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Summary Tables of Shoulder and Arm Anatomy

NOTE: The purpose of these anatomy tables is to provide a relatively comprehensive catalog in tabular
form of the major anatomial structures found within a given organ system or region. You may find these
tables helpful in reviewing anatomy, but they are NOT meant to be 'checklists' of all the structures that
you are expected to find during your dissections.

Osteology

Bone Structure Description Notes

scapula

(N420, N421, TG2-03A, TG2-03B, Practical1, Practical2) the bone of the shoulder the
scapula floats in a sea of muscles, so it is difficult to fracture; it articulates with the axial skeleton through
only one bone - the clavicle at the coracoclavicular and acromioclavicular joints

scapular notch a notch on the superior border of the scapula located medial to the attachment of the
coracoid process it is bridged by the superior transverse scapular ligament; the suprascapular a.
passes superior to the superior transverse scapular ligament and the suprascapular n. passes inferior to
it (Army goes over the bridge, Navy goes under the bridge)

acromion(Practical) a broad, flat process located at the lateral end of the scapular spine it
articulates with the clavicle through a synovial joint (acromioclavicular joint) (Latin, akron = tip + omos =
shoulder, therefore the tip of the shoulder)

supraspinous fossa a broad depression located superior to the spine of the scapula it is the site of
origin of the supraspinatus m.

infraspinous fossa a broad depression located inferior to the spine of the scapula it is the site of
origin of the infraspinatus m.

humerus

(N420,N421, TG2-03A, TG2-03B, Practical) the bone of the arm (brachium) the humerus
articulates proximally with the scapula at the glenoid fossa; it articulates distally with the radius and ulna
at the elbow joint

head(Practical) the smooth, rounded proximal end of the humerus it articulates with the glenoid
cavity of the scapula to form the shoulder joint

anatomical neck the constricted region located inferolateral to the head it is located at the
circumference of the smooth articular surface of the head

surgical neck the proximal part of the shaft of the humerus it is located inferior to the greater and
lesser tubercles; it is a site of frequent fracture; fractures of the surgical neck of the humerus endanger
the axillary n. and the posterior circumflex humeral a.

greater tuberclethe large projection located lateral to the head of the humerus it is the attachment site
of the supraspinatus, infraspinatus & teres minor mm.

lesser tubercle the projection located lateral to the head of the humerus on the anterior surface it is the
insertion site of the subscapularis m.

intertubercular groove the groove on the anterior surface of the humerus that is located between the
crest of the greater tubercle and the crest of the lesser tubercle it is occupied by the tendon of the long
head of the biceps brachii m.; the transverse humeral ligament spans the intertubercular groove and
holds the biceps tendon in place; it is the attachment site for the tendon of the pectoralis major (lateral
lip), teres major (medial lip), and latissimus dorsi (floor)

crest of the greater tubercle the ridge of bone on the anterior surface of the humerus extending
inferiorly from the greater tubercle it forms the lateral lip of the intertubercular groove; it is the
attachment site for the transverse humeral ligament and the pectoralis major m.

crest of the lesser tubercle the ridge of bone on the anterior surface of the humerus extending
inferiorly from the lesser tubercle it forms the medial lip of the intertubercular groove; it is the
attachment site for the transverse humeral ligament and the teres major m.

deltoid tuberosity the roughened process on the lateral surface of the mid-shaft of the humerus
it is the insertion site of the deltoid m.

radial groove (Practical) the groove that spirals around the posterior surface of the shaft of the humerus
it is a depression for the radial n. and the deep brachial vessels; fracture of the humerus at mid-
shaft can injure the radial nerve and deep brachial vessels because they are in contact with bone at this
location

lateral epicondyle a knob-like projection on the lateral side of the humerus proximal to the
capitulum it is the site of attachment of the common extensor tendon which is the origin of several
forearm extensor muscles (extensor carpi radialis brevis m., extensor digitorum m., extensor digiti
minimi m., extensor carpi ulnaris m. and supinator m.); inflammation of the attachment of the common
extensor tendon is called lateral epicondylitis which is also known as "tennis elbow" (Greek, kondylos =
the knob formed by the knuckle of any joint)

lateral supracondylar ridge a narrow ridge running proximally from the lateral epicondyle of the
humerus it is the site of origin of the brachioradialis m. and the extensor carpi radialis longus m.

medial epicondyle a knob-like projection on the medial side of the humerus proximal to the
trochlea it is the attachment site of the common flexor tendon which is the origin for the
superficial group of forearm flexor muscles (pronator teres m., flexor carpi radialis m., palmaris longus
m., flexor carpi ulnaris m. and flexor digitorum superficialis m.); inflammation of the attachment of the
common flexor tendon is called medial epicondylitis which is also known as "tennis elbow"; the ulnar
nerve is in contact with bone as it courses posterior to the medial epicondyle where it is susceptible to
injury from blunt trauma or fracture Greek, kondylos = the knob formed by the knuckle of any joint)

medial supracondylar ridge a narrow ridge running proximally from the medial epicondyle of the
humerus the pronator teres m. takes origin from the common flexor tendon near the most inferior
part of the medial supracondylar ridge

ulna
(N436,N439, TG2-04AB, Practical) the bone on the medial side of the forearm
(antebrachium) the ulna articulates proximally with the trochlea of the humerus and the head of the
radius; it articulates distally with the ulnar notch of the radius (Latin, ulna = elbow or arm)

body the long slender midportion of the ulna it is also called the shaft or diaphysis; the interosseous
membrane attaches to the entire length of the interosseous crest of the body of the ulna

olecranon the proximal end of the ulna it is the insertion site of the tendon of the
triceps brachii m.; when the elbow is extended, the olecranon of the ulna engages the olecranon fossa of
the humerus (Greek, olecranon = the head or point of the elbow)

coronoid process the anterior projection of bone located distal to the trochlear notch
(Greek, coronoid = resembles a crow)

styloid process a small projection from the distal surface of the head of the ulna it is the site of
attachment of the articular disk of the distal radioulnar joint

radius

(N436,N439, TG2-04AB, Practical)

the bone on the lateral side of the forearm (antebrachium) the radius pivots on its long axis
and crosses the ulna during pronation

head the rounded proximal end of the radius it has a smooth, rounded surface for articulation
with the ulna; the head of the radius is encircled by the annular ligament (4/5 of a circle) and the radial
notch of the ulna (1/5 of a circle)

neck the constricted area of the radius located distal to the head the annular ligament of
the radius surrounds the head of the radius, not the neck of the radius

radial tuberosity a roughened area on the anteromedial surface of the radius located just
distal to the neck it is the insertion site of the tendon of the biceps brachii m.

body the long, slender midportion of the radius it is also known as the shaft or diaphysis; the
interosseous membrane attaches to the entire length of the body of the radius along its interosseous
crest; a fracture of the distal end of the body of the radius with a dorsal displacement of the distal
fragment is quite common and is called a Colles' fracture

dorsal tubercle

(N439,TG2-04) lies dorsally between grooves for the passage of the forearm tendons
styloid process the distal-most projection from the lateral side of the radius the radial styloid
process projects lateral to the proximal row of carpal bones

carpal bones

(N452,TG2-31, TG2-32) the bones of the wrist eight bones arranged in two rows; a mnemonic
for memorizing the carpal bones is " some lovers try positions that they can't handle" - the first letters of
these eight words are the first letters of the names of the eight carpal bones arranged from lateral to
medial, proximal row first: scaphoid, lunate, triquetrum, pisiform/trapezium, trapezoid, capitate, hamate

proximal row lateral to medial: scaphoid, lunate, triquetrum, pisiform the scaphoid and lunate bones
of the proximal row articulate with the distal end of the radius

distal row lateral to medial: trapezium, trapezoid, capitate, hamate the distal row of carpal bones
articulates with the metacarpal bones of the hand

scaphoid

(N452,TG2-31, TG2-32) the most lateral carpal bone of the proximal rowthe scaphoid bone is
located in the floor of the anatomical snuff box; it is frequently fractured by hyperextension and
abduction of the wrist; (Greek, scaphoid = boat-shaped)

lunate

(N452,TG2-31, TG2-32, Practical) the carpal bone located between the scaphoid and
triquetrum in the proximal row the lunate is so named because it is "moon-shaped" (crescent shaped) in
longitudinal section; the head of the capitate sits within the crescent of the lunate (Latin, lunate =
lunatus, crescent-shaped, from luna, the moon)

triquetrum

(N452,TG2-31, TG2-32) the most medial bone in the proximal row of carpal bones it
articulates with the pisiform which sits anterior to it (Latin, triquetrum = having three corners)

pisiform

(N452,TG2-31) a sesamoid bone in the tendon of the flexor carpi ulnaris m. it articulates
with the triquetrum; the pisiform bone provides a protective function for the flexor carpi ulnaris tendon
by bearing the forces generated by the tendon riding across the triquetrum, especially during wrist
extension; (Latin, pisiform = pea-shaped)

trapezium

(N452,TG2-31, TG2-32) the most lateral carpal bone of the distal row it forms a saddle joint
with the metacarpal bone of the thumb; "the thumb swings on the trapezium"
trapezoid

