Suprascapular Nerve The suprascapular nerve arises from the upper trunk of the brachial plexus (C5 a nd 6) in the

e posterior triangle in the neck. It runs downward and laterally and passes beneath the suprascapular ligament, wh ich bridges the suprascapular notch, to reach the supraspinous fossa It supplies the supraspinatus and infraspinatus muscles and the shoulder joint. Axillary Nerve The axillary nerve arises from the posterior cord of the brachial plexus (C5 and 6) in the axilla It passes backward and enters the quadrangular space with the posterior circumfl ex humeral artery. As the nerve passes through the space, it comes into close relationship with the inferior aspect of the capsule of the shoulderjoint and with the medial side of the surgical neck of the humerus. It terminates by dividing into anterior and posterior branches. Branches The axillary nerve has the following branches: An articular branch to the shoulder joint An anterior terminal branch, which winds around the surgical neck of the humerus beneath the deltoid muscle; it supplies the deltoid and the skin that covers it s lower part. A posterior terminal branch, which gives off a branch tothe teres minor muscle a nd a few branches to the deltoid, then emerges from the posterior border of the deltoid as the upper lateral cutaneous nerve of the arm Musculocutaneous Nerve The origin of the musculocutaneous nerve from the lateral cord of the brachial p lexus (C5, 6, and 7) in the axilla. It runs downward and laterally, pierces the coracobrachialis muscle and then passes downward between the biceps and brachialis muscles . It appears at the lateral margin of the biceps tendon pierces the deep fascia just above the elbow. It runs down the lateral aspect of the forearm as the lateral cutaneous nerve of the forearm Branches Muscular branches to the biceps, coracobrachialis, and brachialis Cutaneous branches; the lateral cutaneous nerve of the forearm supplies the skin of the front and lateral aspects of the forearm down as far as the root of the thumb. Articular branches to the elbow joint

Median Nerve ( IN ARM ) It originate from the medial and lateral cords of the brachial plexus in the ax illa It runs downward on the lateral side of the brachial artery Halfway down the upper arm, it crosses the brachial artery and continues downwar d on its medial side. The nerve, like the artery, is therefore superficial, but at the elbow, it is cr ossed by the bicipital aponeurosis. The median nerve has no branches in the upper arm except for a small vasomotor n erve to the brachial artery. IN FOREARM The median nerve leaves the cubital fossa by passing between the two heads of th e pronator teres It continues downward behind the flexor digitorum superficialis and rests poster iorly on the flexor digitorum profundus. At the wrist, the median nerve emerges from the lateral border of the flexor dig

itorum superficialis muscle lies behind the tendon of the palmaris longus It enters the palm by passing behind the flexor retinaculum. Branches Muscular branches in the cubital fossa to the pronator teres, the flexor carpi r adialis, the palmaris longus, and the flexor digitorum superficialis Articular branches to the elbow joint Anterior interosseous nerve : Largest branch of the median nerve, originate bet ween two heads of pronator teres , passing down with interosseous artery and ine vates muscles of deep layer ( Flexor Pollicis longus, Lateral half of Flexor dig itorum profundus & Pronator Quadratus). Palmar cutaneous branch. This arises in the lower part of the forearm and is dis tributed to the skin over the lateral part of the palm (IN PALM) The median nerve enters the palm by passing behind the flexor retinaculum and th rough the carpal tunnel. It immediately divides into lateral and medial branches. The muscular branch takes a recurrent course around the lower border of the flex or retinaculum and lies about one fingerbreadth distal to the tubercle of the sc aphoid It supplies the muscles of the thenar eminence (the abductor pollicis brevis, th e flexor pollicis brevis, and the opponens pollicis) and the 1st lumbrical muscl e. The cutaneous branches supply the palmar aspect of the lateral three and a half fingers and the distal half of the dorsal aspect of each finger. One of these br anches also supplies the second lumbrical muscle. The palmar cutaneous branch of the median nerve given off in the front of the fo rearm crosses anterior to the flexor retinaculum and supplies the skin over the lateral part of the palm Radial Nerve (IN THE POSTERIROR COMPARTMENT OF ARM ) It originate from the posterior cord of the brachial plexus in the axilla The nerve winds around the back of the arm in the spiral groove on the back of t he humerus between the heads of the triceps It pierces the lateral fascial septum above the elbow and continues downward int o the cubital fossa in front of the elbow, between the brachialis and brachiorad ialis muscles. In the spiral groove,the nerve is accompanied by the profunda vessels, and it li es directly in contact with the shaft of the humerus Branches In the axilla, branches are given to the long and medial heads of the triceps, a nd the posterior cutaneous nerve of the arm is given off. In the spiral groove (Fig. 9.46), branches are given to the lateral and medial h eads of the triceps and to the anconeus. The lower lateral cutaneous nerve of th e arm supplies the skin over the lateral and anterior aspects of the lower part of the arm. The posterior cutaneous nerve of the forearm runs down the middle of the back of the forearm as far as the wrist. In the anterior compartment of the arm, after the nerve has pierced the lateral fascial septum, it gives branches to the brachialis, the brachioradialis, and th e extensor carpi radialis longus muscles . It also gives articular branches to the elbow joint. LATERAL COMPARTMENT OF THE FOREARM

