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Questions and Answers
The ulnar nerve descends along the triceps to lie on the shaft of the humerus between the medial epicondyle and the coronoid process.
The ulnar nerve descends along the triceps to lie on the shaft of the humerus between the medial epicondyle and the coronoid process.
False (B)
The ulnar nerve supplies the flexor carpi ulnaris via nerve root C7 and the ulnar half of flexor digitorum profundus via C8 and T1.
The ulnar nerve supplies the flexor carpi ulnaris via nerve root C7 and the ulnar half of flexor digitorum profundus via C8 and T1.
True (A)
The palmar branch of the median nerve innervates the skin towards the center of the palm after perforating the flexor retinaculum distally.
The palmar branch of the median nerve innervates the skin towards the center of the palm after perforating the flexor retinaculum distally.
False (B)
The palmar cutaneous branch of the ulnar nerve supplies skin over the thenar muscles.
The palmar cutaneous branch of the ulnar nerve supplies skin over the thenar muscles.
The ulnar nerve's digital branches supply the ulnar one and a half fingers on their palmar surfaces, tips, and their ventral surfaces over the distal one and a half phalanges.
The ulnar nerve's digital branches supply the ulnar one and a half fingers on their palmar surfaces, tips, and their ventral surfaces over the distal one and a half phalanges.
The dorsal cutaneous branch of the ulnar nerve provides sensory innervation to the dorsal skin of two and a half fingers, including the nail beds.
The dorsal cutaneous branch of the ulnar nerve provides sensory innervation to the dorsal skin of two and a half fingers, including the nail beds.
Grey rami communicantes transmit sensory information from the skin arterioles, sweat glands, and arrectores pilorum muscles to the central nervous system for processing.
Grey rami communicantes transmit sensory information from the skin arterioles, sweat glands, and arrectores pilorum muscles to the central nervous system for processing.
The superficial branch of the ulnar nerve supplies the palmaris longus muscle and provides sensory innervation to the ulnar one and a half fingers, including their nail beds.
The superficial branch of the ulnar nerve supplies the palmaris longus muscle and provides sensory innervation to the ulnar one and a half fingers, including their nail beds.
Periarterial sympathectomy is a surgical procedure that denervates an extended segment of the artery to treat distal vascular conditions.
Periarterial sympathectomy is a surgical procedure that denervates an extended segment of the artery to treat distal vascular conditions.
The deep branch of the ulnar nerve passes between abductor and flexor digiti minimi, then between opponens digiti minimi, and supplies all three hypothenar muscles.
The deep branch of the ulnar nerve passes between abductor and flexor digiti minimi, then between opponens digiti minimi, and supplies all three hypothenar muscles.
Preganglionic sympathetic fibers destined for the upper limb originate primarily from cell bodies located in the upper 6 thoracic segments of the spinal cord.
Preganglionic sympathetic fibers destined for the upper limb originate primarily from cell bodies located in the upper 6 thoracic segments of the spinal cord.
The flexor carpi ulnaris and the flexor digitorum superficialis are innervated by the ulnar nerve.
The flexor carpi ulnaris and the flexor digitorum superficialis are innervated by the ulnar nerve.
The lower subscapular nerve (C5, 6) innervates teres major.
The lower subscapular nerve (C5, 6) innervates teres major.
Sympathetic fibers run along the digital arteries to reach an arteriole in a fingertip.
Sympathetic fibers run along the digital arteries to reach an arteriole in a fingertip.
The thoracodorsal nerve is vulnerable during operations on the axillary lymph nodes.
The thoracodorsal nerve is vulnerable during operations on the axillary lymph nodes.
The roots of the brachial plexus are situated in the posterior triangle of the neck.
The roots of the brachial plexus are situated in the posterior triangle of the neck.
The anterior branch of the axillary nerve supplies teres minor and winds around the posterior border of deltoid.
The anterior branch of the axillary nerve supplies teres minor and winds around the posterior border of deltoid.
The posterior cutaneous nerve of the arm (C8, T1) passes back medial to the long head of biceps brachii and supplies a strip of skin along the extensor surface of the arm down to the elbow.
The posterior cutaneous nerve of the arm (C8, T1) passes back medial to the long head of biceps brachii and supplies a strip of skin along the extensor surface of the arm down to the elbow.
In a post-fixed brachial plexus, the plexus originates from the spinal nerve roots C6-T2.
