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NERVES OF UPPER LIMB                                                     -KESHAVA PAVAN K


  NERVE     ROOT      ORIGIN           COURSE AND BRANCHES             SENSORY         MOTOR              CLINICAL
            VALUE                                                      INNERVATION     INNERVATION        ASPECTS
AXILLARY    C5 AND   POSTERIOR   -PASSES THROUGH QUADRANGULAR          -SHOULDER       -DELTOID           -REGIMENTAL
            C6       CORD OF     SPACE                                 JOINT           -TERES MINOR       BADGE
NERVE
                     BRACHIAL    -RUNS AROUND SURGICAL NECK OF         -SKIN OVER                         ANASTHESIA
                     PLEXUS      HUMERUS                               LOWER LATERAL                      -WASTING OF
                                 -GIVES A BRANCH TO SHOULDER JOINT,    PART OF                            DELTOID
                                 THEN DIVIDES TO ANTERIOR &            SHOULDER                           -IMPAIRED
                                 POSTERIOR BRANCHES                                                       ABDUCTION OF
                                 -ANTERIOR BRANCH CONTINUES AS                                            SHOULDER
                                 UPPER LATERAL CUTANEOUS NERVE OF                                         -ALL THESE
                                 ARM                                                                      OCCUR DURING
                                                                                                          INFERIOR
                                                                                                          DISLOCATION OF
                                                                                                          HEAD OF
                                                                                                          HUMERUS FROM
                                                                                                          SHOULDER AND
                                                                                                          FRACTURE OF
                                                                                                          SURGICAL NECK
                                                                                                          OF HUMERUS
MUSCULO-    C5, C6   LATERAL     -PIERCES CORACO BRACHIALIS            -SKIN OF        -CORACO
            AND C7   CORD OF     -PASSES BETWEEN BICEPS & BRACHIALIS   LATERAL PART    BRACHIALIS
CUTANEOUS
                     BRACHIAL    -MUSCULAR BRANCHES TO MUSCLES OF      OF FOREARM      -BICEPS BRACHII
NERVE                PLEXUS      ANTERIOR FOREARM                                      -BRACHIALIS
                                 -LATERAL CUTANEOUS NERVE OF
                                 FOREARM
                                 -ARTICULAR BRANCH TO ELBOW
RADIAL   C5 TO   POSTERIOR   -IN AXILLA 3 BRANCHES: POSTERIOR     -SKIN ON BACK &   -TRICEPS          -INJURY TO
         T1      CORD OF     CUTANEOUS NERVE OF ARM, NERVES TO    LATERAL           -ANCONEUS         RADIAL NERVE
NERVE
                 BRACHIAL    LONG & MEDIAL HEADS OF TRICEPS       SURFACE OF ARM    -SMALL PART OF    RESULTS MAINLY
                             -ENTERS ARM AT LOWER BORDER OF       UPTO ELBOW        BRACHIALIS &      IN ‘WRIST DROP’
                 PLEXUS
                             TERES MAJOR                          -SKIN DOWN THE    BRACHIORADIALIS   -‘SATURDAY
                             -PASSES THROUGH LOWER TRIANGULAR     MIDDLE OF BACK    -ECRL & ECRB      NIGHT PARALYSIS’
                             SPACE & REACHES SPIRAL GROOVE        OF FOREARM        -SUPINATOR        -RADIAL TUNNEL
                             -IN SPIRAL GROOVE, 5 BRANCHES:       UPTO WRIST        -ALL EXTENSOR     SYNDROME
                             LOWER LATERAL CUTANEOUS NERVE OF     -SKIN OVER        MUSCLES OF        -INJURY TO DEEP
                             ARM, POSTERIOR CUTANEOUS NERVE OF    LATERAL PART      FOREARM           BRANCH
                             FOREARM, NERVES TO LATERAL &         OF DORSUM OF
                             MEDIAL HEADS OF TRICEPS AND TO       HAND & DORSAL
                             ANCONEUS                             SURFACES OF
                             -AT LOWER END OF SPIRAL GROOVE,      LATERAL 3 AND
                             PIERCES LATERAL MUSCULAR SEPTUM      HALF DIGITS
                             OF ARM & ENTERS ANTERIOR             PROXIMAL TO
                             COMPARTMENT OF ARM WHERE IT GIVES    NAIL BEDS.
