joint but interphalangeal joints can be extended Wrist drop Sensory loss