 The radial nerve pierces the lateral intermuscular septum in the lower part of the arm passes forward into the cubital fossa . It then passes downward in front of the lateral epicondyle of the humerus, lying between the brachialis on the medial side and the brachioradialis and extensor carpi radialis longus on the lateral side At the level of the lateral epicondyle, it divides into superficial and deep bra nches Branches Muscular branches to the brachioradialis, to the extensor carpi radialis longus, and a small branch to the lateral part of the brachialis muscle Articular branches to the elbow joint Deep branch of the radial nerve. This winds around the neck of the radius, withi n the supinator muscle and enters the posterior compartment of the forearm Superficial Branch of the Radial Nerve The superficial branch of the radial nerve is the direct continuation of the ner ve after its main stem has given off its deep branch in front of the lateral epi condyle of the humerus . It runs down under cover of the brachioradialis muscle on the lateral side of th e radial artery. In the distal part of the forearm, it leaves the artery and passes backward unde r the tendon of the brachioradialis . It reaches the posterior surface of the wrist, where it divides into terminal br anches that supply the skin on the lateral two thirds of the posterior surface o f the hand .and the posterior surface over the proximal phalanges of the lateral three and a half fingers. The area of skin supplied by the nerve on the dorsum of the hand is variable. (IN THE POSTERIOR COMPARTMENT) Deep Branch of the Radial Nerve The deep branch arises from the radial nerve in front of the lateral epicondyle of the humerus in the cubital fossa . It pierces the supinator and winds around the lateral aspect of the neck of the radius in the substance of the muscle to reach the posterior compartment of the forearm. The nerve descends in the interval between the superficial and deep groups of mu scles .It eventually reaches the posterior surface of the wrist joint. Branches Muscular branches to the extensor carpi radialis brevis and the supinator, the e xtensor digitorum, the extensor digiti minimi, the extensor carpi ulnaris, the a bductor pollicis longus, the extensor pollicis brevis, the extensor pollicis lon gus, and the extensor indicis (ECRB, ECU, S, ED, EDM, , APL, EPL & EPB , EI) Articular branches to the wrist and carpal joints IN THE DORSUM OF HAND Radial Nerve in the hand is the continuation of the superficial branch of the ra dial nerve. It reaches the dorsum of hand after winding around the lateral side of the radius. And divides into 4 dorsal digital branches which supply the skin of the digits as follows. 1. Lateral Side of the Thumb 2. Medial Side of the Thumb 3. Lateral side of Index Finger 4. Contiguous sides of index and middle finger 5. Contiguous sides of index and ring finger Ulnar Nerve ANTERIOR COMPARTMENT OF ARM Originate from the medial cord of the brachial plexus in the axilla is describe