                             3 BRANCHES (ABOVE LATERAL
                             EPICONDYLE): NERVES TO BRACHIALIS,
                             BRACHIORADIALIS & ECRL
                             -ENTERS CUBITAL FOSSA
                             -DEEP BRANCH (POSTERIOR
                             INTEROSSEUS NERVE) PIERCES
                             SUPINATOR & ENTERS EXTENSOR
                             COMPARTMENT OF FOREARM
                             -SUPERFICIAL BRANCH IN ANTERIOR
                             COMPARTMENT PASSES THROUGH
                             TENDON OF BRACHIORADIALIS INTO
                             POSTERIOR COMPARTMENT, PROXIMAL
                             TO RADIAL STYLOID PROCESS
                             -CONTENT OF ANATOMICAL SNUFF BOX,
                             THEN GIVING CUTANEOUS BRANCHES.
MEDIAN       C5 TO   -LATERAL    -ENTERS ARM AT LOWER BORDER OF        -SKIN OF          -FPL, LATERAL    -INJURY AT ELBOW
             T1      ROOT FROM   TERES MAJOR                           PALMAR ASPECT     HALF OF FDP &    RESULTS IN
NERVE                                                                                                     SYMPTOMS LIKE APE
                     LATERAL     -IN ARM, CROSSES IN FRONT OF          OF LATERAL 3      PRONATOR
(LABOROR’S           CORD &      BRACHIAL ARTERY AT MIDHUMERAL         AND HALF DIGITS   QUADRATUS BY
                                                                                                          THUMB DEFORMITY
                                                                                                          & BENEDICTION
NERVE)               MEDIAL      LEVEL                                 INCLUDING NAIL    A.I.N.
                                                                                                          ATTITUDE
                     ROOT FROM   -ENTERS CUBITAL FOSSA                 BEDS & SKIN ON    -3 THENAR        -INJURY AT
                     MEDIAL      -IN CUBITAL FOSSA, COVERED BY         DORSAL ASPECT     MUSCLES AND      FOREARM LEADS TO
                     CORD        BICIPETAL APONEUROSIS SEPARATING IT   OF DISTAL         FIRST 2          POINTING INDEX
                                 FROM MEDIAN CUBITAL VEIN              PHALANGES         LUMBRICALS       FINGER
                                 -GIVES MUSCULAR BRANCHES IN                             -PRONATOR        -CARPAL TUNNEL
                                 CUBITAL FOSSA                                           TERES,           SYNDROME :
                                                                                                          COMPRESSION OF
                                 -LEAVES CUBITAL FOSSA BY PASSING                        FCR,PALMARIS
                                                                                                          MEDIAN NERVE IN
                                 THROUGH 2 HEADS OF PRONATOR                             LONGUS & FDS
                                                                                                          THE CARPAL
                                 TERES & GIVES OFF THE BRANCH-                           -WRIST &
                                                                                                          TUNNEL
                                 ANTERIOR INTEROSSEOUS NERVE                             INFERIOR RADIO   -TESTS USED TO
                                 -IN FOREARM PASSES BETWEEN FDS &                        ULNAR JOINT      DETECT ARE TINEL’S
                                 FDP                                                                      SIGN, PHALEN’S TEST
                                 -MUSCULAR BRANCH IN MIDARM
                                 -ARTICULAR BRANCHES TO ELBOW &
                                 PROXIMAL RADIO ULNAR JOINT
                                 -PALMAR CUTANEOUS BRANCH PASSES
                                 SUPERFICIAL TO FLEXOR RETINACULUM
                                 -PASSES THROUGH CARPAL TUNNEL
                                 -IN PALM, DIVIDES INTO LATERAL &
                                 MEDIAL DIVISIONS. LATERAL DIVISION
                                 GIVES RECURRENT BRANCH & MEDIAL
                                 DIVISION GIVES 2 PALMAR DIGITAL
                                 NERVES.
