musculocutaneous nerve : from the lateral cord

axillary nerve : a branch of the posterior cord

radial nerve : a branch of the posterior cord
median nerve : from the lateral and medial cords
ulnar nerve : from the medial cord
Axillary Nerve
Spinal cord segment C5, C6
Muscle innervation Deltoid, teres minor
Sensory distribution Lateral arm over lower portion of deltoid
Clinical motor features of paralysis Loss of shoulder abduction; weakened shoulder lateral
Rotation
Musculocutaneous Nerve
Spinal cord segment
Muscle innervation
Sensory distribution
Clinical motor features of paralysis
C5, C6
Coracobrachialis, biceps, brachialis
anterior lateral surface of forearm
Loss of elbow supination, weakened supination
Radial Nerve
Spinal cord segment C6, C7, C8, T1
Muscle innervation Triceps, anconeus, brachioradialis, supinator, wrist,
finger, and thumb extensors
Sensory distribution posterior arm, posterior forearm, and radial side of
posterior hand
Clinical motor features of paralysis Loss of elbow, wrist, finger, and thumb extension
(wrist drop)
Median Nerve
Spinal cord segment
Muscle innervation
Sensory distribution
Clinical motor features of paralysis Loss of thumb opposition, flexion, and abduction
C6, C7, C8, T1
Pronators, wrist and finger flexors on radial side, most
thumb muscles
palmar aspect of thumb, second, third, fourth (radial
half) fingers
(ape hand), weakened wrist flexors (radial side),
weakened wrist radial deviation; weakened second and
third finger flexion (pope’s blessing / hand of
benediction)
Ulnar Nerve
Spinal cord segment C8, T1
Muscle innervation Flexor carpi ulnaris; flexor digitorum profundus (medial
half); interossei, fourth and fifth lumbricales
Sensory distribution palmar aspect of thumb, second, third, fourth (radial
half) fingers
Clinical motor features of paralysis Loss of wrist ulnar, finger flexion, loss of thumb
adduction; loss of most intrinsics (claw hand)
Femoral Nerve
Spinal cord segment L2, L3, L4
Muscle innervation Iliopsoas (iliacus and psoas major), Sartorius,
pectineus, quadriceps femoris
Sensory distribution anterior and medial thigh, medial leg, and foot
Clinical motor features of paralysis weakened hip flexion, loss of knee extension
Obturator Nerve
Spinal cord segment L2, l3, L4
Muscle innervation Hip adductor, obturator externus
Sensory distribution middle part of medial thigh
Clinical motor features of paralysis loss of hip adduction, weakened hip lateral rotation
Sciatic Nerve (made up of tibial and common peroneal nerves)
Spinal cord segment L4, L5, S1, S2, S3
Muscle innervation Hamstring muscles
Sensory distribution none
Clinical motor features of paralysis weakened hip extension, loss of knee flexion
Tibial nerve (divides into the medial and lateral plantar nerves)
Spinal cord segment L4, L5, S1, S2, S3
Muscle innervation Popliteus, ankle plantar flexors, tibialis posterior, foot
intrinsics (medial and lateral plantar)
Sensory distribution posterior lateral leg, lateral foot
Clinical motor features of paralysis Loss of ankle plantar flexion, weakened ankle
inversion, loss of toe flexion
Common Peroneal Nerve (Divides into Superficial and Deep Peroneal Nerves)
Spinal cord segment L4, L5, S1, S2
Muscle innervation Peroneals (mostly superficial peroneal); tibialis anterior
(deep peroneal); toe extensors (deep peroneal)
Sensory distribution anterior lateral aspect of leg and foot
Clinical motor features of paralysis Loss of ankle dorsiflexion (foot drop); loss of toe
extension, loss of ankle eversion

scapular winging  injury to the long thoracic nerve weakens or paralyzes the serratus
anterior muscle, causing the medial border of the scapula to rise away from the rib cage

