Nerves of Upper Limb

Learning Outcomes
• General Anatomy of Nervous System
• Formation of spinal nerve
• Brachial plexus
• Nerves of arm and forearm
1. Course
2. Branches
3. Supply
General Anatomy
• Structural classification of nervous system:
1. Central nervous system: consists of brain and spinal
cord
2. Peripheral nervous system: consists of structures that
connect CNS with rest of the body i.e, 12 pairs of cranial
nerves and 31 pairs of spinal nerves and nerve plexuses.
• Functional Classification:
1. Somatic nervous system: It deals with innervation of
somatic tissues of body e.g, skeletal muscles, joints and
bones (voluntary structures).
2. Autonomic nervous system: It deals with innervation of
splanchnic system of body including visceral, vascular,
glandular and cardiac supply.
Structure and types of neuron
Formation of spinal nerve
• The 31 pairs of spinal nerves are grouped as:
1. Cervical 1-8
2. Thoracic 1-12
3. Lumbar 1-5
4. Sacral 1-5
5. Coccygeal 1
Brachial Plexus
• The brachial plexus is a somatic plexus
formed by the anterior rami of C5-8 and T1.
• Location: It originates in neck, passes over
1st rib and enters axilla.
• Parts: from medial to lateral these are;
1. Roots
2. Trunks
3. Divisions
4. Cords
• All major nerves of upper limb originate
from brachial plexus
 Nerves of Arm
• Musculocutaneous nerve: It enters the arm from axilla, passes between
the biceps brachii and brachialis muscle and continues into forearm as
lateral cutaneous nerve of forearm. It supplies:
1. Muscles of anterior compartment of arm
2. Skin of lateral surface of forearm
• Median nerve: In proximal region it is related laterally to brachial artery
while distally it cross brachial artery to lie on its medial side. It has no
major branches in arm.
• Ulnar nerve: It enters arm from axilla with median nerve and axillary
artery. It gives no major branches in arm and leaves to forearm by passing
posterior to medial epicondyle of humerus.
• Radial Nerve: It enter arm from axilla through inferior border of teres
major, accompanies profunda brachii artery and enters posterior
compartment of arm. It gives following branches:
1. Muscular branches to triceps brachii, brachioradialis, extensor carpi
radialis longus
2. Inferior lateral cutaneous nerve of arm
3. Posterior cutaneous nerve of forearm
Nerves of Anterior Compartment of forearm

• Median nerve: In the forearm median nerve lies in the anterior

compartment and leaves by passing through the carpal tunnel into palm
of hand. It gives the following important branches in forearm:
1. Muscular branches to muscles of anterior compartment of forearm
except flexor carpi ulnaris and medial part of flexor digitorum profundus
2. Anterior interosseous nerve supplies muscles of deep layer and distal
radioulnar and wrist joint
3. Palmar branch
• Ulnar nerve: In the forearm it only innervates flexor carpi ulnaris and
medial part of flexor digitorum profundus. It gives following branches:
1. Muscular branches to flexor carpi ulnaris and medial part of flexor
digitorum profundus
2. Palmar branch supplies skin of medial half of palm
3. Dorsal branch supplies skin of posteromedial side of back of hand and
medial and and a half digit.
• Radial nerve: It bifurcates into superficial and deep branches under
margin of brachioradialis muscle.
1. Deep branch supplies muscles of posterior compartment of forearm
2. Superficial nerve innervates skin of posterolateral surface of hand.
Nerves of Posterior
Compartment of
forearm
• Radial nerve: It forms the posterior
interosseous nerve in the lateral wall
of cubital fossa and divides into
superficial and deep branches. It
supplies:
1. Brachioradialis
2. Extensor carpi radialis longus
3. Extensor carpi radialis brevis
4. Suppinator
5. Wrist joint
Cutaneous Innervation
of Upper Limb
• Dermatomes: It is an area of skin
supplied by single spinal nerve root.
• Myotome: A group of muscles
supplied by a single spinal nerve.