Key facts about the brachial plexus

Roots C5, C6, C7, C8, T1

Trunks Superior trunk

Middle trunk
Inferior trunk

Divisions Three anterior divisions

- Anterior division of superior trunk
- Anterior division of middle trunk
- Anterior division of inferior trunk
Three posterior divisions
- Posterior division of superior trunk
- Posterior division of middle trunk
- Posterior division of inferior trunk

Cords Lateral
Medial
Posterior

Terminal branches Musculocutaneous nerve

Axillary nerve
Radial nerve
Median nerve
Ulnar nerve

Innervation Complete sensory and motor innervation of the arm

Key facts about the ulnar nerve

Origin Brachial plexus (C8-T1)

Branches Muscular branches, articular branches, palmar cutaneous branch, dorsal cutaneous branch, superficial
branch, deep branch

Supply Motor:
- Flexor carpi ulnaris and medial half of flexor digitorum profundus
- Most of the intrinsic hand muscles
Sensory:
- Anterior aspect of the ulnar 1½ fingers (little finger and half of the ring finger) and medial palmar skin
- Dorsal aspect of the ulnar 1½ fingers and medial aspect of dorsum of hand

Mnemonic Ulnar nerve supplies all intrinsic muscles of the hand except the LOAF muscles.
(standing for: Lateral two lumbricals, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis
brevis)

Key facts about the radial nerve

Origin Posterior cord of brachial plexus (C5-T1)

Branches Posterior brachial cutaneous nerve, inferior lateral brachial cutaneous nerve, posterior antebrachial
cutaneous nerve, muscular branches, deep branch of radial nerve, superficial branch of radial nerve

Supply Motor: triceps brachii, anconeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis
brevis, supinator, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis
longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis
Sensory: lower outer aspect and posterior surface of the arm, central and posterior aspect of the forearm,
thenar eminence and dorsal aspect of the radial three and half digits of the hand
Key facts about the median nerve

Origin Brachial plexus (C5-T1)

Branches Muscular branches, anterior interosseus nerve, articular branches, cutaneous nerve of palm, common
palmar digital nerves, reccurent branch

Motor supply - Flexor muscles in the forearm (except flexor carpi ulnaris and the ulnar head of flexor digitorum
profundus)
- Muscles of the thenar eminence
- Radial two lumbricals

Sensory supply The skin of the:

- Palmar and distal dorsal aspects of the lateral three-and-the-half digits and adjacent palm
- Palmar and distal dorsal aspects of the thumb and radial half of 2nd digit
- Palmar and distal dorsal aspects of the adjacent sides of 2nd–4th digits
- Central palm

Key facts about the musculocutaneous nerve

Origin Brachial plexus (C5-C7)

Supply area Coracobrachialis, biceps brachii and brachialis muscles

Clinical relations Brachial plexus injury

Key facts about the axillary nerve

Origin Posterior cord of brachial plexus (C5-C6)

Branches Anterior, posterior, articular branches

Innervation Motor - deltoid muscle, teres minor muscle, lateral head of the triceps brachii muscle
Sensory - glenohumeral joint, skin of the deltoid region/upper arm 

Clinical relations Neuropathy, quadrangular space syndrome

Key facts about the suprascapular nerve

Origin Superior trunk of brachial plexus

Branches Motor muscular branches, sensory articular branches

Supply Motor supply: supraspinatus muscle, infraspinatus muscle

Sensory supply:
glenohumeral
and
acromioclavicular
joints
Key facts about the thoracodorsal nerve

Origin Posterior cord of brachial plexus (C6, C7, C8)

Branches Small terminal muscular branches

Supply Latissimus dorsi muscle

Clinical relations

Brachial plexus injury

Injuries to the brachial plexus affect both motor and sensory functions in the upper limb.
Different injuries, such as inflammation, stretching, and wounds in the lateral cervical region
of the neck or in the axilla may cause brachial plexus injuries, and the manifestations depend
on the part of the plexus that is affected. In any case, injuries to the brachial plexus are
followed by paralysis and anesthesia of the respective supply area of the affected nerves.
Median nerve injury

In case of the median nerve involvement, the injury causes a palsy that results in a hand
deformity called ape hand. It manifests as an inability to abduct the thumb. In addition, it is
accompanied by a loss of sensation in the lateral 3½ fingers.
Ulnar nerve injury

An injury of the ulnar nerve causes a characteristic hand deformity called the claw hand,
which is a result of the paralysis of intrinsic hand muscles innervated by this nerve. The claw
hand deformity is characterized by hyperextended metacarpophalangeal joints, and flexed
interphalangeal joints.
Radial nerve injury

Injuries of the radial nerves result in a wrist drop, due to the paralysis of all the muscles of the
posterior compartment of the forearm that are supplied by the radial nerve.
Mnemonic
 Here is a helpful mnemonic to help you remember the above nerve injuries and associated
hand lesions.

DR. CUMA

 Drop = Radial nerve

 Claw = Ulnar nerve
 Median nerve = Ape (Apostle's) hand