ULNAR         C7, C8 &   -MEDIAL    -IN AXILLA, LIES BETWEEN AXILLARY      -SKIN OVER        -FCU & MEDIAL     -INJURY AT
              T1         CORD OF    ARTERY & VEIN                          HYPOTHENAR        HALF OF FDP       ELBOW LEADS TO
NERVE
                         BRACHIAL   -AT THE LEVEL OF INSERTION OF          EMINENCE          -ALL INTRINSIC    CUBITAL TUNNEL
(MUSICIAN’S              PLEXUS &   CORACO BRACHIALIS, IT PIERCES MEDIAL   -SKIN OVER        MUSCLES OF HAND   SYNDROME,
NERVE)                   VENTRAL    INTERMUSCULAR SEPTUM & ENTERS          MEDIAL THIRD OF   EXCEPT THE 5      VALGUS
                         RAMUS OF   POSTERIOR COMPARTMENT OF ARM           DORSUM OF         MUSCLES           DEFORMITY OF
                         C7         -RUNS DOWNWARDS TO BACK OF             HAND & MEDIAL     SUPPLIED BY       ELBOW
                                    MEDIAL EPICONDYLE OF HUMERUS           1 AND HALF        MEDIAN NERVE      -INJURY AT WRIST
                                    -PASSES THROUGH FLOOR OF CUBITAL       FINGERS                             OCCURS AT
                                    TUNNEL                                 -SKIN ON                            GUYON’S CANAL
                                    -ENTERS FOREARM BY PASSING             PALMAR                              LEADING TO
                                    BETWEEN 2 HEADS OF FCU                 SURFACE OF                          ULNAR PARADOX
                                    -IN LOWER TWO THIRD OF FOREARM,        MEDIAL 1 AND                        -MAIN SYMPTOM
                                    BECOMES SUPERFICIAL & RUNS             HALF FINGERS                        OF ANY INJURY TO
                                    TOGETHER WITH ULNAR ARTERY ON ITS                                          ULNAR NERVE IS
                                    MEDIAL SIDE                                                                CLAW HAND
                                    -BRANCHES AT FOREARM: MUSCULAR                                             DEFORMITY
                                    BRANCHES TO FCU, FDP; PALMAR                                               -POSITIVE
                                    CUTANEOUS BRANCH & DORSAL                                                  FORMENT’S SIGN
                                    CUTANEOUS BRANCH
                                    -ENTERS PALM BY PASSING THROUGH
                                    ULNAR TUNNEL, SUPERFICIAL TO FLEXOR
                                    RETINACULUM
                                    -SUPERFICIAL & DEEP TERMINAL
                                    BRANCHES
