RADIAL NERVE

LOCATION OF CORD AND SPINAL ROOT:The radial nerve originates from the posterior cord
of the brachial plexus with the roots from C5, C6, C7,C8 and T1.STRUCTURES SERVED BY THE
NERVE:Triceps brachii, anconeus and extensor muscles of the forearm; skin of the posterior
arm and forearm,lateral two-thirds of dorsum of hand, and fingers over proximal and middle
phalanges.STRUCTURES THAT THE NERVE TRAVELS AND /OR ARE PIERCED BY THE NERVE:
From the brachial plexus, it travels posteriorly through what is often called
the triangularinterval then enters the arm behind the axillary artery/brachial artery, and it
then travelsposteriorly on the medial side of the arm. After giving off branches to the long and
medialheads of the triceps brachii, it enters a groove on the humerus, the radial sulcus. Then it
windsaround in the groove (between the medial and lateral heads of the triceps) towards
theforearm, running laterally on the posterior aspect of the humerus. While in the groove, it
givesoff a branch to the lateral head of the triceps brachii. The radial nerve then emerges from
thegroove on the lateral aspect of the humerus where it pierces the lateral intramuscular
septumand enters the anterior compartment of the arm. It continues its journey inferiorly
between thebrachialis and brachioradialis muscles. When the radial nerve reaches the distal
part of thehumerus, it passes anterior to the lateral epicondyle and continues in the forearm.
Here, itbranches into a superficial branch (primarily sensory) and a deep branch (primarily
motor). Thesuperficial branch descends in the forearm under the brachioradialis. It eventually
pierces thedeep fascia near the back of the wrist. It provides
sensory innervations to much of the back of thehand, including the web of skin between the
thumb and index finger.
The deep branch pierces thesupinator muscle, after which it is known as the posterior
interosseous nerve.COMMON NERVE PATHOLOGIES:The usual causes are direct trauma, prolonged
pressure on the nerve, or compression of thenerve caused by swelling or injury of nearby body
structures. A fracture or pressure on theupper arm from arm positions during sleep or coma
are also common problems. The radialnerve may be injured at the axilla by direct pressure, such
as "crutch palsy," caused byimproper use of crutches, or pressure caused by hanging the arm
over the back of a chair."Saturday-night palsy" is a term for an injury that occurs to the radial
nerve during deep sleep,such as that which may occur when a person is intoxicated. Prolonged or
repeated constrictionof the wrist (caused by wearing a tight watch strap, for example) may also
cause an injury toterminal portions of the radial nerve.