No intrinsic hand muscles overflexion distally and overextension proximally. The median nerve is responsible for innervating the muscles involved in the fine precision and pinch function of the hand. Carpal tunnel syndrome median nerve compression, ulnar claw claw hand, median nerve palsy and more in this article, you get an overview of the pathology of the brachial nerves and understand how a hand of benediction or a median claw hand, an ulnar claw and a hand extension loss with the radial nerve paralysis may. It doesnt pass through the carpal tunnel, but it runs superficial to the flexor retinaculum in guyons canal or the ulnar canal to go and supply some muscles within the hand. We looked at the axillary artery, its three divisions and branches, and anastomosis around the scapula. The muscular branches of the musculocutaneous nerve terminate at the elbow, and those of the radial nerve end at the wrist. The movements of the arms must be fast, precise, and strong to complete the. Nerve blocks of the hand and wrist down east emergency medicine. The symptoms of numbness in the hand, pain in the hand, pain in the wrist, pain in the forearm, or weakness particularly in the thumb can be present. Upper extremity anatomy arteries, veins, muscles free.
The muscles of the back that work together to support the spine, help keep the body upright and allow twist and bend in many directions. The ulnar artery is the primary contribution to the superficial palmar arch. The ulnar nerve supplies the remaining intrinsic muscles of the hand. Forearm muscles are divided into two compartment anterior compartment posterior compartment anterior compartment of forearm muscles anterior compartment is split into three categories superficial intermediate deep anterior superficial compartment muscle flexor carpi ulnaris flexor carpi radialis palmaris longus pronator teres anterior intermediate compartment muscle. Anatomy lectures, hand, nerve supply of hand muscles youtube.
Brachial artery breast and anterior upper limb trudy van houten, september 1, 2010 page 23. Harsh sharma descending abdominal aorta branches from diaphragm to iliacs id 6 prostitutes cause sagging swollen red testicles in men living in sin. The ulnar artery gives rise to the common interosseous artery, which divides into anterior and posterior interosseous arteries. Median arises from the medial cord of the brachial plexus c8 and t1, humerusthis nerve passes posterior to the medial epicondyle of the humerus. Pdf anatomy, shoulder and upper limb, hand compartments. Damage to nerves is common and therefore potential damage to the three major nerves that supply the hand should be looked for, ie the radial nerve, the median nerve and the ulnar nerve. Sometimes it is the ulnar nerve, which extends down the arm into the hand, that is affected. The ulnar nerve originates from c8t1 nerve roots which form the medial cord of the brachial plexus. The subclavian artery becomes the axillary artery after crossing the 1st ribthe axillary artery b this website provides over 0 free medical books and more for all students and doctors this website the best choice for medical students during and after learning medicine.
The median nerve is likely the most well known nerve of the brachial plexus because it can be compressed as it crosses the wrist and cause carpal tunnel syndrome. The back of the hand is formally called the dorsum of the hand. In the forearm, the motor branches supply the pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis muscles. The median nerve supplies the flexors of the wrist and digits, the abductors and opponens of the thumb, the first and second lumbrical. Posteriorly they received fibers from the nerves running distally on the back of the hand. This nerve yields sensory cutaneous innervation to a significant portion of the dorsolateral. The purpose of this study was to investigate the effect of nerve supply on the strength of coupling among hand muscles during a static grip task by means of emgemg coherence analysis. The radial nerve provides sensory innervation to the dorsal lateral half of the hand and the dorsal aspect of the thumb. Nerve arises from the posterior cord of the brachial plexus c5 and 6, this nerve passes to the posterior aspect of the arm through the quadrangular space in the company of the posterior circumflex vessels. Influence of nerve supply on hand electromyography coherence. Swelling in any area, dorsal or volar, inhibits flexion extension of the part affected. Nerve supply the muscles of the hand are innervated by the radial, median, and ulnar nerves. Clinical examination a comprehensive collection of clinical examination osce guides that include stepbystep images of key steps, video demonstrations and pdf mark schemes. Nerve and blood supply three principal nerves serve the muscles of the hand fig.
Nerve supply is indicated, except for minor variations and exceptions, in table 3. It descends in the forearm to the wrist where it divides into a lateral and a medial branch to innervate the skin of the thumb and and back of the hand respectively. Summary of the nerve supply of upper extremity youtube. An overview of the anatomy of the hand, including the bones of the hand, muscles, blood supply and nerve supply. The hand is supplied on the palmar aspect by variable anastomoses between branches of the radial and ulnar arteries. The distribution pattern of the muscular branch of median and ulnar nerves and motor innervation of the thenar and hypothenar muscles were studied in 68 palmar regions taken from 34 adult cadavers of both sexes aged 40 to 70 y. Most modern sources distinguish the superior and inferior, but some still include a single lateral brachial cutaneous nerve. The radial nerve innervates the finger extensors and the thumb abductor. Also superior lateral cutaneous nerve of arm inferior lateral cutaneous nerve of arm near blue axillary area, but actually branches from radial nerve. In the forearm, the motor branches supply the pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum. The sources of nerve fibres to a joint conform well to hiltons lawthe nerves to the muscles acting on a joint give branches to that joint as well as to the skin over the area of action of these muscles. A pinched nerve in the hand can be caused by a number of conditions, including arthritis, cysts, diabetes and even carpal tunnel syndrome. Blood supply of the hand overview of arterial supply to.