(N452,TG2-31, TG2-32) the carpal bone located between the trapezium and the capitate in the
distal row the trapezoid is named for its trapezoid shape

capitate

(N452,TG2-31, TG2-32, Practical) the carpal bone located between the trapezoid and the
hamate in the distal carpal row the capitate is the largest carpal bone; it is named for its rounded head;
forces generated in the hand (as during a punching blow with the fist) are transmitted through the third
metacarpal bone to the capitate and proximally through the lunate to the radius (Latin, capit- = head)

hamate

(N452,TG2-31, TG2-32, Practical) the most medial carpal bone in the distal row the
hamulus (hook) of the hamate is its distinguishing characteristic; it is an attachment point of the flexor
retinaculum (Latin, hamus = a hook)

metacarpal bones

(N452,N456, TG2-31,TG2-32) the bones located between the carpal bones and the phalanges
of the hand there are a total of five metacarpal bones in the hand; the metacarpals of the four
fingers are bound together by ligaments to form a firm foundation for finger movements; the metacarpal
of the thumb is more independent in its range of motion

base the proximal end of the metacarpal it articulates with the distal row of carpal bones

body the slender shaft of the metacarpal it is also known as the diaphysis

head the rounded distal end of the metacarpal it articulates with the proximal phalanx of the
corresponding digit

phalanx (phalanges)

(N456,TG2-31, TG2-32) the distal two or three bones in the digits of the hand there are a total
of 14 phalanges in the hand; the thumb has two phalanges (proximal and distal) and each finger has
three phalanges (proximal, middle and distal); (Latin, phalanx = line of soldiers)

base the proximal end of the phalanx the base of the proximal phalanx articulates with the head of
the corresponding metacarpal bone; the base of the middle or distal phalanx articulates with the head of
the next most proximal phalanx

body the slender shaft of the phalanx also known as the diaphysis; the body of the distal phalanx is
very short

head the distal end of the phalanx the proximal, middle and distal phalanges each have a head; the
head of a proximal or middle phalanx articulates with the base of the next most distal phalanx
Topographic Anatomy of the Shoulder & Arm

Structure/Space Boundaries Significance

quadrangular space

(TG2-08) boundaries: medial - long head triceps tendon, lateral - humerus, superior - teres minor,
inferior - teres major significance: traversed by the axillary nerve & posterior humeral circumflex
artery

subacromial/subdeltoid bursa

(TG2-42) between the deltoid, the supraspinatus tendon and the glenohumeral joint
facilitates movement of the supraspinatus tendon and the deltoid

triangular space

(TG2-08) boundaries: lateral - long head triceps tendon, superior - teres minor, inferior - teres
major significance: traversed by the circumflex scapular artery

anterior compartment (of the arm) separated from the posterior compartment by the medial and
lateral intermuscular septa contains the biceps brachii, coracobrachialis, and brachialis mm. and
musculocutaneous n.

anterior axillary fold anterior boundary of the axilla inferior border of the sternocostal head of the
pectoralis major

bicipital aponeurosis

(TG2-17) a triangular membranous band that runs from the biceps tendon across the cubital fossa
and merges with the antebrachial fascia passes obliquely over the brachial artery and median nerve
(Greek, aponeurosis = a broad, flat nerve)

medial intermuscular septum extends from the deep surface of the brachial fascia to the medial
supracondylar ridges of the humerus divides the arm into anterior and posterior compartments

lateral intermuscular septum extends from the deep surface of the brachial fascia to the lateral
supracondylar ridges of the humerus divides the arm into anterior and posterior compartments

posterior axillary fold posterior border of the axilla composed of skin and muscular tissue of the
latissimus dorsi and teres major

neurovascular compartment of arm formed by a split in the medial intermuscular septa

contains the median & medial antebrachial cutaneous nn. and brachial vessels
posteror compartment of arm separated from the anterior compartment by the medial and lateral
intermuscular septa contains triceps brachii, radial n., and deep brachial vessels, as well as ulnar n. in
its distal, medial half

cubital fossa superior - line between humeral epicondyles, medial - pronator teres, lateral -
brachioradialis site for phlebotomy

Topographic Anatomy of the Forearm & Hand

Structure/Space Boundaries Significance

antebrachial fascia

(N459,N479,TG2-02) anterior and posterior thickening forming the extensor retinaculum; immediatel
distal but deeper to the palmar carpal ligament it forms the flexor retinaculum formation of the carpal
tunnel through which the median n. and flexor tendons pass

anterior compartment

(N449,TG2-23) separated from the posteror compartment by the interosseous membrane (N439,TG2-
21) also called the flexor compartment

posteror compartment

(N449,TG2-29) separated from the anterior compartment by the interosseous membrane (N439,TG2-
21) also called the extensor compartment

anatomical snuffbox

(N444,N450,TG2-29) at the base of the thumb; bordered laterally by the tendons of abductor pollicis
longus and extensor pollicis brevis, medially by tendon of extensor pollicis longus branches of
superficial radial n. cross the snuffbox; radial artery lies deeply in snuffbox; scaphoid can be palpated
there in cases of suspected fracture

Joints and Associated Structures of the Shoulder & Arm

Joint or structure Description Notes

costoclavicular ligament (G 6.23a; N 402C) a ligament that attaches the clavicle to the first rib
it resists superior displacement of the proximal end of the clavicle; the combined effect of this
ligament, the sternoclavicular ligament and the interclavicular ligament is to produce a very strong
sternoclavicular joint that seldom dislocates

sternoclavicular joint (G 6.23a; N 402C) the joint what connects the clavicle with the sternum a
synovial joint; its joint capsule is subdivided by a fibrous articular disc; it is strengthened by the
sternoclavicular, interclavicular and costoclavicular ligaments; the sternoclavicular joint has the range of
movement, but not the form, of a ball and socket joint

sternoclavicular ligament (G 6.23a; N 402C) a ligament that reinforces the capsule of the
sternoclavicular joint the sternoclavicular ligament has two parts: anterior and posterior; it is a very
strong ligament; the combined effect of this ligament, the costoclavicular ligament and the
interclavicular ligament is to produce a very strong sternoclavicular joint that seldom dislocates

acromioclavicular joint (N 406A, 408A) the joint between the distal end of the clavicle and the
acromion of the scapulaa plane synovial joint; the shape of the articulation encourages the acromion to
slide inferior to the clavicle during dislocation (shoulder separation) a condition that occurs when the
coracoclavicular ligament is torn; a small articular disk occurs within this joint capsule

coracoacromial ligament (N 406A, 408B, 409A, 408A) the ligament that connects the coracoid process
to the acromion of the scapula it passes superior to both the head of the humerus and the
supraspinatus tendon; it provides support for the head of the humerus that prevents superior
dislocation

coracoclavicular joint (N 406A, 408A). the joint between the coracoid process of the scapula and the
inferior surface of the lateral portion of the clavicle a syndesmosis; this joint provides stability to the
acromioclavicular joint

coracoclavicular ligament (N 406A, 408A). the ligament that connects the upper surface of the
coracoid process to the under surface of the clavicle it has two parts: conoid ligament
(posteromedial part) and trapezoid ligament; tearing of the coracoclavicular ligament permits the
acromion to move inferior to the distal end of the clavicle (shoulder separation), a condition which could
result from a fall on the point of the shoulder

coracohumeral ligament (N 406A) the ligament that connects the infero-lateral surface of the
coracoid process to the antero-superior surface of the head of the humerus

shoulder joint (N 406A, 408A, 408B, 408C, 409A, 409B) the articulation between the head of the
humerus and the glenoid fossa of the scapula a synovial ball and socket joint; the glenoid labrum
deepens the socket; glenohumeral ligaments reinforce the joint capsule anteriorly; the tendon of the
long head of the biceps brachii m. passes through the shoulder joint cavity; the shoulder joint is
supported by the muscles of the rotator cuff group (supraspinatus, infraspinatus, teres minor and
subscapularis); also known as the glenohumeral joint; it is frequently dislocated
glenohumeral ligament, inferior (G 6.42c; N 406C) a ligament reinforcing the anterior wall of the
capsule of the glenohumeral joint it connects the humerus to the scapula; a thickening of the
anteroinferior shoulder joint capsule

glenohumeral ligament, middle (G 6.42c; N 406C) a ligament reinforcing the anterior wall of the
capsule of the glenohumeral joint it connects the humerus to the scapula; a thickening of the
anterior shoulder joint capsule

glenohumeral ligament, superior (G 6.42c; N 406C) a ligament reinforcing the anterior wall of the
capsule of the glenohumeral joint it connects the humerus to the scapula; a thickening of the
anterosuperior shoulder joint capsule

transverse humeral ligament (N 406A) the ligament that spans the intertubercular sulcus of the
humerus it connects the greater tubercle of the humerus to the lesser tubercle of the humerus
and acts to retain the tendon of the long head of the biceps brachii m. in the intertubercular sulcus