                                    -DEEP TERMINAL BRANCH ENTERS
                                    GUYON’S CANAL & ENDS IN ADDUCTOR
                                    POLLICIS

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Nerves of upper limb

  • 1. NERVES OF UPPER LIMB -KESHAVA PAVAN K NERVE ROOT ORIGIN COURSE AND BRANCHES SENSORY MOTOR CLINICAL VALUE INNERVATION INNERVATION ASPECTS AXILLARY C5 AND POSTERIOR -PASSES THROUGH QUADRANGULAR -SHOULDER -DELTOID -REGIMENTAL C6 CORD OF SPACE JOINT -TERES MINOR BADGE NERVE BRACHIAL -RUNS AROUND SURGICAL NECK OF -SKIN OVER ANASTHESIA PLEXUS HUMERUS LOWER LATERAL -WASTING OF -GIVES A BRANCH TO SHOULDER JOINT, PART OF DELTOID THEN DIVIDES TO ANTERIOR & SHOULDER -IMPAIRED POSTERIOR BRANCHES ABDUCTION OF -ANTERIOR BRANCH CONTINUES AS SHOULDER UPPER LATERAL CUTANEOUS NERVE OF -ALL THESE ARM OCCUR DURING INFERIOR DISLOCATION OF HEAD OF HUMERUS FROM SHOULDER AND FRACTURE OF SURGICAL NECK OF HUMERUS MUSCULO- C5, C6 LATERAL -PIERCES CORACO BRACHIALIS -SKIN OF -CORACO AND C7 CORD OF -PASSES BETWEEN BICEPS & BRACHIALIS LATERAL PART BRACHIALIS CUTANEOUS BRACHIAL -MUSCULAR BRANCHES TO MUSCLES OF OF FOREARM -BICEPS BRACHII NERVE PLEXUS ANTERIOR FOREARM -BRACHIALIS -LATERAL CUTANEOUS NERVE OF FOREARM -ARTICULAR BRANCH TO ELBOW
  • 2. RADIAL C5 TO POSTERIOR -IN AXILLA 3 BRANCHES: POSTERIOR -SKIN ON BACK & -TRICEPS -INJURY TO T1 CORD OF CUTANEOUS NERVE OF ARM, NERVES TO LATERAL -ANCONEUS RADIAL NERVE NERVE BRACHIAL LONG & MEDIAL HEADS OF TRICEPS SURFACE OF ARM -SMALL PART OF RESULTS MAINLY -ENTERS ARM AT LOWER BORDER OF UPTO ELBOW BRACHIALIS & IN ‘WRIST DROP’ PLEXUS TERES MAJOR -SKIN DOWN THE BRACHIORADIALIS -‘SATURDAY -PASSES THROUGH LOWER TRIANGULAR MIDDLE OF BACK -ECRL & ECRB NIGHT PARALYSIS’ SPACE & REACHES SPIRAL GROOVE OF FOREARM -SUPINATOR -RADIAL TUNNEL -IN SPIRAL GROOVE, 5 BRANCHES: UPTO WRIST -ALL EXTENSOR SYNDROME LOWER LATERAL CUTANEOUS NERVE OF -SKIN OVER MUSCLES OF -INJURY TO DEEP ARM, POSTERIOR CUTANEOUS NERVE OF LATERAL PART FOREARM BRANCH FOREARM, NERVES TO LATERAL & OF DORSUM OF MEDIAL HEADS OF TRICEPS AND TO HAND & DORSAL ANCONEUS SURFACES OF -AT LOWER END OF SPIRAL GROOVE, LATERAL 3 AND PIERCES LATERAL MUSCULAR SEPTUM HALF DIGITS OF ARM & ENTERS ANTERIOR PROXIMAL TO COMPARTMENT OF ARM WHERE IT GIVES NAIL BEDS. 3 BRANCHES (ABOVE LATERAL EPICONDYLE): NERVES TO BRACHIALIS, BRACHIORADIALIS & ECRL -ENTERS CUBITAL FOSSA -DEEP BRANCH (POSTERIOR INTEROSSEUS NERVE) PIERCES SUPINATOR & ENTERS EXTENSOR COMPARTMENT OF FOREARM -SUPERFICIAL BRANCH IN ANTERIOR COMPARTMENT PASSES THROUGH TENDON OF BRACHIORADIALIS INTO POSTERIOR COMPARTMENT, PROXIMAL TO RADIAL STYLOID PROCESS -CONTENT OF ANATOMICAL SNUFF BOX, THEN GIVING CUTANEOUS BRANCHES.
