upper and lower limb nerves

7/27/2019 Upper and Lower Limb Nerves

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Nerve Origin Branches /

Terminus

Path / Relationships Motor

Innervation Cutaneous

Innervation Injury

Dorsal Scapular Nerve

Brachial Plexus:C5 Root

Long Thoracic Nerve

Brachial Plexus:C5-7 Roots

Runs along SerratusAnterior. You gotta

watch it during amastectomy

RhomboideusMajor and

Minor, andSerratus

Anterior muscles

WINGEDSCAPULA: No

innervation to themuscles holding

down the scapula

Lateral Pectoral Nerve

Brachial Plexus:Lateral Cord

Pectoralis Major and Minor

muscles

MammaryGlands

MedialAntebrachial

Cutaneous

Brachial Plexus:Medial Cord Anteromedialforearm

Thoracodorsal

Nerve

Brachial Plexus:

Posterior Cord

Latissimus

Dorsi muscle

Radial Nerve Brachial Plexus:Posterior Cord

(C5-C8, T1)

Posterior Brachial and

AntebrachialCutaneous

Nerves; Deep

Branch;Superficial

Branch

Radial groove of mid-humerus; deep to

Triangular Interval; inthe Anatomical

Snuffbox; Gives off

posterior brachial andantebrachial cutaneous

nerves

POSTERIOR ARM,

POSTERIOR FOREARM

Posterior armand forearm;

dorsal aspect of hand, except

(1) the last two

digits and (2)the fingertips.

Central dorsal

forearm.

WRIST-DROP: No extensors

Axillary Nerve Brachial Plexus:

Posterior Cord

(C5, C6)

Surgical neck of

humerus; it goes

through theQuadrangular Space

Shoulder DUCHENNE-ERB

PARALYSIS:

Drooping shoulder with hand in

"Waiter's Tip" position




Terminus



Innervation Injury

Subclavius Nerve Brachial Plexus:Superior Trunk

Given off at ERB'SPOINT (C5-C6 union)

in the Upper BrachialTrunk

SubclaviusMuscle

Upper BrachialPlexus Injury,

resulting inDuchenne-Urb

Paralysis

Suprascapular

Nerve

Brachial Plexus:

Superior Trunk

Given off at ERB'S

POINT (C5-C6 union)in the Upper Brachial

Trunk

Supraspinatus,

Infraspinatusmuscles

Damaged by

Upper BrachialPlexus Injury,

resulting in

Duchenne-UrbParalysis

Musculocutaneous

Nerve

Brachial Plexus:

Lateral Cord (C5-C7)

Lateral

AntebrachialCutaneous

Nerve

It pierces the

CoracobrachialisMuscle

ANTERIOR

ARM

Anterolateral

forearm

Median Nerve Brachial Plexus:

Lateral / MedialCords (C6-T1, C5)

Palmar

Branch;Common and

Proper

Digitals (1stthru 3rd);

Anterior Interosseus

Nerve

Between the

Flex.Dig.Superficialisand Profundus muscles;

goes through carpal

tunnel

ANTERIOR

FOREARM,EXCEPT Flexor

Carpi Ulnaris

and lateral half of Flexor

digitorum profundus;

Thenar Muscles

Lateral 2/3 of

palm (1st thru3rd digits);

dorsal

fingertips of 1stthru 3rd digits;

parts of anterior

forearm

Can contribute to

Klumpke'sParalysis; no

opposition of

thumb; nosensation on palm

of hand;Supracondylar

Syndrome




Terminus



Innervation Injury

Ulnar Nerve Brachial Plexus:Medial Cord (C8-

T1, C7)

Deep andSuperficial

Branches

It passes throughGuyon's Tunnel,

superficial to CarpalTunnel; "Funny Bone"

between medialepicondyle and

olecranon; Divides intodeep and superficial

branches

The Flexor Carpi Ulnaris

and medial half of the Flexor

DigitorumProfundus

Medial 1/3 of hand, both

dorsal and palmar

KLUMPKE'SPARALYSIS /

CLAW-HAND: No intrinsic hand

muscles =overflexion

distally andoverextension

proximally; loss of cutaneous

sensation

Superficial

Peroneal Nerve

Common Peroneal

Nerve

Crosses the front of the

ankle verysubcutaneously.Traverses very

superficial to the

extensor retinaculum.

LATERAL

LEG

Dorsum of the

foot except firstweb-space;lateral lower

leg

VARUS: Foot

bends inward dueto lost eversion of foot; It is so

superficial that it

can be irritated bytight shoes

Deep Peroneal

Nerve

Common Peroneal

Nerve

Lateral and

Medial

branches todorsum of

foot

Gives lateral and medial

branches to dorsum of

foot

ANTERIOR

LEG

Dorsal web-

space between

1st and 2ndtoes

FOOT DROP:

Cannot raise foot

during a normalgait due to lost

dorsiflexion

Lateral Sural

Cutaneous Nerve

Common Peroneal

Nerve

Lateral upper

leg

Spinal Accessory

Nerve

Cranial Nerve XI Trapezius

Muscle

Saphenous Nerve Femoral Nerve Runs with Saphenous

vein ONLY IN LEG,runs just in front of

medial malleolus

Medial aspect

of the leg andfoot

It would be the

only residualinnervation of the

foot, should you

lost the Sciatic




Terminus



Innervation Injury

Nerve

Lateral Femoral

Cutaneous

Lumbar Plexus

(L2-4)