Joints and Associated Structures of the Forearm

Joint or structure Description Notes

antebrachial fascia

(N459,N479, TG2-02) the deep fascia of the forearm, or antebrachium, forming a tubular investment
around the forearm muscles

extensor retinaculum

(N470,TG2-29, Practical)a thickening of the antebrachial fascia at the wrist it holds the extensor
tendons against the distal radius and ulna to prevent their bow-stringing (Latin, retinaculum = a band or
halter)

interosseous membrane, forearm

(N439,TG2-21) a fibrous membrane that connects the interosseous borders located on the shafts of the
radius and the ulna a syndesmosis; its fibers are oriented obliquely downward from the radius
toward the ulna; the interosseous membrane is the classic example of a syndesmosis; proximally
directed forces from the hand pass through the radius and are transferred to the ulna through the
interosseous membrane; marked proximally by the oblique cord (Latin, inter = between + os = bone)
palmar carpal ligament

(N459,TG2-23) a thickening of the antebrachial fascia over the palmar surface of the wrist the
palmaris longus and ulnar neurovascular bundle pass deep to it, and the flexor retinaculum lies deeper
and more distal

synovial bursa (sheath)

(N470,TG2-34) synovial sheaths are bursae that stretch along tendons and reduce the friction produced
by their movements

Joints and Associated Structures of the Hand

Joint or structure Description Significance

palmar aponeurosis

(N459, TG2-33, Practical) a thick aponeurotic layer overlying the central compartment of the palm
the palmaris longus inserts into it (Greek, aponeurosis = a broad, flat nerve)

fibrous flexor digital sheaths

(N462, TG2-34) fibrous tunnels formed on the palmar surfaces of the phalanges transmits the flexor
tendons

flexor retinaculum

(N460, TG2-34, Practical) a ligament stretching from the scaphoid and trapezeum to the hamate
and pisiform, deep and slightly distal to the palmar carpal ligament forms the carpal tunnel (Latin,
retinaculum = a band or halter)

carpal tunnel

(N461, TG2-36, Practical) formed by the carpal bones and the flexor retinaculum transmits the
flexor pollicis longus, flexor digitorum superficialis & profundus, and the median n. (Latin, carpus = the
wrist)

thenar compartment

(N460, N462, TG2-34, TG2-36) the lateral compartment of the palmar surface of the hand
contains the abductor pollicis brevis laterally, flexor pollicis brevis medially, and opponens pollicis
deeply (Greek, thenar = the palm of the hand)

hypothenar compartment
(N460, N462, TG2-34, TG2-36) the medial compartment of the palmar surface of the hand
contains the abductor digiti minimi, flexor digiti minimi brevis, and opponens digiti minimi

central compartment

(N462, TG2-36) the central compartment of the palmar surface of the hand contains the flexor
tendons, the lumbricals, the superficial palmar arterial arch, and common palmar digital branches of the
median and ulnar nerves

adductor-interosseous compartment

(N462, TG2-36) the deepest compartment of the palmar surface of the hand contains the adductor
pollicis, 3 palmar interossei, 4 dorsal interossei, the deep palmar arterial arch, and the deep branch of
the ulnar n. (Latin, adduct = to bring towards,inter = between + os = bone)

radial bursa

(N462) the synovial sheath of the tendon of flexor pollicis longus

ulnar bursa

(N462, TG2-34) the synovial sheath surrounding the tendons of flexor digitorum superficialis and
profundus it usually extends into the fibrous flexor sheath of the fifth digit

vincula

(N464, TG2-45) slips of synovial membrane extending between phalanges and flexor tendons vincula
conduct neurovascular bundles to the flexor tendons (Latin, vincula = to bind)

Muscles of the Shoulder & Arm

Muscle Origin Insertion Action Innervation Notes Image

deltoid

(N424, TG2-07, Practical) lateral one-third of clavicle, acromion, lower lip of the crest of the spine
of the scapula deltoid tuberosity of the humerus abducts arm; anterior fibers flex & medially
rotate arm; posterior fibers extend & laterally rotate arm axillary nerve (C5,6) from posterior cord
of brachial plexus deltoid is the principle abductor of the arm but due to poor mechanical
advantage it cannot initiate this action; assisted by supraspinatus

teres major
(N424, TG2-07, TG2-08) dorsum of the inferior angle of scapula crest of lesser tubercle of humerus
adducts arm, medially rotates arm, assists in arm extension lower subscapular nerve (C5,6)
from the posterior cord of the brachial plexus teres major inserts beside the tendon of latissimus
dorsi, and assists latissimus in its actions (Latin, teres = round)

rotator cuff

supraspinatus

(N425, N426, TG2-08, TG2-16A, TG2-16B, TG2-16C, Practical) supraspinatus fossa greater tubercle
of humerus (highest facet) abduct arm (initiate abduction) suprascapular nerve (C5,6) from
superior trunk of brachial plexus supraspinatus initiates abduction of the arm, then the deltoid
muscle completes the action

infraspinatus

(N425, N426, TG2-08, TG2-16A, TG2-16B, TG2-16C, Practical) infraspinatus fossa greater tubercle
of humerus (middle facet) laterally rotate arm suprascapular nerve infraspinatus,
supraspinatus, teres minor and subscapularis are the rotator cuff muscles

teres minor

(N425, N426, TG2-08, TG2-16A, TG2-16B, TG2-16C, Practical) upper 2/3 of the lateral border of the
scapula greater tubercle of humerus (lowest facet) laterally rotates arm axillary fixes head of
humerus in glenoid fossa during abduction & flexion of arm

subscapularis

(N425, N426, TG2-08, TG2-16A, TG2-16B, TG2-16C) medial two-thirds of costal surface of scapula
(subscapular fossa) lesser tubercle of humerus medially rotates arm; assists extension of arm
upper and lower subscapular nerves (C5,6) subscapularis, supraspinatus, infraspinatus, and
teres minor are the rotator cuff muscles

biceps brachii

(N431, TG2-17) short head: tip of coracoid process; long head: supraglenoid tubercle of scapula
tuberosity of radius flexes forearm, flexes arm (long head), supinatesmusculocutaneous
nerve (C5,6) a powerful supinator only if the elbow is flexed

brachialis

(N431, TG2-17) anterior surface of lower one-half of humerus and intermuscular septa ulnar tuberosity
of ulna flexes forearm musculocutaneous nerve (C5,6) powerful flexor

coracobrachialis
(N431, TG2-17, Practical) coracoid process of scapula medial humerus at mid-shaft flexes
and adducts arm musculocutaneous nerve (C5,6) musculocutaneous nerve passes through the
coracobrachialis muscle to reach the other arm flexors (biceps brachii and brachialis)

serratus anterior

(N191, TG4-07, Practical1, Practical2) ribs 1-8 or 9 medial border of the scapula on its costal (deep)
surface it draws the scapula forward; the inferior fibers rotate the scapula superiorly long thoracic
nerve (from ventral rami C5-C7) a lesion of long thoracic nerve will cause winging of the scapula (i.e., the
medial border of the scapula falls away from the posterior chest wall and looks like an angel's wing)
(Latin, serratus = to saw)

triceps brachii

(N432, TG2-18A, TG2-18B, Practical) long head: infraglenoid tubercle of scapula; lateral head:
posterolateral humerus & lateral intermuscular septum; medial head: posteromedial surface of inferior
1/2 of humerus olecranon process of the ulna extends forearm; long head extends and adducts arm
radial nerve long head of triceps separates the triangular and quadrangular spaces (teres
major, teres minor and the humerus are the other boundaries)

anconeus

(N432,N444, TG2-18) lateral epicondyle lateral side of olecranon and upper one-fourth of ulna
extends forearm nerve to anconeus from radial nerve (Greek, ankon = elbow or a
bend)

