Nerves of the Brachial Plexus

C5 (8 nerves)

1) long thoracic 2) dorsal scapular 3) suprascapular 4) lateral pectoral 5) upper subscapular 6) musculocutaneous 7) axillary 8) radial

C7 (8 nerves)

1) long thoracic 2) lateral pectoral 3) thoracodorsal 4) medial pectoral 5) musculocutaneous 6) radial 7) median 8) ulnar

C6 (10 nerves)

1) long thoracic 2) suprascapular 3) lateral pectoral 4) upper subscapular 5) thoracodorsal 6) lower subscapular 7) musculocutaneous 8) axillary 9) radial 10) median

T1 (6 nerves)

1) medial pectoral 2) brachial cutaneous 3) antebrachial cutaneous 4) radial 5) median 6) ulnar

C8 (7 nerves?)

1) thoracodorsal 2) medial pectoral 3) brachial cutaneous(?) 4) antebrachial cutaneous 5) radial 6) median 7) ulnar

Ulnar nerve C7,8,T1

All intrinsic muscles of hand (except 3 thenar muscles and 2 of 4 lumbricals) Flexor carpi ulnaris ½ FDP Cutaneous to medial half (pinky and ½ of ring finger) of hand both palmer and dorsal sides

Median nerve C6,7,8,T1

All muscles of anterior forearm (except for flexor carpi ulnaris and ½ of FDP) 3 thenar muscles Lumbricals 1 & 2 (index and middle) Cutaneous to thumb & 1st two fingers (palmer side) and lateral ½ of palm

Superficial Radial n

BR, ECRL, and cutaneous to dorsal hand (sensory)

Medial brachial cutaneous nerve T1

Cutaneous to medial arm

Medial antebrachial cutaneous nerve C8,T1

Cutaneous to medial forearm

Deep Radial n

ECRB, supinator

Posterior Interosseous n (Radial n br; 7 muscles)

EDC, EDM, ECU, APL, EPB, EPL, EI

course of Ulnar nerve (hand)

Enters hand w/ ulnar artery through fascial tunnel of Guyon, superficial to transverse carpal ligament, btwn pisiform & hamate, where it splits into Superficial & Deep Ulnar branches. Deep br threads through ODM and pierces AP. Supplies motor to 14 intrinsic hand muscles (PB, the 3 hypothenar muscles, the 7 interossei, AP, and lumbricals 3 & 4) as well as cutan to ulnar 1/2 of hand (dorsal and bottom 1/2 of ventral palm: Palmar Branch) and medial 1.5 fingers (Superficial br of ulnar n).

course of Radial nerve

From Posterior Cord, carries fibers from C5-T1, goes along spiral groove, innervating triceps. Enters forearm anterior to lateral epicondyle btwn brachialis and brachioradialis where it splits. Superficial Radial Nerve: deep to brachioradialis, supplies BR, ECRL, and cutan to dorsal hand (sensory) Deep Radial Nerve: deep to supinator in radial tunnel, supplies ECRB & supinator, then pierces supinator to posterior compartment where it becomes Posterior Interosseous br, supplying the rest of muscles in ext compt

course of Median nerve (forearm)

In Cubital Fossa, multiple motor branches sent to superficial flexor muscles, as well as Anterior Interosseous nerve (br), which supplies deep compartment. Continues through forearm btwn FDS & FDP.

Recurrent Median br of Median n C8

LLOAF, cutaneous to palm, thumb, and 2.5 fingers

Medial pectoral nerve C7,8,T1

Pectoralis major Pectoralis minor

course of Median nerve (hand)

Prior to entering carpal tunnel, gives off a Cutaneous Palmar br, which innervates proximal 1/2 of palm in the median nerve cutaneous region. In the hand, supplies motor to Thenar muscles via Recurrent Median n, lumbricals 1 & 2 (LLOAF), and skin of palm, thumb, and 2.5 fingers.

names of Median nerve branches

Superficial (pronator teres, FCR, PL, FCU) Intermediate (FDS) Anterior Interosseous n (FPL, FDP, PQ) Cutaneous Palmar br (prox 1/2 palm) Recurrent Median br (LLOAF, cutan to palm, thumb, 2.5 fingers)

names of Radial nerve branches

Superficial Radial n Deep Radial n -> Posterior Interosseous br

course of Median nerve (arm)

Two heads originate from Medial & Lateral Cords, carrying fibers from C6-T1. Descends in arm via Medial Intermuscular Septum, posterior to biceps brachii. Enters forearm in Cubital Fossa, medial to brachial artery & posterior to bicipital aponeurosis. Runs deep to FDS.

each branch

both motor and cutaneous (sensory)

Anterior Interosseous n, C8 (Median n br)

deep anterior compartment of forearm (FDP, FPL, pronator quadratus)

Axillary nerve (passes inferiorly and laterally around neck of humerus) C5,6

deltoid teres minor cutaneous to lateral shoulder accompanied by posterior circumflex artery

course of Ulnar nerve (arm & forearm)

from Medial Cord, carrying fibers from C7-T1, descends arm in Medial Intermuscular Septum, but in distal arm continues posteriorly around medial epicondyle (funny bone). Enters forearm btwn two heads of FCU, continuing to wrist deep to FCU.

course of Musculocutaneous nerve

from lateral cord, pierces coracobrachialis, goes between biceps and brachialis where it arise to supply cutaneous to lateral forearm innervates brachialis + all others in flexor compartment of arm, as well as cutaneous distribution on lateral forearm

each cord

has two terminal branches

Musculocutaneous nerve (passes laterally) C5,6,7

innervates anterior compartment of arm: corachobrachialis biceps brachii brachialis cutaneous to lateral forearm

Thoracodorsal nerve C6,7,8

latissimus dorsi

Lateral Pectoral nerve (passes anteriorly) C5,6,7

pectoralis major (clavicular head) pectoralis minor

Radial nerve C5,6,7,8,T1

posterior compartments of arm and forearm cutaneous to posterior arm, forearm, and hand

cutaneous distribution of Radial nerve

posterior lateral arm, posterior forearm, posterior lateral 2/3 of hands

danger points for ulnar n

posterior to medial epicondyle of humerus, tunnel of Guyon

Cutaneous Palmar br of Median n

proximal 1/2 of palm

Dorsal Scapular C4,5

rhomboids major rhomboids minor levator scapulae

Long Thoracic nerve C5,6,7

serratus anterior

danger points for radial n

spiral groove, radial tunnel

Upper Subscapular nerve (short in length) C5,6

subscapularis

Lower Subscapular nerve C6

subscapularis teres major (sidenote* not in Fred's notes, but is in the book)

Suprascapular (travels laterally through neck to posterior scapular region) C5,6

supraspinatus infraspinatus