  • 3. MEDIAN C5 TO -LATERAL -ENTERS ARM AT LOWER BORDER OF -SKIN OF -FPL, LATERAL -INJURY AT ELBOW T1 ROOT FROM TERES MAJOR PALMAR ASPECT HALF OF FDP & RESULTS IN NERVE SYMPTOMS LIKE APE LATERAL -IN ARM, CROSSES IN FRONT OF OF LATERAL 3 PRONATOR (LABOROR’S CORD & BRACHIAL ARTERY AT MIDHUMERAL AND HALF DIGITS QUADRATUS BY THUMB DEFORMITY & BENEDICTION NERVE) MEDIAL LEVEL INCLUDING NAIL A.I.N. ATTITUDE ROOT FROM -ENTERS CUBITAL FOSSA BEDS & SKIN ON -3 THENAR -INJURY AT MEDIAL -IN CUBITAL FOSSA, COVERED BY DORSAL ASPECT MUSCLES AND FOREARM LEADS TO CORD BICIPETAL APONEUROSIS SEPARATING IT OF DISTAL FIRST 2 POINTING INDEX FROM MEDIAN CUBITAL VEIN PHALANGES LUMBRICALS FINGER -GIVES MUSCULAR BRANCHES IN -PRONATOR -CARPAL TUNNEL CUBITAL FOSSA TERES, SYNDROME : COMPRESSION OF -LEAVES CUBITAL FOSSA BY PASSING FCR,PALMARIS MEDIAN NERVE IN THROUGH 2 HEADS OF PRONATOR LONGUS & FDS THE CARPAL TERES & GIVES OFF THE BRANCH- -WRIST & TUNNEL ANTERIOR INTEROSSEOUS NERVE INFERIOR RADIO -TESTS USED TO -IN FOREARM PASSES BETWEEN FDS & ULNAR JOINT DETECT ARE TINEL’S FDP SIGN, PHALEN’S TEST -MUSCULAR BRANCH IN MIDARM -ARTICULAR BRANCHES TO ELBOW & PROXIMAL RADIO ULNAR JOINT -PALMAR CUTANEOUS BRANCH PASSES SUPERFICIAL TO FLEXOR RETINACULUM -PASSES THROUGH CARPAL TUNNEL -IN PALM, DIVIDES INTO LATERAL & MEDIAL DIVISIONS. LATERAL DIVISION GIVES RECURRENT BRANCH & MEDIAL DIVISION GIVES 2 PALMAR DIGITAL NERVES.
  • 4. ULNAR C7, C8 & -MEDIAL -IN AXILLA, LIES BETWEEN AXILLARY -SKIN OVER -FCU & MEDIAL -INJURY AT T1 CORD OF ARTERY & VEIN HYPOTHENAR HALF OF FDP ELBOW LEADS TO NERVE BRACHIAL -AT THE LEVEL OF INSERTION OF EMINENCE -ALL INTRINSIC CUBITAL TUNNEL (MUSICIAN’S PLEXUS & CORACO BRACHIALIS, IT PIERCES MEDIAL -SKIN OVER MUSCLES OF HAND SYNDROME, NERVE) VENTRAL INTERMUSCULAR SEPTUM & ENTERS MEDIAL THIRD OF EXCEPT THE 5 VALGUS RAMUS OF POSTERIOR COMPARTMENT OF ARM DORSUM OF MUSCLES DEFORMITY OF C7 -RUNS DOWNWARDS TO BACK OF HAND & MEDIAL SUPPLIED BY ELBOW MEDIAL EPICONDYLE OF HUMERUS 1 AND HALF MEDIAN NERVE -INJURY AT WRIST -PASSES THROUGH FLOOR OF CUBITAL FINGERS OCCURS AT TUNNEL -SKIN ON GUYON’S CANAL -ENTERS FOREARM BY PASSING PALMAR LEADING TO BETWEEN 2 HEADS OF FCU SURFACE OF ULNAR PARADOX -IN LOWER TWO THIRD OF FOREARM, MEDIAL 1 AND -MAIN SYMPTOM BECOMES SUPERFICIAL & RUNS HALF FINGERS OF ANY INJURY TO TOGETHER WITH ULNAR ARTERY ON ITS ULNAR NERVE IS MEDIAL SIDE CLAW HAND -BRANCHES AT FOREARM: MUSCULAR DEFORMITY BRANCHES TO FCU, FDP; PALMAR -POSITIVE CUTANEOUS BRANCH & DORSAL FORMENT’S SIGN CUTANEOUS BRANCH -ENTERS PALM BY PASSING THROUGH ULNAR TUNNEL, SUPERFICIAL TO FLEXOR RETINACULUM -SUPERFICIAL & DEEP TERMINAL BRANCHES -DEEP TERMINAL BRANCH ENTERS GUYON’S CANAL & ENDS IN ADDUCTOR POLLICIS