In a post-fixed brachial plexus, the plexus originates from the spinal nerve roots C6-T2.
The long thoracic nerve, which innervates the serratus anterior muscle, originates from nerve roots C5, C6, C7 and runs posterior to the midaxillary line.
The long thoracic nerve, which innervates the serratus anterior muscle, originates from nerve roots C5, C6, C7 and runs posterior to the midaxillary line.
The midcarpal joint, located within the carpus, is characterized by a Z-shaped synovial space that separates the proximal and distal rows of carpal bones.
The midcarpal joint, located within the carpus, is characterized by a Z-shaped synovial space that separates the proximal and distal rows of carpal bones.
The skin covering the shoulder region receives its nerve supply from the supraclavicular nerves, which originate from the cervical plexus.
The skin covering the shoulder region receives its nerve supply from the supraclavicular nerves, which originate from the cervical plexus.
The intercostobrachial nerve, originating from the lateral branch of the second intercostal nerve, consistently innervates the skin of the axillary floor and the medial surface of the arm extensively.
The intercostobrachial nerve, originating from the lateral branch of the second intercostal nerve, consistently innervates the skin of the axillary floor and the medial surface of the arm extensively.
The lateral surface of the arm is innervated by the upper lateral cutaneous nerve, a branch of the radial nerve, and the lower lateral cutaneous nerve, a branch of the axillary nerve.
The lateral surface of the arm is innervated by the upper lateral cutaneous nerve, a branch of the radial nerve, and the lower lateral cutaneous nerve, a branch of the axillary nerve.
The posterior cutaneous nerve of the arm, a branch of the radial nerve, provides sensory innervation to a strip of skin located posteriorly over the biceps brachii muscle.
The posterior cutaneous nerve of the arm, a branch of the radial nerve, provides sensory innervation to a strip of skin located posteriorly over the biceps brachii muscle.
The medial cutaneous nerve of the forearm exclusively supplies the skin of the forearm and does not contribute to the innervation of the arm above the cubital fossa.
The medial cutaneous nerve of the forearm exclusively supplies the skin of the forearm and does not contribute to the innervation of the arm above the cubital fossa.
The medial and lateral cutaneous nerves of the forearm both originate from the medial cord of the brachial plexus and innervate the medial and lateral aspects of the forearm, respectively.
The medial and lateral cutaneous nerves of the forearm both originate from the medial cord of the brachial plexus and innervate the medial and lateral aspects of the forearm, respectively.
The posterior cutaneous nerve of the forearm, a branch of the radial nerve, provides sensory innervation to the posterior aspect of the forearm.
The posterior cutaneous nerve of the forearm, a branch of the radial nerve, provides sensory innervation to the posterior aspect of the forearm.
The lateral pectoral nerve, originating from the lateral cord, exclusively innervates the upper fibers of the pectoralis major muscle.
The lateral pectoral nerve, originating from the lateral cord, exclusively innervates the upper fibers of the pectoralis major muscle.
The musculocutaneous nerve transitions into the lateral cutaneous nerve of the forearm after emerging at the medial border of the biceps tendon.
The musculocutaneous nerve transitions into the lateral cutaneous nerve of the forearm after emerging at the medial border of the biceps tendon.
Both the lateral and medial roots of the median nerve contain nerve fibers originating from spinal nerve roots C5, C6, and C7.
Both the lateral and medial roots of the median nerve contain nerve fibers originating from spinal nerve roots C5, C6, and C7.
The medial pectoral nerve, arising from the medial cord, directly supplies the sternocostal fibers of pectoralis major before innervating pectoralis minor.
The medial pectoral nerve, arising from the medial cord, directly supplies the sternocostal fibers of pectoralis major before innervating pectoralis minor.
The median nerve in the forearm supplies flexor carpi ulnaris and flexor digitorum profundus muscles.
The median nerve in the forearm supplies flexor carpi ulnaris and flexor digitorum profundus muscles.
The palmar cutaneous branch of the median nerve passes through the carpal tunnel to supply sensation to the palm.
The palmar cutaneous branch of the median nerve passes through the carpal tunnel to supply sensation to the palm.
The recurrent branch of the median nerve, originating from the medial branch in the hand, innervates the thenar muscles.
The recurrent branch of the median nerve, originating from the medial branch in the hand, innervates the thenar muscles.
