ULNAR NERVE Flashcards
Medial cord of b plexus C8-T1
Ulnar nerve
Formed in axilla is
ULnar nerve
ULnar nerve in axilla
Between axillary (third part) artery and vein
Then Ulnar nerve enters in arm
Posteromedial to Brachial Artery and stays medial in arm
At the mid arm level the nerve pierces the
medial intermuscular septum at the arcade of struthers
Arcade of struthers are
aponeurotic fibers from medial triceps to intermuscular septum
Arcade of Struthers is located 8 cm proximal to the
medial epicondyle
So up to the mid arm level the ulnar nerve is in the
Anterior compartment of the arm
After piercing the IM septum, it becomes in the
posterior arm compartment
Then lies antero medial to the
Triceps Brachii muscle
Then becomes posterior to the
medial epicondyle
Then goes through the
CUBITAL TUNNEL
Also the artery in the cubital tunnel is the
SUPERIOR ULNAR COLLATERAL ARTERY
Cubital Tunnel roof formed proximally by
OSBORNE LIGAMENT
Cubital tunnel floor is formed by
Posterior and transverse bands of medial carpal ligaments and elbow joint capsule
Then nerve passes through the 2 heads of the
FCU
Also the nerve passes under the
FLEXOR PRONATOR APONEUROSIS
Then nerve dives into the
Anterior compartment of the forearm
In the forearm it passes between FCU and
FDP
Enters the hand passing lateral to which bone?
PISIFORM
The ulnar nerve is Superficial or Deep to the flexor retinaculum?
SUPERFICIAL
ULnar nerve if superficial to the Transverse carpal ligament ? T/F
TRUE
GUYON’S CANAL ROOF
VOLAR CARPAL LIGAMENT
Guyon Canal floor
Transverse carpal ligament, Hypothenar muscles and flexor retinaculum
Guyon Canal Ulnar border
Pisiform bone and pisohamate ligamentm, abductor digiti minimi muscle belly
Guyon canal radial border
The hook of the hamate
As it enters the hand the nerve divides into
2 branches (superficial and deep)
Ulnar nerve gives no branches in the
arm
In forearm, ulnar nerve gives 3 branches:
muscular branches, cutaneous branches and articular branches
muscular branches of ulnar nerve in forearm:
FCU, ulnar half of FDP
Cutaneous branch of ulnar nerve in forearm
palmar and dorsal branches
Palmar cutaneous branch of ulnar nerve
arises in the middle of the forearm and supplies the skin of the HYPOTHENAR eminance
Palmar cutaneous branch of ulnar nerve passes
superficial to volar ligament (roof of Guyon Canal)
Dorsal Branch of Ulnar nerve
Ulnar 1.5 fingers
Articular branch of ulnar nerve
through cubital tunnel to the Elbow joint
DEEP Branch of Ulnar nerve
MOTOR NERVE
Muscular branches supplied by the deep branch
8 Interossei, Ulnar 2 lumbricals, Adductor pollicis brevis
Also the deep branches give articular branches to the
wrist joint
SUPERFICIAL BRANCH is
SENSORY mainly
Superficial branch only motor brach supplies the
PALMARIS BREVIS MUSCLE
Superficial branch divides into
medial (ulnar) and lateral (radial)
Ulnar part supplies the
ulnar aspect of the little finger
Radial branch AKA common digital branches
Supplies the radial aspect of the small finger and the ulnar aspect of the RING finger
Ulnar nerve Motor inntervation in FOREARM
FCU, FDP (ulnar)
Ulnar nerve Motor inntervation in Thenar muscles
Adductor pollicis, deep head of FPB
Ulnar nerve Motor inntervation in Fingers
Interossei (8), 3rd and 4th lumbricals, Hypothenar muscles, abductor digiti minimi, opponens digiti minimi, flexor digiti minimi.
Musician’s nerve is
ULNAR NERVE
Ulnar nerve trapped at
Cubital and guyon tunnel
If injury of UN at the elbow
loss of motor innervation at forearm, hand and loss of sensation
FCU and ulnar FDP motor loss leads to
pt cannot make a fist
Los of FCU leads to
loss of flexion at the wrist
Adduction of the thumb is lost bc of
paralysis of adductor pollicis
Injury of the ulnar nerve at the wrist causes
CLAW HAND
CLAW HAND features
Hyperextension of MCP joints, flexion of IP joints, inability to spread fingers, loss of flexion of ring and little finger, loss of adduction power of the thumb