Muscles of the Forearm

Muscle Origin Insertion Action Innervation Blood Supply Notes Image

abductor pollicis longus

(N445, TG2-30, Practical) middle one-third of the posterior surface of the radius, interosseous
membrane, mid-portion of posterolateral ulna radial side of the base of the first metacarpal abducts
the thumb at carpometacarpal joint radial nerve, deep branch posterior interosseous a.
the tendons of abductor pollicis longus and extensor pollicis brevis make the lateral border of
the anatomical snuffbox (Latin, pollicis = the thumb, from pollere, to be strong, because the thumb is
stronger than the other fingers) image

brachioradialis

(N444,N446, TG2-29, Practical1, Practical2) upper two-thirds of the lateral supracondylar ridge of
the humerus lateral side of the base of the styloid process of the radius flexes the elbow, assists
in pronation & supination radial nerve radial recurrent a. although brachioradialis is
innervated by the nerve for extensors (radial), its primary action is elbow flexion; the neutral position of
this muscle is half way between supination and pronation (elbow flexed, thumb up) image

extensor carpi radialis longus

(N444,N446, TG2-29, Practical) lower one-third of the lateral supracondylar ridge of the humerus
dorsum of the second metacarpal bone (base) extends the wrist; abducts the hand radial
nerve radial a.works with the extensor carpi radialis brevis and flexor carpi radialis in abduction of the
hand (Latin, carpus = the wrist) image

extensor carpi radialis brevis

(N444,TG2-29) common extensor tendon (lateral epicondyle of humerus) dorsum of the third
metacarpal bone (base) extends the wrist; abducts the hand deep radial nerve radial a.works
with the extensor carpi radialis longus and flexor carpi radialis in abduction of the hand (Latin, carpus =
the wrist) image

extensor carpi ulnaris

(N444,TG2-29) common extensor tendon & the middle one-half of the posterior border of the ulna
medial side of the base of the 5th metacarpal extends the wrist; adducts the hand deep
radial nerve ulnar a. works with the flexor carpi ulnaris in adduction of the hand image

extensor digiti minimi

(N444,TG2-29) common extensor tendon (lateral epicondyle of the humerus) joins the extensor
digitorum tendon to the 5th digit and inserts into the extensor expansion extends the
metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the 5th digit deep
radial nerve interosseous recurrent a. extensor digiti minimi appears to be the ulnar-most
portion of extensor digitorum image

extensor digitorum

(N444,TG2-29, Practical)common extensor tendon (lateral epicondyle of the humerus) extensor

expansion of digits 2-5 extends the metacarpophalangeal, proximal interphalangeal and distal
interphalangeal joints of the 2nd-5th digits; extends wrist deep radial nerve interosseous
recurrent a. and posterior interosseous a. the extensor expansion inserts via a central band on the
base of the middle phalanx, while lateral & medial slips insert on the distal phalanx image

extensor indicis

(N445,TG2-30) interosseous membrane and the posterolateral surface of the distal ulna its tendon joins
the tendon of the extensor digitorum to the second digit; both tendons insert into the extensor
expansion extends the index finger at the metacarpophalangeal, proximal interphalangeal and
distal interphalangeal joints deep radial nerve posterior interosseous aextensor indicis is a
deep forearm extensor, whereas extensor digiti minimi is in the superficial layer of extensors image

extensor pollicis brevis

(N445, TG2-30) interosseous membrane and the posterior surface of the distal radius base of the
proximal phalanx of the thumb extends the thumb at the metacarpophalangeal joint deep radial
nerve posterior interosseous athe tendons of extensor pollicis brevis and abductor pollicis longus make
the lateral border of the anatomical snuffbox, in which the radial arterial pulse can be felt (Latin, pollicis
= the thumb, from pollere, to be strong, because the thumb is stronger than the other fingers) image

extensor pollicis longus

(N445,TG2-30) interosseous membrane and middle part of the posterolateral surface of the ulna
base of the distal phalanx of the thumb extends the thumb at the interphalangeal joint deep
radial nerve posterior interosseous athe tendon of extensor pollicis longus hooks around the dorsal
radial tubercle; it forms the medial border of the anatomical snuffbox, in which the radial arterial pulse
can be felt (Latin, pollicis = the thumb, from pollere, to be strong, because the thumb is stronger than
the other fingers) image

flexor carpi radialis

(N446,TG2-23,

Practical) common flexor tendon from the medial epicondyle of the humerus base of the
second and third metacarpals flexes the wrist, abducts the hand median nerve ulnar a. works
with the extensor carpi radialis longus and brevis mm. to abduct hand (Latin, carpus = the wrist) image

flexor carpi ulnaris

(N446,TG2-23) common flexor tendon & (ulnar head) from medial border of olecranon & upper 2/3 of
the posterior border of the ulna pisiform, hook of hamate, and base of 5th metacarpal flexes wrist,
adducts hand ulnar nerve ulnar a. the ulnar nerve passes between the two heads of origin of the
flexor carpi ulnaris m. (Latin, carpus = the wrist) image

flexor digitorum profundus

(N448,TG2-25) posterior border of the ulna, proximal two-thirds of medial border of ulna, interosseous
membrane base of the distal phalanx of digits 2-5 flexes the metacarpophalangeal, proximal
interphalangeal and distal interphalangeal joints median nerve via anterior interosseous branch (radial
one-half); ulnar nerve (ulnar one-half) ulnar a., anterior interosseous a. ulnar nerve innervates
the portion of profundus that acts on digits 4 & 5 (the ulnar 2 digits) image

flexor digitorum superficialis

(N447,TG2-24) humeroulnar head: common flexor tendon; radial head: middle 1/3 of radius shafts
of the middle phalanges of digits 2-5 flexes the metacarpophalangeal and proximal interphalangeal
joints median nerve ulnar a. median nerve travels distally in the forearm on the deep surface of the
flexor digitorum superficialis m. image

flexor pollicis longus

(N447, N461, TG2-25)

anterior surface of radius and interosseous membrane base of the distal phalanx of the thumb flexes
the metacarpophalangeal and interphalangeal joints of the thumb median nerve via anterior
interosseous branch anterior interosseous a. the tendon of flexor pollicis longus passes through the
carpal tunnel with the other long digital flexor tendons and the median nerve (Latin, pollicis = the
thumb, from pollere, to be strong, because the thumb is stronger than the other fingers) image

pronator quadratus

(N440,N448,TG2-25) medial side of the anterior surface of the distal one-fourth of the ulna anterior
surface of the distal one-fourth of the radius pronates the forearm median nerve via anterior
interosseous branch anterior interosseous a. pronator quadratus is the deepest muscle in the distal
forearm; it works with pronator teres and has the same nerve supply image

palmaris longus

(N446,TG2-23) medial epicondyle of humerus distal half of flexor retinaculum and palmaris
aponeurosis flexes hand (at wrist) and tightens palmar aponeurosis median n. (C7 and C8) ulnar a.
palmaris longus is a useful guide to the median nerve at the wrist image

pronator teres

(N440,N447, N448,TG2-23, TG2-24) common flexor tendon and (deep or ulnar head) from medial
side of coronoid process of the ulna midpoint of the lateral side of the shaft of the radius
pronates the forearm median nerve ulnar a., anterior ulnar recurrent a. median nerve
passes between the two heads of origin of pronator teres image

supinator

(N440,N445, TG2-30, Practical) lateral epicondyle of the humerus, supinator crest & fossa of the ulna,
radial collateral ligament, annular ligament lateral side of proximal one-third of the radius
supinates the forearm deep radial nerve recurrent interosseous a. deep radial
nerve passes through the supinator to reach the posterior compartment of the forearm (Latin, supinare
= to bend backward) image
Intrinsic Muscles of the Hand

Muscle Origin Insertion Action Innervation Blood Supply Notes Image

abductor digiti minimi (hand)

