The Wrist & Hand Complex - Nerves

What are the three main nerves of the upper limb?

• The Radial nerve

• The Ulnar nerve

• The Median nerve

Where does the Radial nerve exit the spine?

The Radial nerve exits the spine at C5-T1

Where does the Radial nerve go after exiting the spine?

The Radial nerve travels to the Brachial plexus (in the Axilla) after exiting the spine

Where does the Radial nerve go after travelling to the Brachial plexus?

The Radial nerve travels distally down the Humerus within the Radial Groove after travelling to the Brachial plexus

Where does the Radial nerve go after travelling through the Radial Groove?

The Radial nerve travels anteriorly to the Lateral Epicondyle of the Humerus after travelling through the Radial Groove

Where does the Radial nerve go after travelling to the Lateral Epicondyle of the Humerus?

The Radial nerve travels distally along the Radius to the Base of the First Metacarpal, through the ‘anatomical snuff box’ after travelling to the Lateral Epicondyle of the Humerus

Where does the Radial nerve go after travelling to the Base of the First Metacarpal?

The Radial nerve finishes laterally over the dorsal surface of the First, Second and Third Digits after travelling to the Base of the First Metacarpal

What muscles at the wrist & hand complex are innervated by the Radial nerve?

• Supinator

• Extensor Carpi Radialis Longus

• Extensor Carpi Radialis Brevis

• Extensor Carpi Ulnaris

• Extensor Digiti Minimi

• Extensor Digitorum Communis

• Extensor Indicis

Where does the Ulnar nerve exit the spine?

The Ulnar nerve exits the spine at C5-T1 (mainly C8/T1)

Where does the Ulnar nerve go after exiting the spine?

After exiting the spine, the Ulnar nerve travels to the Brachial plexus (in the Axilla)

Where does the Ulnar nerve go after travelling to the Brachial plexus?

After travelling to the Brachial plexus, the Ulnar nerve travels distally along the medial side of the Humerus to the elbow

Where does the Ulnar nerve go after travelling to the elbow?

After travelling to the elbow, the Ulnar nerve travels distally between the Medial Epicondyle of the Humerus and the Olecranon of the Ulna

Where does the Ulnar nerve go after travelling between the Medial Epicondyle and Olecranon?

After travelling between the Medial Epicondyle and the Olecranon, the Ulnar nerve travels distally along the Ulna to the wrist and passes between Pisiform and Hamate (Guyon’s canal)

Where does the Ulnar nerve go after passing through Guyon’s canal?

After passing through Guyon’s canal, the Ulnar nerve finishes on the palmar and dorsal surface of the hand into the Fourth and Fifth Digits.

What muscles of the wrist & hand complex are innervated by the Ulnar nerve?

• Flexor Carpi Ulnaris

• Flexor Digitorum Superficialis

• Flexor Digitorum Profundus

Where does the Median nerve exit the spine?

The Median nerve exits the spine at C5-T1 (mainly C6-T1)

Where does the Median nerve go after exiting the spine?

After exiting the spine, the Median nerve travels to the Brachial plexus (in the Axilla)

Where does the Median nerve go after travelling to the Brachial plexus?

After travelling to the Brachial plexus, the Median nerve travels distally down the medial side of Biceps Brachii

Where does the Median nerve go after travelling down Biceps Brachii?

After travelling down Biceps Brachii, the Median nerve enters the anterior compartment of the forearm via the cubital fossa

Where does the Median nerve go after the cubital fossa?

After the cubital fossa, the Median nerve travels down the anterior forearm between Flexor Digitorum Profundus and Flexor Digitorum Superficialis

Where does the Median nerve go after passing between the finger flexors?

After passing between the finger flexors, the Median nerve enters the palm of the hand via the carpal tunnel

Where does the Median nerve go after entering the palm of the hand?

After entering the palm of the hand, the Median nerve terminates over the palmar surface of the First, Second, Third and radial side of the Fourth Digits

What muscles of the wrist & hand complex are innervated by the Median nerve?

• Pronator Teres

• Flexor Carpi Radialis