The medial cutaneous nerve of the arm is a large and consistently present nerve that extends to the elbow.
The medial cutaneous nerve of the arm is a large and consistently present nerve that extends to the elbow.
The medial cutaneous nerve of the forearm and the lateral cutaneous nerve of the forearm have overlapping territories of sensory innervation.
The medial cutaneous nerve of the forearm and the lateral cutaneous nerve of the forearm have overlapping territories of sensory innervation.
The ulnar nerve consistently picks up C7 fibers from the medial cord to innervate flexor carpi ulnaris.
The ulnar nerve consistently picks up C7 fibers from the medial cord to innervate flexor carpi ulnaris.
The second branch to the medial head of the triceps brachii muscle, also known as the ulnar collateral nerve, innervates the anconeus muscle after passing deep to the triceps.
The second branch to the medial head of the triceps brachii muscle, also known as the ulnar collateral nerve, innervates the anconeus muscle after passing deep to the triceps.
The lower lateral cutaneous nerve of the arm (C5) emerges from the radial nerve prior to the radial nerve's passage through the lateral intermuscular septum, and it provides sensory innervation to the skin of the lateral arm extending inferiorly to the wrist.
The lower lateral cutaneous nerve of the arm (C5) emerges from the radial nerve prior to the radial nerve's passage through the lateral intermuscular septum, and it provides sensory innervation to the skin of the lateral arm extending inferiorly to the wrist.
In the flexor compartment of the forearm, the radial nerve's main trunk, situated between the brachialis and brachioradialis muscles, gives off a primary motor branch to the brachialis muscle.
In the flexor compartment of the forearm, the radial nerve's main trunk, situated between the brachialis and brachioradialis muscles, gives off a primary motor branch to the brachialis muscle.
The posterior interosseous nerve, after branching off at the elbow, initially provides motor innervation to the extensor carpi radialis longus and supinator muscles within the cubital fossa.
The posterior interosseous nerve, after branching off at the elbow, initially provides motor innervation to the extensor carpi radialis longus and supinator muscles within the cubital fossa.
Within the extensor compartment of the forearm, the posterior interosseous nerve provides motor innervation to a total of ten muscles, including the extensor digitorum, extensor carpi ulnaris, and all three thenar muscles.
Within the extensor compartment of the forearm, the posterior interosseous nerve provides motor innervation to a total of ten muscles, including the extensor digitorum, extensor carpi ulnaris, and all three thenar muscles.
Flashcards
Midcarpal Joint
Midcarpal Joint
An S-shaped joint that creates a continuous synovial space between rows of carpal bones.
Supraclavicular Nerves
Supraclavicular Nerves
Supplies skin over the shoulder.
Intercostobrachial Nerve
Intercostobrachial Nerve
Supplies the floor of the axilla and part of the medial arm.
Upper and Lower Lateral Cutaneous Nerves
Upper and Lower Lateral Cutaneous Nerves
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Posterior Cutaneous Nerve of Arm
Posterior Cutaneous Nerve of Arm
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Medial Cutaneous Nerve of Arm & Intercostobrachial Nerve
Medial Cutaneous Nerve of Arm & Intercostobrachial Nerve
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Posterior Cutaneous Nerve of Forearm
Posterior Cutaneous Nerve of Forearm
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Medial and Lateral Cutaneous Nerves of Forearm
Medial and Lateral Cutaneous Nerves of Forearm
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Lower lateral cutaneous nerve
Lower lateral cutaneous nerve
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Posterior cutaneous nerve of the forearm
Posterior cutaneous nerve of the forearm
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Main trunk of the radial nerve (in forearm)
Main trunk of the radial nerve (in forearm)
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Posterior interosseous nerve
Posterior interosseous nerve
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Muscles supplied by posterior interosseous nerve
Muscles supplied by posterior interosseous nerve
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Musculocutaneous nerve
Musculocutaneous nerve
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Radial nerve
Radial nerve
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Median nerve (forearm)
Median nerve (forearm)
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Ulnar nerve (forearm)
Ulnar nerve (forearm)
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Ulnar nerve (hand)
Ulnar nerve (hand)
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Median nerve (hand)
Median nerve (hand)
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Grey ramus communicans
Grey ramus communicans
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Roots of brachial plexus
Roots of brachial plexus
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Dorsal scapular nerve