(N461, N465, TG2-35) pisiform base of the proximal phalanx of the 5th digit on its ulnar side
abducts the 5th digit deep branch of the ulnar nerve ulnar a. abductor digiti minimi, flexor
digiti minimi brevis, and opponens digiti minimi are located in the hypothenar compartment of the hand

abductor pollicis brevis

(N465, TG2-34) flexor retinaculum, scaphoid, trapezium base of the proximal phalanx of the first digit
abducts thumb recurrent branch of median nerve superficial palmar br. of the radial a.
abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis are located in the thenar
compartment of the hand (Latin, pollicis = the thumb or first finger from pollere, to be strong, because
the thumb is stronger than other fingers)

adductor pollicis

(N461, N465, TG2-35) oblique head: capitate and base of the 2nd and 3rd metacarpals; transverse
head: shaft of the 3rd metacarpal base of the proximal phalanx of the thumb adducts the
thumb ulnar nerve, deep branch deep palmar arterial arch deep palmar arch and deep
ulnar nerve pass between the two heads of adductor pollicis, which is in the adductor-interosseous
compartment (Latin, pollicis = the thumb or first finger from pollere, to be strong, because the thumb is
stronger than other fingers)

flexor digiti minimi brevis (hand)

(N461, N465, TG2-34) hook of hamate & the flexor retinaculum proximal phalanx of the 5th
digit flexes the carpometacarpal and metacarpophalangeal joints of the 5th digit ulnar nerve,
deep branch ulnar a. flexor digiti minimi brevis, abductor digiti minimi, and opponens digiti minimi
are in the hypothenar compartment of the hand

flexor pollicis brevis

(N465, TG2-34) flexor retinaculum, trapezium proximal phalanx of the 1st digitflexes the
carpometacarpal and metacarpophalangeal joints of the thumb recurrent branch of the median nerve
superficial palmar br. of the radial a. flexor pollicis brevis, abductor pollicis brevis, and
opponens pollicis are the three muscles of the thenar compartment of the hand(Latin, pollicis = the
thumb or first finger from pollere, to be strong, because the thumb is stronger than other fingers)

interosseous, dorsal (hand)

(N465, N464, N470, TG2-41, TG2-35) four muscles, each arising from two adjacent metacarpal shafts
base of the proximal phalanx and the extensor expansion on lateral side of the 2nd digit, lateral
& medial sides of the 3rd digit, and medial side of the 4th digit flex the metacarpophalangeal joint,
extend the proximal and distal interphalangeal joints of digits 2-4, abduct digits 2-4 (abduction of digits
in the hand is defined as movement away from the midline of the 3rd digit) ulnar nerve, deep
branch dorsal and palmar metacarpal aa. bipennate muscles; remember DAB & PAD - Dorsal
interosseous mm. ABduct and Palmar interosseous mm. ADduct - then you can figure out where they
must insert to cause these actions (Latin, inter = between + os = bone)

interosseous, palmar

(N465, N464,N470, TG2-41,TG2-35)

three (or four) muscles, arising from the palmar surface of the shafts of metacarpals 1, 2, 4, & 5 (the 1st
palmar interosseous is often fused with the adductor pollicis m.) base of the proximal phalanx and
extensor expansion of the medial side of digits 1 & 2, and lateral side of digits 4 & 5 flexes the
metacarpophalangeal, extends proximal and distal interphalangeal joints and adducts digits 1, 2, 4, & 5
(adduction of the digits of the hand is in reference to the midline of the 3rd digit) ulnar nerve,
deep branch palmar metacarpal aa. unipennate muscles; remember PAD & DAB: Palmar interossei
ADduct and Dorsal interossei ABduct, and you will be able to figure out where they must insert (Latin,
inter = between + os = bone)

lumbrical (hand)

(N463, (N464,N470, TG2-41, TG2-34) flexor digitorum profundus tendons of digits 2-5 extensor
expansion on the radial side of the proximal phalanx of digits 2-5flex the metacarpophalangeal joints,
extend the proximal and distal interphalangeal joints of digits 2-5 median nerve (radial 2) via
palmar digital nerves & ulnar nerve (ulnar 2) via deep branch superficial palmar arterial arch
lumbricals, (lumbricus is latin for "worm") arise from the profundus tendons and have the same
pattern of innervation as does the profundus muscle (ulnar and median nn. split the task equally) (Latin,
lumbricus = earthworm)

opponens digiti minimi

(N461, N448, TG2-35) hook of hamate and flexor retinaculum shaft of 5th metacarpal opposes the
5th digit ulnar nerve, deep branch ulnar a. opposition is a rotational movement of the 5th
metacarpal around the long axis of its shaft; opponens digiti minimi, abductor digiti minimi, and flexor
digiti minimi brevis are in the hypothenar compartment of the hand

opponens pollicis

(N465, TG2-35, Practical) flexor retinaculum, trapezium shaft of 1st metacarpal opposes the
thumb recurrent branch of median nerve superficial palmar branch of the radial a.
opposition is a rotational movement of the 1st metacarpal around the long axis of its shaft;
opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis are in the thenar compartment of the
hand (Latin, pollicis = the thumb or first finger from pollere, to be strong, because the thumb is stronger
than other fingers)

palmaris brevis

(N459, TG2-33) fascia overlying the hypothenar eminence skin of the palm near the ulnar border
of the hand draws the skin of the ulnar side of the hand toward the center of the palm
superficial br. of the ulnar n. ulnar a. palmaris brevis improves the grasp

Arteries of the Shoulder & Arm

Artery Source Branches Supply Notes

suprascapular

(N426, TG2-08, N427TG2-15, Practical) thyrocervical trunk muscular supraspinatus &

infraspinatus, shoulder joint anastomoses with the circumflex scapular a. and the dorsal scapular a.
to form the scapular anastomosis

axillary

(N184,N189, TG2-15A, TG2-15B, Practical) subclavian (continuation of the subclavian lateral to the
1st rib) 1st part: superior thoracic; 2nd part: thoracoacromial, lateral thoracic; 3rd part: ant. & post.
humeral circumflex, subscapularshoulder & upper limb pectoralis minor crosses the axillary artery
anteriorly and is used to delineate the 3 parts mentioned at left (Latin, axillary = armpit)

superior thoracic axillary, 1st part muscular intercostal spaces 1 & 2 laterally

thoracoacromial

(N427, TG2-15, Practical1, Practical2) axillary, 2nd part pectoral br., clavicular br., acromial br.,
deltoid br. pectoralis major & minor, subclavius, deltoid, shoulder joint

lateral thoracic

(N191,N427, TG2-15A, TG2-15B) axillary, 2nd part muscular serratus anterior &
adjacent muscles, skin & fascia a rare artery in that it enters the serratus anterior from its superficial
surface

subscapular

(N427, TG2-15A, TG2-15B) axillary, 3rd part circumflex scapular, thoracodorsal

subscapularis, teres major, teres minor, infraspinatus, latissimus dorsi anastomoses with
suprascapular, dorsal scapular & deep br. of transverse cervical
circumflex scapular

(N427, TG2-09A, TG2-15) subscapular muscular teres major & minor, infraspinatus
anastomoses with suprascapular & dorsal scapular branches (Latin, circum- = around + -flex = to
bend)

thoracodorsal

(N427, TG2-15A, TG2-15B) subscapular muscular latissimus dorsi

anterior circumflex humeral

(N427, TG2-09A, TG2-15, Practical) axillary, 3rd part muscular arm muscles near
surgical neck of humerus (Latin, circum- = around + -flex = to bend)

posterior circumflex humeral

(N427, TG2-09A, TG2-15) axillary, 3rd part muscular arm muscles near surgical neck
of humerus passes through quadrangular space with axillary nerve

brachial

(N434,N429, TG2-17, TG2-19, Practical) axillary (continuation distal to teres major m.) deep brachial,
sup. ulnar collateral, nutrient, inf. ulnar collateral; terminal branches are the radial & ulnar arm,
forearm & handnormally terminates at the level of the elbow, but high branching may occur

deep brachial

(N434, TG2-18, TG2-19) brachialascending br., terminal branches are the middle collateral & radial
collateral post. arm

Arteries of the Forearm

Artery Source Branches Supply Notes

brachial

(N448,TG2-26A, TG2-26B, TG2-46, Practical) axillary a. (brachial a. is the continuation of the axillary
a. distal to the teres major m.) deep brachial a., superior ulnar collateral a., nutrient a., inferior ulnar
collateral a.; terminal branches are the radial a. and the ulnar a. arm, forearm and hand brachial a.
normally terminates at the level of the elbow, but high branching may occur

interosseous, anterior
(N448,N466,TG2-26A,TG2-26B) common interosseous a. muscular brs.; a. of the median nerve
flexor pollicis longus m., flexor digitorum profundus m., pronator quadratus m., radius, ulna,
carpal bones anterior interosseous a. pierces the interosseous membrane at its distal end to reach the
dorsal carpal anastomosis (Latin, inter = between + os = bone)

interosseous, common

(N448,TG2-26A, TG2-26B, Practical) ulnar a. anterior interosseous a., posterior interosseous a.