d It runs downward on the medial side of the brachial artery as far as the middle of the arm Here, at the insertion of the coracobrachialis, the nerve pierces the medial fas cial septum, accompanied by the superior ulnar collateral artery, and enters the posterior compartment of the arm; the nerve passes behind the medial epicondyle of the humerus. The ulnar nerve has no branches in the anterior compartment of the upper arm (POSTERIOR COMPARTMENT OF ARM ) Having pierced the medial fascial septum halfway down the upper arm, the ulnar n erve descends behind the septum, covered posteriorly by the medial head of the triceps. The nerve is accompanied by the superior ulnar collateral vessels. At the elbow, it lies behind the medial epicondyle of the humerus on the medial ligament of the elbow joint. It continues downward to enter the forearm between the two heads of origin of th e flexorcarpi ulnaris Branches The ulnar nerve has an articular branch to the elbow joint IN FOREARM The ulnar nerve passes from behind the medial epicondyle of the humerus, crosses the medial ligament of the elbow joint Enters the front of the forearm by passing between the two heads of the flexor c arpi ulnaris. It then runs down the forearm between the flexor carpi ulnaris and the flexor di gitorum profundus muscles. In the distal two thirds of the forearm, the ulnar artery lies on the lateral si de of the ulnar nerve At the wrist, the ulnar nerve becomes superficial and lies between the tendons o f the flexor carpi ulnaris and flexor digitorum superficialis muscles . The ulnar nerve enters the palm of the hand by passing in front of the flexor re tinaculum and lateral to the pisiform bone; here, it has the ulnar artery latera l to it Branches Muscular branches to the flexor carpi ulnaris and to the medial half of the flex or digitorum profundus Articular branches to the elbow joint The palmar cutaneous branch is a small branch that arises in the middle of the fo rearm and supplies the skin over the hypothenar eminence. The dorsal posterior cutaneous branch is a large branch that arises in the distal third of the forearm. It passes medially between the tendon of the flexor carpi ulnaris and the ulna and is distributed on the posterior surface of the hand an d fingers.

IN HAND (PALM) The ulnar nerve enters the palm anterior to the flexor retinaculum alongside the lateral border of the pisiform bone. As it crosses the retinaculum, it divides into a superficial and a deep terminal branch. Superficial Branch of the Ulnar Nerve The superficial branch of the ulnar nerve descends into the palm, lying in the s ubcutaneous tissue between the pisiform bone and the hook of the hamate .The uln

ar artery is on its lateral side. Here, the nerve and artery may lie in a fibroosseous tunnel, the tunnel of Guyon, created by fibrous tissue derived from the superficial part of the flexor retinaculum. The nerve may be compressed at t his site, giving rise to clinical signs and symptoms. The nerve gives off the fo llowing branches: a muscular branch to the palmaris brevis and cutaneous branche s to the palmar aspect of the medial side of the little finger and the adjacent sides of the little and ring fingers .It also supplies the distal half of the do rsal aspect of each finger. Deep Branch of the Ulnar Nerve The deep branch of the ulnar nerve runs backward between the abductor digiti min imi and the flexor digiti minimi It pierces the opponens digiti minimi, winds ar ound the lower border of the hook of the hamate, and passes laterally within the concavity of the deep palmar arch. The nerve lies behind the long flexor tendon s and in front of the metacarpal bones and interosseous muscles. It gives off mu scular branches to the three muscles of the hypothenar eminence, namely, the abd uctor digiti minimi, the flexor digiti minimi, and the opponens digiti minimi. I t supplies all the palmar and dorsal interossei, the 3rd and 4th lumbrical muscl es, and both heads of the adductor pollicis muscle. The palmar cutaneous branch of the ulnar nerve given off in the front of the for earm crosses anterior to the flexor retinaculum (Fig. 9.54) and supplies the ski n over the medial part of the palm