Dorsal scapular nerve
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Lateral Pectoral Nerve Function
Lateral Pectoral Nerve Function
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Musculocutaneous Nerve Function
Musculocutaneous Nerve Function
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Lateral Root of Median Nerve
Lateral Root of Median Nerve
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Medial Pectoral Nerve function
Medial Pectoral Nerve function
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Medial Root of Median Nerve
Medial Root of Median Nerve
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Median Nerve Function
Median Nerve Function
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Anterior Interosseous Nerve
Anterior Interosseous Nerve
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Palmar Cutaneous Branch of Median Nerve
Palmar Cutaneous Branch of Median Nerve
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Recurrent Branch of Median Nerve
Recurrent Branch of Median Nerve
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Medial Cutaneous Nerve of Forearm Function
Medial Cutaneous Nerve of Forearm Function
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Ulnar Nerve Forearm Supply
Ulnar Nerve Forearm Supply
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Ulnar Nerve Palmar Cutaneous Branch
Ulnar Nerve Palmar Cutaneous Branch
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Ulnar Nerve Dorsal Cutaneous Branch
Ulnar Nerve Dorsal Cutaneous Branch
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Ulnar Nerve Superficial Branch
Ulnar Nerve Superficial Branch
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Ulnar Nerve Deep Branch
Ulnar Nerve Deep Branch
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Subscapular Nerves
Subscapular Nerves
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Thoracodorsal Nerve
Thoracodorsal Nerve
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Axillary Nerve
Axillary Nerve
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Radial Nerve Function
Radial Nerve Function
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Posterior Cutaneous Nerve of the Arm
Posterior Cutaneous Nerve of the Arm
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Study Notes
Summary of Upper Limb Innervation
Cutaneous Innervation
- The skin over the shoulder is supplied by the supraclavicular nerves (C4) from the cervical plexus.
- The floor of the axilla and a variable area of the medial surface of the arm are supplied by the lateral branch of the second intercostal nerve, the intercostobrachial nerve.
- The lateral surface of the arm is supplied by the upper lateral cutaneous and the lower lateral cutaneous nerves, branches of the axillary and radial nerves respectively.
- A strip of skin posteriorly over the triceps is supplied by the posterior cutaneous nerve of the arm, a branch of the radial nerve.
- The intercostobrachial nerve and the medial cutaneous nerve of the arm supply the medial and anterior surfaces of the arm.
- The medial cutaneous nerve of the forearm supplies some skin of the arm just above the cubital fossa.
- A strip of skin posteriorly in the forearm is supplied by the posterior cutaneous nerve of the forearm, a branch of the radial nerve.
- The medial and lateral sides of the forearm are supplied by the medial and lateral cutaneous nerves of the forearm (from medial cord of the brachial plexus and musculocutaneous nerves respectively).
- The palm of the hand is supplied on the ulnar side by the superficial branches of the ulnar nerve.
- The skin towards the centre of the palm is innervated by the palmar branch of the median nerve.
- The palmar surfaces of the fingers and thumb are supplied by digital branches of the ulnar and median nerves.
- The ulnar digital branches supply the ulnar one and a half fingers on their palmar surfaces, tips, and dorsal surfaces over the distal one and a half phalanges.
- The median nerve supplies the radial three and a half digits on their palmar surfaces, tips, and dorsal surfaces over the distal one and a half phalanges via its digital branches.
- The dorsal surface of the hand is supplied on the ulnar side (one and a half fingers) by the dorsal branch of the ulnar nerve.
- The radial three and a half digits and the web of the thumb are supplied by the terminal cutaneous branches of the radial nerve.
Sympathetic Innervation
- Each dermatome of the upper limb is supplied via the cutaneous nerves by hitch-hiking grey fibres from cell bodies in the appropriate sympathetic ganglion.
- Dermatomes C5 and 6 receive fibres from cell bodies in the middle cervical ganglion.
- Dermatomes C7 and 8 receive fibres from the inferior cervical ganglion and Tl from the first thoracic, or stellate, ganglion.
- In the skin, the grey rami innervate arterioles, sweat glands, and the arrectores pilorum muscles.
- The deep sympathetic supply to the limb is by a series of grey fibers that join the main artery from adjacent nerves, forming a periarterial plexus.
- The preganglionic fibres for the upper limb come mostly from cell bodies in the upper six thoracic segments of the spinal cord.