deep structures of the forearm common interosseous a. supplies the deep forearm flexor and
deep forearm extensor muscles (Latin, inter = between + os = bone)

interosseous, posterior

(N448,N445,TG2-26A,TG2-30) common interosseous a. interosseous recurrent muscles of the

posterior (extensor) forearm compartment: supinator m., abductor pollicis longus m., extensor pollicis
longus m., extensor pollicis brevis m., extensor indicis m. posterior interosseous a. passes
proximal to the interosseous membrane to reach the extensor compartment of the forearm (Latin, inter
= between + os = bone)

radial

(N447,N466,TG2-26A,TG2-26B, TG2-46, Practical1, Practical2) brachial a. radial recurrent a.,

palmar carpal br., superficial palmar br., dorsal carpal br., 1st dorsal metacarpal a., princeps pollicis a.,
radialis indicis a., deep palmar arterial arch posterior elbow, posterior forearm, posterior hand,
deep portion of palmar side of the hand, thumb radial a. provides the majority of blood supply to the
deep palmar arterial arch; normally it arises at the level of the elbow but high branching of the brachial
a. may result in the radial a. arising as proximal as the axilla

ulnar

(N448,TG2-26A, TG2-26B, TG2-46, Practical1) brachial a. anterior ulnar recurrent a., posterior
ulnar recurrent a., common interosseous a., palmar carpal br., dorsal carpal br., deep palmar br.,
superficial palmar arterial arch medial side of the anterior forearm, posterior forearm, superficial palm,
fingers ulnar a. supplies the majority of blood to the superficial palmar arterial arch; it normally arises at
the level of the elbow, but high branching of the brachial a. may cause the ulnar a. to arise as far
proximally as the axilla (Latin, ulna = elbow or arm)

Arteries of the Hand

Artery Source Branches Supply Notes

arch, deep palmar

(N466, TG2-37A, TG2-37B, Practical) radial a., deep br. of ulnar a. palmar metacarpal aa. (2nd-
4th), perforating brs. deep palm, digits including the dorsum of the distal phalangeal segment deep
palmar arterial arch receives the majority of its blood supply from the radial a.

arch, superficial palmar

(N448, N466, TG2-37A, TG2-37B, TG2-26A, TG2-26B, TG2-46) ulnar a., superficial palmar br. of the
radial a.common palmar digital aa. (3) superficial palm, palmar surface of the digits excluding thumb,
dorsum of the distal phalangeal segments of digits 2-5 superficial palmar arterial arch receives the
majority of its blood supply from the ulnar a.

digital, common palmar

(N466, TG2-37A, TG2-37B) superficial palmar arterial arch proper palmar digital aa. (2) palmar
aspect two adjacent digits common palmar digital aa. anastomose with palmar metacarpal aa.

digital, proper palmar

(N466, TG2-37A, TG2-37B, Practical) common palmar digital a. no named branches palmar
aspect of each digit proper palmar digital aa. supply the dorsum of the distal phalangeal segment
and nail bed

princeps pollicis

(N466, TG2-37, Practical) radial a.two brs. to the thumb palmar aspect of the thumb including
the dorsum of the distal phalangeal segment arteria princeps pollicis is similar in function to a proper
digital aa.; this artery has a large pulse which can be felt when attempting to take the pulse of a patient -
use fingers to feel for the patient's pulse (Latin, pollicis = the thumb or first finger from pollere, to be
strong, because the thumb is stronger than other fingers)

radial

(N466, TG2-37, Practical1, Practical2) brachial a. radial recurrent a., palmar carpal br., superficial
palmar br., dorsal carpal br., 1st dorsal metacarpal a., princeps pollicis a., radialis indicis a., deep palmar
arterial arch posterior elbow, posterior forearm, posterior hand, deep portion of palmar side of the
hand, thumb radial a. provides the majority of blood supply to the deep palmar arterial arch; normally
it arises at the level of the elbow but high branching of the brachial a. may result in the radial a. arising
as proximal as the axilla

radialis indicis

(N466, TG2-37) radial a.no named branches lateral (radial) side of the index finger arteria radialis
indicis is equivalent to a proper digital a.

recurrent, anterior ulnar

(N466, TG2-37A, TG2-37B) ulnar a. unnamed muscular brs. medial side of elbow and proximal ends
of forearm flexor mm. anterior ulnar recurrent a. often arises in common with the posterior ulnar
recurrent a. (Latin, ulna = elbow)

superficial ulnar

(N466, TG2-37A, TG2-37B) ulnar a. no named branches palm continues as the superficial
palmar arch (Latin, ulna = elbow)

Nerves of the Shoulder & Arm

Nerve Source Branches Motor SensoryNotes

brachial plexus

(N429,N430, TG2-14, TG2-13, Practical1, Practical2, Practical3, Practical4) ventral primary rami of
C5-8 & T1 dorsal scapular, long thoracic, n. to subclavius, suprascapular, lateral & medial pectoral,
medial brachial & antebrachial cutaneous, upper, middle & lower subscapular, musculocutaneous, ulnar,
median, axillary, radial muscles of upper limb, excluding trapezius skin of upper limb axons
from spinal cord levels C5-T1 are mixed (braided) in the brachial plexus and repackaged into terminal
branches so that each branch contains axons from several spinal cord levels (Latin, plexus = a braid. A
network of nerves, blood vessels, or lymphatic vessels)

dorsal scapular

(N429, TG2-14, Practical1, Practical2) brachial plexus (C5) rhomboid major & minor;
levator scapulae passes through scalenus medius

long thoracic

(N429,N190, TG2-13, TG2-14) brachial plexus (C5-C7) serratus anterior located

on superficial surface of serratus anterior; lesion causes scapular winging, hence the saying "C5, 6, & 7
keep the wings from heaven"

lateral cord

(N429, N474, TG2-13, TG2-14) union of anterior divisions of upper & middle trunks lateral pectoral,
lateral root of median n., musculocutaneous anterior arm; contributes to anterior forearm & thenar
compartment lateral forearm; contributes to palmar hand

medial cord
(N430, TG2-14) anterior division of lower trunk medial pectoral, medial brachial cutaneous, medial
antebrachial cutaneous, medial root of median n., ulnar fl. carpi ulnaris & medial half of fl. dig.
profundus, contributes to other anterior forearm muscles; hand muscles medial forearm & hand

posterior cord

(N430, TG2-13, TG2-14) posterior divisions of upper, middle, & lower trunks upper, middle, & lower
subscapular, axillary, radial deltoid, teres major & minor, subscapularis, posterior arm & forearm
posterior arm & forearm, posterolateral hand

suprascapular

(N429, N426, TG2-08, TG2-14, Practical) superior trunk of the brachial plexus (C5-C6) no named
branches supraspinatus, infraspinatus no cutaneous branches passes through the
suprascapular notch inferior to the superior transverse scapular ligament

lateral pectoral

(N429, TG2-13, TG2-14, Practical) lateral cord of brachial plexus pectoralis major
communicates with medial pectoral n. anterior to axillary a.; pierces clavipectoral fascia

musculocutaneous

(N474, TG2-13, TG2-14, Practical) lateral cord of brachial plexus (C5,6) lateral antebrachial
cutaneous coracobrachialis, biceps brachii, brachialis skin of lateral side of forearm pierces
coracobrachialis

medial pectoral

(N429, TG2-13, Practical1, Practical2) medial cord of the brachial plexus pectoralis
minor & major communicates with lateral pectoral n. anterior to axillary a.; pierces pectoralis
minor

medial brachial cutaneous

(N433,N479, TG2-13, TG2-14) medial cord of brachial plexus skin of the medial side
of the arm communicates with intercostobrachial n. (Latin, cutis = skin)

medial antebrachial cutaneous

(N433,N479, TG2-13, TG2-14) medial cord of brachial plexus skin of medial side of
forearmtravels with basilic vein for part of course (Latin, cutis = skin)

