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Doctor i

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9 views14 pages

Doctor i

Uploaded by

Ayush Raj
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© © All Rights Reserved
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Anatomy

Topic : Radial
Nerve
Name : Kumari
Snehlata
Roll:105
GROUP D
adial nerve
The radial nerve is a continuation of
posterior cord of brachial plexus in the
axilla. It is the largest nerve of the brachial
plexus. It carries fibres from all the roots
(C5, C6, C7, C8, and T1) of brachial plexus.
In the axilla, the radial nerve lies posterior
to the third part of the axillary artery and
anterior to the muscles forming the
posterior wall of the axilla.
• Radial nerve enters the arm at the
lower border of the teres major. It
passes between the long and medial
heads of triceps to enter the lower
triangular space, through which it
reaches the spiral groove along with
profunda brachii artery. The radial
nerve in the spiral groove lies in direct
contact with the humerus.
• At the lower end of the spiral groove,
the radial nerve pierces the lateral
muscular septum of the arm and enters
the anterior compartment of the arm.
Here, it first descends between the
brachialis and brachioradialis, and then
between brachialis and extensor carpi
In the spiral groove, it gives
off the following five
branches:
1. Lower lateral cutaneous
nerve of the arm, which
provides sensory
innervation to the skin on
the lateral surface of the
arm up to the elbow.
2. Posterior cutaneous
nerve of the forearm, which
provides sensory
innervation to the skin
down the middle of the
back of the forearm up to
the wrist.
3. Nerve to lateral head of
triceps.
4. Nerve to medial head of
triceps.
The deep branch (also
called posterior
interosseous
nerve), in the cubital
fossa supplies two
muscles, viz.
1. Extensor carpi radialis
brevis.
2. Supinator.

After supplying these two


muscles, it passes
through the
substance of supinator
and enters the posterior
compartment of the
forearm and supplies all
the extensor muscles of
the forearm. It also gives
articular branches to the
distal
• The superficial branch (also called
superficial radialnerve) is sensory. It runs
downwards over the supinator,pronator
teres, and flexor digitorum superficialis
deep tobrachioradialis.
• About one-third of the way down
theforearm (at about 7 cm above wrist),
it passes posteriorly,emerging from
under the tendon of brachioradialis,
proximalto the styloid process of radius
and then passes over the tendons of
anatomical snuff-box.
• It terminates as cutaneous branches
which provide sensory innervation to skin
over the lateral part of the dorsum of
hand and dorsal surfaces of lateral 3½
digits proximal to the nail beds.
Cutaneous
distribution of
radial nerve
Clinical co-realtions
1.Crutch palsy
2.Saturday night palsy
3.Lateral epicondylar fracture
4.PIN injury
5.Radial tunnel syndrome
6.De Quervain Tenosynovitis
Crutch palsy
Motor loss
Loss of extension of elbow—due to paralysis of triceps.
Loss of extension of wrist—due to paralysis of wrist
xtensors. This causes wrist drop due to unopposed
ction of flexor muscles of the forearm (Fig. 13.4).
Loss of extension of digits—due to paralysis of extensor
igitorum, extensor indicis, extensor digiti minimi, and
xtensor pollicis longus.
Loss of supination in extended elbow because supinator
nd brachioradialis are paralyzed but supination becomes
ossible in flexed elbow by the action of biceps brachii.
Sensory loss
Sensory loss on small area of skin over the posterior
urface of the lower part of the arm.
Sensory loss along narrow strip on the back of forearm.
Sensory loss on the lateral part of dorsum of hand at the
ase of thumb and dorsal surface of lateral 3½ digits.
ore often, there is an isolated sensory loss on the
orsum of hand at the base of the thumb
Saturday night
•palsy
Motor loss
Loss of supination when the arm is
extended.
• \Wrist drop.
• Loss of supination when the arm is
extended.
• Sensory loss is restricted only to a
variable small area over the dorsum of
hand between the first and second
metacarpals.
Radial tunnel syndrome
an entrapment neuropathy of
deep branch of radial nerve at elbow. The compression
dial nerve at elbow may be caused by the following four
ctures:
Fibrous bands, which can tether the radial nerve to the
dio-humeral joint.
) Sharp tendinous margin of extensor carpi radialis
evis.
Leash of vessels from the radial recurrent artery.
) Arcade of Frohse, a fibro-aponeurotic proximal edge of
e superficial part of the supinator muscle.
racteristic clinical features:
ss of extension of the wrist and fingers but no wrist
.
in over the extensor aspect of the forearm.
Quervain Tenosynovitis
ervain tenosynovitis the tendons of the abductor pollicis longus and extensor pollicis
uscles pass through the same tendinous sheath on the dorsum of the wrist (first compartment in
nsor retinaculum).
e and repetitive use of the hands in a power grip or a twisting-wringing
an cause friction and thickening of the sheath, leading to pain over the styloid process of the rad
n is mediated by the superficial radial nerve (sensory), and the pain can extend distally into the
nd radiate up the lateral forearm.
Thank you!!

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