BRACHIAL NERVES

thoracic outlet syndrome  a group of disorder that occur when the nerves of the brachial
plexus and/ or the subclavian artery and vein become compressed in the thoracic outlet –
the space between the clavicle and 1st rib and possibly the scalene muscles.
Burner or stinger syndrome  can occur following a stretch or compression injury to the
brachial plexus from a blow to the head or shoulder (common in football players, wrestlers,
gymnasts) – symptoms include immediate burning pain, prickly paresthesia radiating from
the neck, numbness and even brief paralysis of the arm

Erb’s palsy  traction injury to a baby’s upper brachial 0lexus and occurs most commonly
during a difficult childbirth (the affected arm hangs in shoulder extension and medial
rotation, elbow extended, forearm pronated and wrist flexed)

RADIAL NERVES

Saturday night palsy  radial nerve becomes compressed as it spirals around the mid
humerus

Wrist drop (loss of wrist extension) and a weakened ability to release objects (finger
extension)  will result from a high radial nerve injury, which is often a complication of a
mid-humeral fracture.

MEDIAN NERVES

Carpal tunnel syndrome  compression on the median nerve as it passes within the carpal
tunnel, the tunnel is formed by the transverse carpal ligament superficially and the bony
floor of the carpal bones deep

Cubital tunnel syndrome  ulnar nerve crosses the medial border of the elbow as the
nerve runs through a bony passageway called the cubital tunnel

Ape hand  loss of thumb opposition (median nerve injury); unable to oppose the thumb,
inability to flex the thumb, index, and middle fingers (also median nerve) gives the
appearance of pope’s blessing / hand of benediction

Claw hand  loss of the intrinsic muscles due to ulnar nerve damage; the proximal
phalanges are hyperextended, and the middle and distal phalanges are in extreme flexion

Sciatica  irritation on the sciatic nerve roots, with pain radiating down the back of the leg,
often caused by compression from a herniated lumbar disc

Foot drop  damage to the common peroneal nerve; caused by cast pressure at the head
of the fibula, where the nerve is quite superficial as it lies over the bony fibular head

Morton’s neuroma  enlarged nerve and usually occurs between the 3rd and 4th toes
(branches of the tibial nerve); the enlargement usually involves nerve compression in a
confines space. This could be from a flattening of the metatarsal arch, putting more
pressure on the metatarsal arch area or wearing a shoe with a tight toe box, creating
compression on the nerves as they pass between the metatarsals.
SHOULDER GIRDLE

The shoulder complex consists of the scapula, clavicle, sternum, humerus and rib cage and
includes the: sternoclavicular joint, acromioclavicular joint, glenohumeral joint, and
scapulothoracic articulation.

The important bony landmarks of the scapula are the following (resting position of the
scapula on the thorax 2nd ribs until 7th ribs):

SUPERIOR ANGLE  superior medial aspect, providing attachment for the levator scapula
muscle

INFERIOR ANGLE  most inferior point and where vertebral and axillary border meet. This
point determines scapular rotation

VERTEBRAL BORDER  between superior and inferior angles medially, and attactment of
the rhomboid and serratus anterior muscles

AXILLARY BORDER  the lateral side between glenoid fossa and inferior angle

SPINE  projection on posterior surface, running from medial border laterally to the
acromion process. It provides attachment for the middle and lower trapezius muscles

CORACOID PROCESS  projection on anterior surface, providing attachment for the

pectoralis minor muscle
ACROMION PROCESS  broad, flat area on superior lateral aspect, providing attachment
for the upper trapezius muscle

GLENOID FOSSA  slightly concave surface that articulates with humerus on superior
lateral side above the axillary border and below the acromion process

the clavicle is an S-shaped bone that connects the upper extremity to the axial skeleton at
the sternoclavicular joint; the important bony landmarks of the clavicle:

STERNAL END  attaches medially to sternum

ACROMIAL END  attaches laterally to scapula and provides attachment for the upper
trapezius muscle

BODY  area between the two ends

the sternum provides attachment for the clavicle, followed beneath by attachments for the
costal cartilages of the ribs – it’s divided into three parts:

MANUBRIUM  the superior end, providing attachment for the clavicle and the first rib

BODY  the middle two thirds of the sternum, providing attachment for the remaining ribs

XIPHOID PROCESS  meaning “sword-shaped” the inferior tip