ulnar

(N433,N476, TG2-13, TG2-14, Practical1, Practical2, Practical3) medial cord of the brachial plexus
palmar cutaneous br., dorsal br., superficial & deep br. flexor carpi ulnaris, flexor digitorum
profundus (ulnar half), abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi, ulnar 2
lumbricals, palmar & dorsal interossei, adductor pollicis skin of medial side of wrist & hand & ulnar 1 1/2
digits on palmar side and 2 1/2 digits dorsally motor to most of the muscles of the hand (Latin, ulna =
elbow or arm)

upper subscapular

(N429, TG2-13, TG2-14) posterior cord of brachial plexus subscapularis (superomedial part)

thoracodorsal (middle subscapular)N426, TG2-13, TG2-14) posterior cord of brachial plexus

latissimus dorsi

lower subscapular

(N426, TG2-13, TG2-14) posterior cord of brachial plexus subscapularis (lateral part), teres major

radial

(N477,N478, TG2-13, TG2-14, Practical1, Practical2) posterior cord of brachial plexusposterior

brachial cutaneous, inferior lateral brachial cutaneous, posterior antebrachial cutaneous, superficial &
deep br. triceps brachii, anconeus, brachioradialis, extensor carpi ulnaris, extensor carpi radialis
longus & brevis, extensor digitorum, extensor digiti minimi, supinator, abductor pollicis longus, extensor
pollicis longus & brevis, extensor indicis skin of posterior arm, forearm & hand motor to the extensor
muscles of the arm and forearm

axillary

(N426, TG2-13, TG2-14. Practical1, Practical2) posterior cord of brachial plexussuperior lateral brachial
cutaneous nerve deltoid, teres minor skin of upper lateral arm endangered by surgical
neck fractures

median

(N473,N475, TG2-13, TG2-14, Practical1, Practical2) lateral & medial cords of brachial plexus anterior
interosseous, palmar br., recurrent (motor) br., common palmar digital ns. (1st-3rd) pronator teres,
flexor carpi radialis, palmaris longus, flexor digitorum superficialis, flexor digitorum profundus (radial
half), flexor pollicis longus, pronator quadratus, abductor pollicis brevis, flexor pollicis brevis, opponens
pollicis, radial 2 lumbricals skin of radial half of palm & palmar side of radial 3 1/2 digits (and nail
bed for these digits) motor to the flexor muscles of the forearm (except flexor carpi ulnaris and the
medial 1/2 of the flexor digitorum profundus),the muscles of the thenar compartment and the lateral 2
lumbricals

intercostobrachial
(N429,N473,N479) lateral cut. branch of 2nd intercostal floor of axilla, medial
and posterior surfaces of arm communicates with the medial brachial cutaneous n.

Nerves of the Forearm

Nerve Source Branches Motor SensoryNotes

interosseous, anterior

(N448, TG2-25,TG2-27) median n. no named branches flexor pollicis longus m., radial half of
flexor digitorum profundus m., pronator quadratus m. none courses along the anterior surface of
the interosseous membrane (Latin, inter = between + os = bone)

interosseous, posterior

(TG2-30) deep radial n. no named branches some authors say none, others say the deep
posterior forearm muscles proprioception to the wrist jointthere is variability in the definition of
this nerve; for some, deep radial and posterior interosseous are synonymous; others define this nerve as
the articular br. to the wrist from the deep radial (Latin, inter = between + os = bone)

median n.

(N466,N458, TG2-27,TG2-48, Practical1, Practical2) lateral and medial cords of the brachial plexus
anterior interosseous n., palmar br., recurrent (motor) br., common palmar digital nn. (for digits
1-3) pronator teres m., flexor carpi radialis m., palmaris longus m., flexor digitorum superficialis m.,
flexor digitorum profundus m. (radial half), flexor pollicis longus m., pronator quadratus m., abductor
pollicis brevis m., flexor pollicis brevis m., opponens pollicis m., lateral 2 lumbrical mm. skin of the
radial half of the palm and palmar side of the lateral 3 1/2 digits (and nail bed for these digits) the
median n. is motor to the flexor muscles of the forearm (except flexor carpi ulnaris and the medial 1/2 of
the flexor digitorum profundus),the muscles of the thenar compartment and the lateral 2 lumbricals

radial n.

(N447,N467, N478,TG2-27, TG2-50, Practical) posterior cord of the brachial plexus posterior
brachial cutaneous n., inferior lateral brachial cutaneous n., posterior antebrachial cutaneous n.,
superficial and deep brs. muscles of the posterior arm: triceps brachii m., anconeus m.; muscles
of the posterior forearm: brachioradialis, extensor carpi ulnaris m., extensor carpi radialis longus m.,
extensor carpi radialis brevis m., extensor digitorum m., extensor digiti minimi m., supinator m.,
abductor pollicis longus m., extensor pollicis longus m., extensor pollicis brevis m., extensor indicis m.
skin of the posterior arm, forearm and hand all of the muscles on the posterior side of the
arm and forearm are innervated by the radial n.
radial, deep

(N447,N467, N478,TG2-27, TG2-50, Practical) radial n. posterior interosseous n.

extensor carpi radialis brevis m., supinator m., extensor digitorum m., extensor digiti minimi m.,
abductor pollicis longus m., extensor pollicis longus m. extensor pollicis brevis m., extensor indicis m.
no cutaneous branches deep radial n. passes through the supinator m.; some authors believe
that the posterior interosseous n. and the deep radial n. are synonymous, others say that when the deep
radial n. emerges from the supinator in the posterior forearm it becomes the posterior interosseous n.,
and others say that the deep radial n. does not become the posterior interosseous n. until after its last
muscular br. has been given off

radial, superficial

(N447,N467, N478,TG2-27, TG2-50, Practical) radial n. dorsal digital brs. sympathetic

motor for the skin skin of the posterolateral wrist and hand; dorsum of the lateral 2 1/2 digits
(excluding the skin over the distal phalanx/nail bed) superficial radial n. is located deep to the
brachioradialis muscle

ulnar n.

(N448,N468, N459,TG2-27 TG2-49, Practical1, Practical2, Practical3) medial cord of the brachial
plexus (C8, T1) palmar cutaneous br., dorsal br., superficial and deep brs. flexor carpi ulnaris m.,
flexor digitorum profundus m. (ulnar half), abductor digiti minimi m., flexor digiti minimi brevis m.,
opponens digiti minimi m., ulnar 2 lumbrical mm., palmar and dorsal interosseous mm. skin of the
medial side of the wrist and hand; skin of the medial 1 1/2 digits ulnar n. is motor to most of the muscles
of the hand (Latin, ulna = elbow or arm)

Nerves of the Hand

Nerve Source Branches Motor SensoryNotes

digital, common palmar

(N466, TG2-38) median n.; superficial br. of the ulnar n. proper palmar digital nn. sympathetic
motor to the skin; motor nn. to the 1st & 2nd lumbrical mm. are carried on common palmar digital brs.
of the median n. skin of the palmar surfaces of the adjacent sides of two digits the proper
branches of these nerves also supply the dorsum of the tip of the digit (nail bed)

digital, dorsal radial n. no named branches sympathetic motor innervation to skin dorsal
skin of the lateral 3 1/2 digits, except the nail bed the nail bed is supplied by palmar digital nn.

digital, proper palmar

(N466, TG2-38A, TG2-38B) common palmar digital branches of the median n.; common palmar
digital branches of the superficial br. of the ulnar n. no named branches sympathetic motor to
the skinmedian: palmar skin and nail bed of digits 1-3 and the lateral side of 4th digit; ulnar: palmar and
dorsal skin on medial side of the 4th digit and all of the 5th digit proper palmar digital nn. supply the
dorsum of the tip of the digit (nail bed)

dorsal branch of the ulnar n.

(N476, TG2-49) ulnar n. dorsal digital sympathetic motor innervation to skin skin of the dorsal
surface of the medial 1 1/2 digits; skin of the medial side of the back of the hand dorsal branch of the
ulnar n. emerges at the level of the ulnar styloid process (Latin, ulna = elbow)

median n.

(N475, TG2-48, Practical1, Practical2) lateral and medial cords of the brachial plexus anterior
interosseous n., palmar br., recurrent (motor) br., common palmar digital nn. (for digits 1-3)
pronator teres m., flexor carpi radialis m., palmaris longus m., flexor digitorum superficialis m.,
flexor digitorum profundus m. (radial half), flexor pollicis longus m., pronator quadratus m., abductor
pollicis brevis m., flexor pollicis brevis m., opponens pollicis m., lateral 2 lumbrical mm. skin of the
radial half of the palm and palmar side of the lateral 3 1/2 digits (and nail bed for these digits) the
median n. is motor to the flexor muscles of the forearm (except flexor carpi ulnaris and the medial 1/2 of
the flexor digitorum profundus),the muscles of the thenar compartment and the lateral 2 lumbricals

recurrent br. of median n.