The ulnar nerve c8t1 supplies all of the intrinsic muscles of the hand, apart from the muscles of the thenar eminence and the radial two lumbricals these muscles are supplied by the median nerve c5t1 the median nerve supplies sensation to the radial 3 and a half fingers on the palmar aspect, as well as the nail beds sensation to the palmar and dorsal side of the. The ulnar nerve course motor sensory teachmeanatomy. Variations in the motor nerve supply of the thenar and. Left gastric artery hepatic artery splenic artery knowledge level 1, system. Ulnar and radial nerves nerve lesion of upper limb lecturio. Inferior lateral cutaneous nerve of arm near blue axillary area, but actually branches from radial nerve. Dec 18, 2015 check the vascular status of the hand by feeling for the radial and ulnar pulses and assessing capillary refill. Intercostobrachial nerve purple medial cutaneous nerve of arm yellow labeled as medial brachial. In contrast, the other two nerves supply the hand muscles. In the hand, we will examine the superficial nerves first. They are responsible for the fine motor functions of the hand. The deep branch of the ulnar nerve supplied all intermetacarpal joints.
It originates from the lateral and medial cords of the brachial plexus c5t1. Bhanu prakash usmle, fmge and neet pg 52,794 views. The ulnar nerve doesnt give branches in the axilla or in the upper arm. The anatomy of hand is the key for individuality of handbased biometrics. How to fix a pinched nerve in the hand healthy living. The internal structure of hand is an assortment of bones, muscles, nerves and veins. In this article, we shall be looking at the anatomy of the intrinsic muscles of the hand. From the posterior cord, the axillary nerve branches backwards under the capsule of the shoulder joint, and winds round the surgical neck of the humerus to supply the whole of the. The important nerves travelling towards the hand from the brachial plexus are the median, ulnar, and radial nerves. Hand anatomy overview bones, blood supply, muscles geeky. The axillary nerve nerve is important in all movements that lift the arm away from the side of the body, since it supplies the deltoid muscle and teres minor. Each of these major nerve trunks diverges into countless smaller branches ending in the papillae of the palmar pads and dorsal skin, and the whole neuromuscular system is.
Mar 15, 20 the median nerve is responsible for innervating the muscles involved in the fine precision and pinch function of the hand. Dorsum of hand skin cutaneous innervation terminal branches of radial nerve dorsal branch ulnar nerve dorsal venous network, arch proximal to mch drain from volar aspect as well pressure of gripping does not impede the. The muscles of the hand are innervated by the radial, median, and ulnar nerves. The best way to learn these, especially the complicated supply to the hand, is literally to draw it on yourselves or on each other. Summary of the nerve supply of upper extremity easy anatomy. Peripheral nerve injury and repair 244 journal of the american academy of orthopaedic surgeons figure 1 crosssectional anatomy of the peripheral nerve. So now lets move to the hand and the blood supply to the hand, which is really formed from the radial and the ulnar artery forming deep and superficial palmar arches, which we can just make out on this diagram here. The ulnar nerve runs down the hand where it passes behind the medial epicondyle of the humerus at the elbow. The uniqueness of the human hand, as compared to the other animals comes from the fact that all the.
The radial nerve provides no motor innervation to the intrinsic muscles of the hand however. Check the vascular status of the hand by feeling for the radial and ulnar pulses and assessing capillary refill. Each nerve fiber is an extension of a neuron whose cell body is held either within the grey matter of the cns or within ganglia of the pns. Deep back muscles superficial back muscles action movements of the shoulder. Innervates the intrinsic muscles of the hand apart from the thenar muscles and two lateral. Carpal tunnel syndrome affects the wrist but the symptoms are usually felt in the finger and hand as well. The ulnar nerve is a major peripheral nerve of the upper limb. Thus, the knee joint is supplied by branches from the femoral, sciatic, and obturator nerves, which among them supply the various muscles moving the joint. An example of a nerve injury that can recur is carpal tunnel syndrome. In this article, we shall look at the anatomy of the ulnar nerve its anatomical course, motor and sensory functions, and its clinical correlations. The superficial branch of the radial nerve branches off the radial nerve above the elbow joint on the lateral side of the arm.
