Nerves of the Upper Extremity: Nerve Musculocutaneous Median Radial Ulnar Axillary Dorsal Scapular Suprascapular Subscapular Innervation All muscles in anterior compartment of arm (Biceps brachii, Coracobrachialis, Brachialis) “ 2LOAF” Most flexors of forearm, thenar muscles in hand (Palmaris longus, Flexor carpi radialis, Pronator teres, Flexor digitorum superficialis, lateral half of Flexor digitorum profundus, Flexor pollicis longus, Pronator quadrates) All muscles in posterior compartments of arm and forearm (Triceps brachii, Brachioradialis, Extensor carpi radialis longus and brevis, Aconeus, Supinator) As posterior interosseous nerve: Abductor pollicis longus, Extensor pollicis brevis and longus, Extensor indicis, Extensor digitorum, Extensor digiti minimi, Extensor carpi ulnaris Most intrinsic hand muscles (hypothenars (OAFs), lumbricals, interossei, Palmaris brevis, adductor pollicis), flexor carpi ulnaris, medial half of flexor digitorum profundus Deltoid, Teres minor Injury Weakness of flexion of arm Carpal Tunnel: weakness of thenar muscles (trouble with opposition), pain and tingling in palmar surface of lateral 3 ½ digits and lateral side of palm and middle of wrist Midshaft humerus fracture: wrist drop due to failure of extensor muscles, and sensory changes in dorsum of hand Fracture of medial epicondyle of humerus: clawed hand, loss of sensation in medial 1 ½ digits Fracture of surgical neck of humerus: loss of arm abduction at shoulder Rotator Cuff: shoulder joint instability, weakness in lateral rotation Levator scapulae, Rhomboid major Scapula drifts laterally, loss and minor of elevation Supraspinatus, Infraspinatus Rotator Cuff muscles: instability of shoulder joint, weakness in lateral rotation Teres Major (Inf. Ss), Subscapularis Weakness in medial (Inf. and Sup. Ss) rotation Thoracodorsal Latissimus dorsi Long Thoracic Serratus anterior Medial Pectoral Pectoralis major and minor Lateral Pectoral Pectoralis Major Weakness in adduction, medial rotation, and extension of humerus at shoulder joint Winged Scapula, loss of elevation of arm Weakness in flexion, adduction, and medial rotation of arm at shoulder and protraction of scapula Weakness in flexion, adduction, and medial rotation of arm at shoulder Special Spaces/Compartments: Space/Compartment Quadrangular Space Triangular Space Triangular Interval Axillary Inlet Cubital Fossa Carpal Tunnel Anatomical Snuffbox Boundaries Post: teres minor, surg. Neck of humerus, teres major, long head of triceps brachii Ant: subscapularis, surg. Neck of humerus, teres major, long head of triceps brachii Post: long head of triceps brachii, teres minor, teres major Ant: long head of triceps brachii, teres major, subscapularis Long head of triceps brachii, shaft of humerus, teres major Lateral border rib 1, posterior surface of clavicle, superior border of scapula Brachioradialis and Pronator teres, base is imaginary line between medial and lateral epicondyles of humerus Pisiform, triquetrum, hamate, capitates, trapezoid, trapezium, and the flexor retinaculum that spans this carpal arch Tendons of pollicis abductor and extensors Contents/Significance Axillary nerve, Posterior circumflex humeral artery Fracture of rib 1 or anterior dislocation of humeral head may compress axillary artery (anastomoses with subclavian artery prevent ischemia) Circumflex scapular artery Profunda brachii artery, radial nerve Axillary Artery and Vein, Lymphatics, Axillary Nerve Biceps brachii tendon, brachial artery, median nerve, median cubital vein Median nerve, tendons of flexor digitorum profundus and superficialis, and tendon of flexor pollicis longus Carpal Tunnel Syndrome Radial artery and nerve, cephalic vein