Travels under Inguinal

Ligament at its laterallimit, creating potentialfor entrapment

Lateral thigh

Obturator Nerve Lumbar Plexus(L2-4)

Through obturator foramen, above, below,

or through Piriformis

MEDIALTHIGH

Medial thigh,right above the

knee

GLUTEAL GAIT: No ADDUCTION

of the thigh

Femoral Nerve Lumbar Plexus

(L2-4)

Saphenous

Nerve;Anterior

cutaneous branches

Travels between

Inguinal Ligament andPsoas Muscle, creating

potential for entrapment

ANTERIOR

THIGH

Anteromedial

thigh, Medialaspect of the

leg and foot

Common and

Proper Digital Nerves

Median Nerve Lateral 3

fingers of palmar hand;

lateral 3 dorsal

fingertips

Anterior Interosseus Nerve

Median Nerve Parts of theAnterior

Forearm

LateralAntebrachialCutaneous

Musculocutaneous Nerve

Posterior andAnterior branches

Anterolateralforearm

Has anterior and posterior branches

Deep (Motor)

Branch of theRadial

Radial Nerve Posterior

Interosseus Nerve

It becomes the Posterior

Interosseus Nerve

POSTERIOR

FOREARM

SUPINATOR

CHANNELSYNDROME: At

lateral epicondyle,

wrist-drop

Posterior

Interosseus Nerve

Radial Nerve It pierces the Supinator

muscle to innervate the

POSTERIOR

FOREARM




Terminus



Innervation Injury

forearm; travels betweenthe superficial and deep

muscles in posterior forearm

Superficial

(Cutaneous)

Branch of theRadial

Radial Nerve (T1) Dorsal Digital

Nerves

Travels deep to the

Brachioradialis

Dorsal Hand:

1st three digits,

EXCEPTfingertips

Gives off Dorsal

Digital Nerves to

the lateral threedigits

Posterior Femoral

Cutaneous

Sacral Plexus (L4-

5,S1-S3)

Posterior thigh

Superior Gluteal

Nerve

Sacral Plexus (L4-

5,S1-S3)

It travels superior to the

Piriformis, then betweenthe Gluteus Minimus

and Medius

Gluteus

Minimus,Gluteus Medius

muscles

GLUTEAL GAIT:

No ABDUCTIONof the thigh

Piriformis Nerve Sacral Plexus (L4-5,S1-S3)

PiriformisMuscle

Sciatic Nerve Sacral Plexus (L4-5,S1-S3)

CommonPeroneal

Nerve; Tibial Nerve

Assoc. with PiriformisMuscle in hip; Joins

femoral nerve atPopliteal Fossa

POSTERIOR THIGH,

Posterior Legand Plantar Foot

via Tibial

Lateral leg anddorsum of foot,

via CommonPeroneal

Inferior Gluteal Nerve

Sacral Plexus (L4-5,S1-S3)

GluteusMaximus

Common Peroneal Nerve

Sciatic Nerve DeepPeroneal

Nerve;Superficial

Peroneal

Nerve;Lateral Sural

Cutaneous Nerve

Travels superficiallyaround the lateral aspect

of the knee (head of thefibula), where it divides.

Anterior Leg,via Deep

Peroneal

Lateral leg anddorsum of foot

FOOT DROP (nodeep peroneal) and

VARUS (nosuperficial

peroneal)




Terminus



Innervation Injury

Tibial Nerve Sciatic Nerve Medial SuralCutaneous

Nerve; Sural Nerve;

Medial andLateral

Plantar Nerves

Passes under the Flexor Retinaculum: TARSAL-

TUNNEL SYNDROME

POSTERIOR LEG; Planter

aspect of thefoot

Plantar Aspectof the foot

CALCANEOUSDEFORMITY:

Can't stand ontiptoes (no

plantarflexion).Also no sensation

to sole of foot.

Medial and Lateral

Planter Nerves

Tibial Nerve Sole of the foot Sole of the foot

Medial SuralCutaneous

Tibial Nerve Posterior Leg below knee

Sural Nerve Tibial Nerve Lateral Dorsal

Cutaneous

Nerve of foot

Pure sensory nerve -- it

is a spare part and does

NOT supply theGastrocs like the Sural

A.

Lateral aspect

of foot;

posterior leg

Medial and LateralPlantar Nerves

Tibial Nerve SOLE OFFOOT

Deep (Motor)

Branch of the

Ulnar

Ulnar Nerve (T1) Dorsal and

Palmar

Interosseimuscles

Superficial

(Cutaneous)

Branch of theUlnar

Ulnar Nerve (T1) Common and

Proper Palmar

Digital (4thand 5th)

Passes through Guyon's

Canal, superficial to

flexor retinaculum;Gives off common and

proper digitals

Palmar

Innervation of

4th and 5thdigits

upper and lower limb nerves

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