Radial & Ulnar Nerves PDF

C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ Prof. Mujahid Khan ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 C o ll e g e o f M e At the end of the lecture, students should be able to: d Describe the anatomy of the radial & ulnar nerves...

C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ Prof. Mujahid Khan ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 C o ll e g e o f M e At the end of the lecture, students should be able to: d Describe the anatomy of the radial & ulnar nerves ic i regarding: origin, course & distribution n e List the branches of the nerves – ‫ك‬ Describe the causes and manifestations of nerve injury ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Origin: Posterior cord of the brachial plexus in the axilla (the largest branch) Supplies: Loading… All Muscles of the posterior compartment of the arm & the forearm ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  It winds around the back of the arm in the Spiral Groove on the back of the humerus between the heads of the triceps ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the spiral groove the nerve is accompanied by the Profunda Vessels, and it lies directly in contact with the shaft of the humerus (a dangerous position)Loading… ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the Axilla: Cutaneous: Posterior cutaneous nerve of arm Muscular: Long & Medial Heads of Triceps ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the Spiral Groove: Cutaneous: Lower lateral cutaneous nerve of arm Posterior cutaneous nerve of forearm Muscular: Lateral & Medial heads of triceps Anconeus ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the arm It pierces the lateral Intermuscular septum Descends in front of the lateral epicondyle Passes forward into the cubital fossa Divides into Superficial & deep branches ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Close to lateral epicondyle: 1. Muscular to: Brachioradialis Extensor carpi radialis longus, brachialis 2. Articular to the elbow joint ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  It descends under cover of brachioradialis Lateral to radial artery It emerges beneath the brachioradialis tendon ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  It reaches the posterior surface of the wrist, where it divides into terminal branches that supply the skin on the lateral two thirds of the posterior surface of the hand and the posterior surface over the Loading… proximal phalanges of the lateral three and a half fingers The area of skin supplied by the nerve on the dorsum of the hand is variable ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  It winds around the neck of the radius, within the supinator muscle, and enters the posterior compartment of the forearm It supplies : Extensor carpi radialis brevis Extensor carpi ulnaris Supinator Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor indicis ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 dicine – ‫كلية الطب‬ ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the Axilla: In the axilla the nerve can be injured by a drunkard falling asleep with one arm over the back of a chair, also by fractures and dislocations of the proximal end of the humerus. The triceps, the anconeus, and the long extensors of the wrist are paralyzed. The patient is unable to extend the elbow joint, the wrist joint, and the fingers (wrist drop) ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the Spiral Groove: Injury or fracture of the spiral groove of the humerus, the patient is unable to extend the wrist and the fingers (wrist drop) ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  The deep branch of the radial nerve is purely motor nerve (It supplies the extensor muscles in the posterior compartment of the forearm) It can be damaged in fractures of the proximal end of the radius or during dislocation of the radial head ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  The nerve that supply the supinator and the extensor carpi radialis longus will be undamaged, and because the later muscle is powerful, it will keep the wrist joint extended, (No wrist Drop) No sensory loss ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Superficial radial nerve, is Sensory nerve. Injury like a stab wound, results in a variable small area of anesthesia over the dorsum of the hand and lateral three & half fingers up to the base of their distal phalanges ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Origin: Medial cord of BP Course: Descends along the medial side of the following arteries: Axillary Brachial Pierces the Medial Intermuscular Septum Passes behind the medial epicondyle of the humerus ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Enters the anterior compartment Descends: Behind the Flexor Carpi Ulnaris Medial to Ulnar Artery ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Passes: Anterior to Flexor Retinaculum Lateral to Pisiform bone Medial to Ulnar artery Divides into : Superficial & Deep branches ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  In the Forearm: a. Muscular to (1 & 1/2 muscles) 1. Flexor Carpi Ulnaris 2. Medial half of Flexor Digitorum Profundus b. Articular to Elbow joint ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  c. Cutaneous: 1. Dorsal (posterior) cutaneous: Supplies the skin over the back of Medial side of the hand & Medial 1+1/2 fingers 2. Palmar cutaneous: Supplies the skin over the Medial part of the palm ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  Gives: 1. Muscular branches to Palmaris Brevis 2. Cutaneous branches to the skin over the Palmar aspect of the medial 1+ ½ fingers (including nail beds) ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  (A) Muscular branches to: Hypothenar eminence All Interossei (palmar & dorsal) 3rd & 4th lumbricals Adductor pollicis (B) Articular branches to: Carpal joints ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  At the Elbow: Atrophy of ulnar side of forearm Flexion of the wrist with abduction Claw hand Wasting of hypothenar hminence ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0  At the wrist: Claw hand Wasting of hypothenar eminence ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 dicine – ‫كلية الطب‬ Loading… ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 C o ll e g e o Gray's Anatomy for Students, Fourth edition f M e d Snell Clinical Anatomy, Ninth edition ic i n Clinically Oriented Anatomy , Keith L. Moore- Seventh edition e – ‫ك‬ Netter’s Clinical Anatomy, Second edition ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0 ‫كلية الطب – ‪dicine‬‬