(N466, TG2-38, Practical) median n. immediately distal to carpal tunnel none abductor
pollicis brevis m., flexor pollicis brevis m., opponens pollicis m. none recurrent br. is also called the
million dollar nerve

ulnar n.

(N466, TG2-37A, TG2-37B, Practical1, Practical2, Practical3) medial cord of the brachial plexus (C8,
T1) palmar cutaneous br., dorsal br., superficial and deep brs. flexor carpi ulnaris m., flexor
digitorum profundus m. (ulnar half), abductor digiti minimi m., flexor digiti minimi brevis m., opponens
digiti minimi m., ulnar 2 lumbrical mm., palmar and dorsal interosseous mm. skin of the medial side
of the wrist and hand; skin of the medial 1 1/2 digits ulnar n. is motor to most of the muscles of the
hand (Latin, ulna = elbow)

Clinical Terms

Term Definition
Allen's test Test for collateral circulation between radial and ulnar arteries or patency of them. The
patient makes a tight fist expressing the blood from the hand. The examiner then compresses either the
radial or ulnar artery and then has the patient open the hand. If the hand turns pinkish the connection
between and both vessels are patent. If on opening the hand blood fails to return to palm and fingers,
the non-compressed artery is occluded and there is no collateral circulation between the two.

ape hand a deformity marked by thumb movements being limited to flexion and extension in the
plane of the palm due to the inability to oppose (and limited abduction of) the thumb. The recurrent
(thenar) branch of the median nerve supplying the thenar muscles lies subcutaneously and may be
severed by relatively minor lacerations involving the thenar eminence. Severence of this nerve paralyzes
the thenar muscles, and the thumb loses much of its usefulness.

carpal tunnel syndrome results from any lesion that significally reduces the size of the carpal tunnel.
Fluid retention, infection, and excessive exercise of the fingers may cause swelling of the tendons or their
synovial sheaths. Median nerve is the most sensitive structure in the carpal tunnel and therefore is the
most affected. Median nerve has sensory branches to the lateral three and a half digits thus paresthesia
(abnormal sensation), hypothesia (reduced sensation), or anesthesia (loss of sensation) may occur.
Furthermore, the only motor branch of the median nerve is the recurrent branch which serves three
thenar muscles. Continued compresion of the median nerve will lead to weakness of the abductor
pollicis brevis and opponens pollicis. To relieve the symptoms, partial or complete surgical division of the
flexor retinaculum (carpal tunnel release) may be necessary. Clinically this syndrome can be tested for by
tapping on the carpal tunnel. If symptoms are elicited (positive Tinel's sign), the syndrome is likely.

claw hand, ulnar Ulnar nerve injury commonly occurs where the nerve passes posterior to the
medial epicondyle of the humerus. The injury results when the posteromedial part of the elbow hits a
hard surface, fracturing the medial epicondyle. Ulnar nerve injury causes extensive motor and sensory
loss to the hand. Power of adduction is impaired, and when an attempt is made to make a fist the hand
is drawn laterally by the flexor carpi radialis (which gets its nerve supply from the median nerve).
Following ulnar nerve injury, patients have difficulty making a fist because they cannot flex their 4th and
5th digits at the distal interphalangeal joints. This characteristic appearance of the hand resulting from a
distal lesion of the ulnar nerve is known as clawhand. (Latin, ulna = elbow)

Colles fracture most common fracture of the forearm. The distal end of the radius is broken, and distal
fragment is displaced dorsally and is often comminuted (broken into pieces). The fracture results from
forced extension of the hand, usually as the result of trying to ease a fall by outstretching the upper limb.

Dupuytren's contracture A progressive shortening, thickening, and fibrosis of the palmar fascia
and aponeurosis. The fibrous degeneration of the longitudinal bands of the palmar aponeurosis on the
medial side of the hand pulls the ring and little fingers into partial flexion at the MP and PIP joints. The
contracture is frequently bilateral and is common in men older than 50 years; the cause is unknown, but
evidence points to a hereditary disposition. Treatment involves excision of the fibrotic parts of the
palmar fascia.
epicondylitis inflammation of the epicondyle or of the tissues adjoining the epicondyle of the
humerus. Lateral epicondylitis is also referred to as "tennis elbow". (Greek, kondylos = the knob formed
by the knuckle of any joint)

Erb-Duchenne palsy injury to the superior roots of the brachial plexus, C5 and C6, leads to paralysis
of the supraspinatus and infraspinatus muscles, and in more severe forms may involve deltoid, biceps,
brachialis, coracobrachialis, brachioradialis, teres minor, and subscapularis; the upper limb is adducted at
the shoulder, medially rotated, and extended at the elbow. This type of injury can result from too much
traction on the neck, or forcible lateral neck bending, as can occur during delivery. This should be
suspected when the muscles of the hand are intact, but the Moro reflex is absent in an infant (Moro
reflex is similar to the startle reflex, and involves abduction and then adduction of the arms).

Klumpke's palsy a lower brachial plexus injury; occurs when a person grabs something to break a fall or a
baby's arm is pulled too much during delivery; the dorsal and ventral roots of the spinal nerves that form
the inferior trunk of the brachial plexus (C8 and T1) may be avulsed; the short muscles of the hand are
affected, and a clawhand results

painful arc syndrome pain caused by subacromial bursitis; felt during the arc of 50 to 120 degrees

radial nerve/Saturday night palsy The radial nerve is often injured when the humerus fractures at
mid-shaft; wrist drop is a common clinical manifestation. The deep branch of the radial nerve can be
injured by deep puncture wounds to the forearm. The deep branch of the radial nerve is responsible for
extending the thumb and the MP joints. Neither deep nor superficial radial nerve injury causes much
sensory loss, but cutting the superifical leaves a coin-shaped area distal to the bases of the 1st and 2nd
metacarpals without sensation.

rotator cuff tearcan lead to rupture of one or more of the tendons of the muscles forming the rotator
cuff; acute tears may occur when the arm is violently pushed into abduction; a tear in the rotator cuff
may present as pain in the anterosuperior part of the shoulder; tears also follow dislocation of the
shoulder

scaphoid fracture/avascular necrosis scaphoid is the most frequently fractured carpal bone, and
injury to this bone is the most common wrist injury. Pain occurs primarly during extension and abduction
of the hand, and is felt on the lateral side of the wrist. Because of poor blood supply to the proximal part
of the scaphoid, union of the fractured parts may take several months. Avascular necrosis of the
proximal fragment of the scaphoid may occur and produce degenerative joint disease of the wrist. In
some cases, it is necessary to fuse the carpals surgically.

subdeltoid/subacromial bursitis the tendon of the supraspinatus is separated from the coracoacromial
ligament, acromion, and deltoid by the subacromial bursa; when this bursa is inflamed (subacromial
bursitis), abduction of the arm is extremely painful during of the arc of 50 to 120 degrees (painful arc
syndrome); pain may radiate as far distally as the hand, acute pain is also felt lateral to the acromion
tennis elbow also called elbow tendinitis, it is due to repetitive use of the superficial extensor muscles
of the forearm. The pain is felt on the lateral epicondyle and radiates down the posterior surface of the
forearm. Patients with this condition will often feel pain when they open a door or lift a glass. The
repeated forceful flexion and extension of the wrist strains the attachment of the common tendon,
producing inflammation of the periosteum of the lateral epicondyle and the common extensor
attachment of the muscles.

wrist drop the radial nerve is usually injured when the humeral shaft fractures. An injury of this
kind is going to be proximal to the wrist extensors, thus wrist drop is a common clinical manifestation.
The deep branch of the radial nerve can be injured by deep puncture wounds to the forearm. The deep
branch of the radial nerve is responsible for extending the thumb and MP joints. Neither deep nor
superficial radial nerve injury causes much sensory loss, but cutting the superficial leaves a coin-shaped
area distal to the bases of the 1st and 2nd metacarpals without sensation.

The material presented in these tables is contained in the book:

MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger

Published by ILOC, Inc., New York

Copyright © 1995, unauthorized use prohibited.

The excellent editorial assistance of

Dr. Pat Tank, UAMS

is gratefully acknowledged.

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