Peripheral Nerve Supply of Upper Limb

Spinal nerve divisions (ventral rami)

Supply anterolateral trunk via intercostal and subcostal nerve, neck and limbs via plexi

Spinal nerve divisions (dorsal rami)

Segmentally supply skin, joints and deep muscles of back - do not form plexi

Ventral rami divisions (anterior division)

Supply flexors, adductors and internal rotators

Ventral rami divisions (posterior division)

Supply extensors, abductors and external rotators

Brachial plexus roots

C5678T1 supply upper limb

Hilton’s law

A nerve that supplies a joint will also supply the muscle crossing that joint and the skin overlaying the muscle and its insertion

Musculocutaneous nerve trace roots

C567, from lateral cord of anterior divisions

Musculocutaneous nerve pathway

Pierces coracobrachialis to enter anterior arm, runs between biceps brachii and brachialis, escapes compartment under biceps to become cutaneous

Musculocutaneous nerve supply

Coracobrachialis, brachialis, biceps brachii, skin over anterolateral forearm

Axillary nerve trace root

C56, from posterior cord of posterior division

Axillary nerve pathway

Exits axilla through quadrangular space and travels posterior to surgical nerve of humerus

Axillary nerve supply

Shoulder joint, teres minor, deltoids, skin over lateral shoulder

Radial nerve trace roots

C5678T1 continuation of posterior cord of posterior divisions

Radial nerve pathway

Exits axilla through triangular interval, runs in radial grove of humerus with profunda brachii artery, exits under lateral triceps brachii and passes deep to brachioradialis, pierces supinator to enter forearm

Radial nerve supply

Triceps, posterior compartment of forearm including brachioradialis, skin of posterior arm and forearm to hand

Median nerve trace roots

C5678T1 from medial and lateral cords of anterior divisions

Median nerve pathway

Travels between biceps brachii and brachialis, runs deep to bicipital aponeurosis in cubital fossa, enters forearm between two heads of pronator teres and runs deep to fds, enters hand via carpal tunnel

Median nerve supply

Anterior forearm except fcu and lateral half of fdp, loaf

Ulnar nerve trace roots

C8T1 from medial cord of anterior divisions

Ulnar nerve pathway

Descends medial to axillary and brachial artery, travels anterior to triceps brachii, passes posterior to medial epicondyle of humerus, enters anterior forearm by passing deep to fcu, runs between fds and fdp, enters hand by passing anterior/superficial to flexor retinaculum - canal of Guyon

Ulnar nerve supply

fcu and medial half of fdp, medial two lumbricals, hypothenar eminence, interosseous, adductor pollicis, palmaris brevis

Long thoracic nerve trace roots

C567

Long thoracic nerve supply

Serratus anterior

Doral scapular nerve trace roots

C5

Dorsal scapular nerve supply

Rhomboids and levator scapulae

Suprascapular nerve trace roots

C456 from upper trunk

Suprascapular nerve supply

Supraspinatus and infraspinatus

Nerve to subclavius trace roots

C56 from upper trunk

Nerve to subclavius supply

Subclavius muscle

Lateral pectoral nerve trace roots

C567 from lateral cord and upper trunk

Lateral pectoral nerve supply

Pectoralis major

Upper subscapular nerve trace roots

C567 from posterior cord

Upper subscapular nerve supply

Subscapularis

Lower subscapular nerve trace roots

C567 from posterior cord

Lower subscapular nerve supply

Subscapularis and teres major

Thoracodorsal nerve trace roots

C678 from posterior cord

Thoracodorsal nerve supply

Latissimus dorsi

Medial pectoral nerve trace roots

C8T1 from medial cord from anterior divisions

Medial pectoral nerve supply

Pectoralis major and minor

Medial cutaneous nerve of arm trace roots

T1 from medial cord

Medial cutaneous nerve of arm supply

Skin of medial arm

Medial cutaneous nerve of forearm trace roots

C8T1 from medial cord

Medial cutaneous nerve of forearm supply

Skin of medial forearm