Influence of nerve supply on hand electromyography. An indepth guide to the nerve supply to the upper limb, including tips on identifying. Thus, the knee joint is supplied by branches from the femoral, sciatic, and obturator nerves, which among them supply the various muscles moving the. The radial artery is the primary contribution to the deep palmar arch. The upper extremity ue is comprised of its associated muscles, nerves, and vessels, organized into anatomical compartments. The subclavian artery becomes the axillary artery after crossing the 1st rib the axillary artery becomes the brachial artery after crossing the posterior axillary fold the brachial artery divides just distal to the elbow into the radial and ulnar arteries. Cranial nerve 11, spinal accessory nerve rhomboids spines of c7 and t15 vertebral medial border of scapula retract and medially rotate the scapula dorsal scapular levator scapulae transverse processes of c14 upper part of medial border of scapula elevate scapula, medial rotation of scapula 3rd and 4 th cervical spinal nerves. Brachial artery begins at the distal border of the tendon of teres major ends about 1 cm distal to the elbow joint by dividing into radial and ulnar arteries. These include the adductor pollicis, palmaris brevis, interossei, lumbricals, thenar and hypothenar muscles. Crosses the front of the ankle very subcutaneously. In the hand, the median nerve supplies the thenar eminence the muscles at the base of the thumb with nerves. When referring to the hand, the radial nerve only provides cutaneous innervation along the outside of the thumb.
Anatomy, shoulder and upper limb, hand cutaneous innervation. Median nerve gross anatomy detailed lecture dr bhanu prakash duration. The muscles of the hand thenar hypothenar teachmeanatomy. All muscles of the hand are innervated by the brachial plexus c5t1 and can be classified by innervation. Posterior upper limb trudy van houten, september 1, 2010 page 29. The median, ulnar and radial nerves cutaneous branch only enter the hand. Bones of the hand and wrist hand, musculoskeletal, tutorials, upper limb, wrist by admin december 27, 2011 11 comments. Jul 24, 2016 the axillary nerve nerve is important in all movements that lift the arm away from the side of the body, since it supplies the deltoid muscle and teres minor. Anterior brachial compartment anterior brachial compartment general function. The ulnar nerve passes close behind the medial epicondyle of the humerus, and then it runs again within the anterior compartment of the arm alongside the ulnar artery. So, all the arterial blood to the hand, like i said, is supplied via the radial and ulnar arteries. Phrenic inferior celiac superior mesenteric suprarenal middle renal testicular in men only.
On emerging from the quadrangular space, the axillary nerve winds around the surgical neck of the humerus to supply the teres minor. The workhorse of the peripheral nervous system are the peripheral nerves. Summary of the nerve supply of upper extremity easy. Nerve supply of the upper limb musculoskeletal key. The sensory supply to the upper limb can be broken down into dermatomes the area supplied by each spinal nerve root and peripheral nerve territories. Muscle name origin insertion action innervation muscles of. Coracobrachialis, biceps brachii, brachialis innervation. There are two ways of discussing nerve distribution in wrist and hand of human body. Nov 26, 2017 this video provides an overview of the nerve supply of the upper extremity. The nerves of the arm and hand perform a substantial twofold role. A knowledge of the territories supplied by specific nerves is important clinically in order to solve nerve damage problems. We hypothesized that muscle pairs receiving the same nerve innervation would exhibit a greater level of coupling than a pair of muscles innervated by different. Apr 23, 2020 the workhorse of the peripheral nervous system are the peripheral nerves.
Each nerve consists of a bundle of many nerve fibers axons and their connective tissue coverings. The intrinsic muscles of the hand are located within the hand itself. Hand anatomy overview bones, blood supply, muscles. Jul 16, 2019 the nerves of the arm and hand perform a substantial twofold role. Dec 17, 2018 the upper extremity ue is comprised of its associated muscles, nerves, and vessels, organized into anatomical compartments. It starts giving muscular and cutaneous branches in the.
The anatomy of wrist, thumb and hand is complex because of the presence. Aug 05, 2017 median nerve gross anatomy detailed lecture dr bhanu prakash duration. The nerve supply to a region is usually broken down into a superficial or cutaneous group and a motor group. Forearm muscles are divided into two compartment anterior compartment posterior compartment anterior compartment of forearm muscles anterior compartment is split into three categories superficial intermediate deep anterior superficial compartment muscle flexor carpi ulnaris flexor carpi radialis palmaris longus pronator teres anterior intermediate compartment muscle flexor.
232 156 810 565 381 1066 939 192 276 1651 938 309 1578 1624 1640 508 517 526 1331 40 691 621 1019 778 227 1249 1083 87 30 1220 948 1075 421 117 541 1004 766 20 401 1235 1342 1000 1486