Muscular Innervation
- In the upper arm, the flexor compartment is supplied by the musculocutaneous nerve and the extensor compartment by the radial nerve.
- The flexor compartment of the forearm is supplied chiefly by the median nerve, except for the flexor carpi ulnaris and half of flexor digitorum profundus, which are supplied by the ulnar nerve.
- The extensor compartment of the forearm is supplied by the radial nerve or its motor branch, the posterior interosseous nerve.
- The intrinsic muscles of the hand are supplied chiefly by the ulnar nerve, with the median nerve supplying only the three muscles of the thenar eminence and the radial two lumbricals.
Brachial Plexus
- The roots of the plexus (anterior rami of C5-T1 nerves) lie between the scalene muscles.
- The trunks are in the posterior triangle.
- The divisions are behind the clavicle.
- The cords are arranged around the second part of the axillary artery.
- About 10% of plexuses are pre-fixed (from C4-C8), and 10% post-fixed (C6-T2).
Branches of the Roots
- C5: Dorsal scapular nerve.
- C5, 6: Nerve to subclavius.
- C5, 6, 7: Long thoracic nerve.
- The dorsal scapular nerve (C5) runs deep to levator scapulae and the two rhomboids, supplying all three muscles.
- The nerve to subclavius (C5, 6) passes over the trunks of the plexus and in front of the subclavian vein.
- The long thoracic nerve (C5, 6, 7) forms on the first digitation of the serratus anterior muscle and runs vertically downwards just behind the midaxillary line.
Branch of the Upper Trunk
- The suprascapular nerve (C5, 6) passes beneath the transverse scapular ligament and supplies supraspinatus, infraspinatus, and the posterior part of the capsule of the shoulder joint.
Branches of the Lateral Cord
- C5, 6, 7: Lateral pectoral nerve.
- C5, 6, 7: Musculocutaneous nerve.
- C5, 6, 7: Lateral root of median nerve.
- The lateral pectoral nerve (C5, 6, 7) passes through the clavipectoral fascia and supplies the upper fibres of pectoralis major.
- The musculocutaneous nerve (C5, 6, 7) supplies coracobrachialis, biceps, and brachialis.
- The lateral root of the median nerve (C5, 6, 7) joins the medial root to form the median nerve.
Branches of the Medial Cord
- C8, T1: Medial pectoral nerve.
- C8, T1: Medial root of median nerve.
- C8, T1: Medial cutaneous nerve of arm.
- C8, T1: Medial cutaneous nerve of forearm.
- C7, 8, T1: Ulnar nerve.
- The medial pectoral nerve (C8, T1) gives a branch to pectoralis minor and then pierces it to supply the lower fibres of pectoralis major.
- The medial root of the median nerve (C8, T1) crosses the axillary artery to join the lateral root and form the median nerve (C5-T1).
- The median nerve (C5, 6, 7, 8, T1) supplies most of the flexor muscles of the forearm, the three thenar muscles, and two lumbricals in the hand.
- The medial cutaneous nerve of the arm (C8, T1) supplies skin medial to the anterior axial line but fails to reach the elbow.
- The medial cutaneous nerve of the forearm (C8, T1) supplies the lower part of the arm above the elbow and then divides into anterior and posterior branches to supply the skin along the ulnar border of the forearm down to the wrist.
- The ulnar nerve (C7, 8, T1) supplies some flexor muscles on the ulnar side of the forearm and the skin of the ulnar one and a half digits.
Branches of the Posterior Cord
- C5, 6: Upper subscapular nerve.
- C6, 7, 8: Thoracodorsal nerve.
- C5, 6: Lower subscapular nerve.
- C5, 6: Axillary nerve.
- C5, 6, 7, 8, T1: Radial nerve.
- The upper and lower subscapular nerves (C5, 6) supply subscapularis, with the lower nerve also innervating teres minor.
- The thoracodorsal nerve (C6, 7, 8) supplies latissimus dorsi.
- The axillary nerve (C5, 6) supplies deltoid, teres minor, the shoulder joint, and skin over the joint.
- The radial nerve (C5, 6, 7, 8, T1) supplies the extensor compartments of the arm and forearm, and skin over them and on the dorsum of the hand.
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Description
The ulnar nerve descends along the triceps to lie on the humerus. The palmar branch of the median nerve innervates the skin of the palm. The ulnar nerve's digital branches supply the ulnar fingers on their palmar and ventral surfaces.