Radial nerve

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Radial nerve

The suprascapular, axillary, and radial nerves.

Details
From

posterior cord

To

posterior interosseous nerve

Innerva posterior compartment of the

tes

arm,posterior compartment of the

forearm

Identifiers
Latin

nervus radialis

MeSH

A08.800.800.720.050.700

TA

A14.2.03.049

FMA

37069

Anatomical terms of neuroanatomy

[edit on Wikidata]
The radial nerve is anerve in the human body that supplies the posterior portion of
the upper limb. It innervates the medial and lateral heads of the triceps brachii
muscle of the arm, as well as all 12 muscles in the posterior osteofascial
compartment of the forearm and the associated joints and overlying skin.
It originates from thebrachial plexus, carrying fibers from the ventral roots of spinal
nerves C5, C6, C7, C8 & T1.
The radial nerve and its branches provide motor innervation to the dorsal arm
muscles (the triceps brachii and the anconeus) and the extrinsic extensors of the
wrists and hands; it also provides cutaneous sensory innervation to most of the
back of the hand, except for the back of the little finger and adjacent half of the ring
finger (which are innervated by the ulnar nerve)
The radial nerve divides into a deep branch, which becomes the posterior
interosseous nerve, and a superficial branch, which goes on to innervate the
dorsum (back) of the hand.
Contents
[hide]

1Structure
o

1.1In arm

1.2In forearm

2Function
o

2.1Cutaneous

2.2Motor

3Clinical significance
o

3.1Injury

4History

5Additional images

6References

7See also

8External links

Structure[edit]
The radial nerve originates as a terminal branch of the posterior cord of the brachial
plexus. It goes through the arm, first in the posterior compartment of the arm, and
later in the anterior compartment of the arm, and continues in the posterior
compartment of the forearm.
In arm[edit]
From the brachial plexus, it travels posteriorly through what is often called
the triangular interval (US), the lower triangular space of the axilla (UK) or the
triceps hiatus (medical terminology).

Radial nerve of the right upper limb, posterior view

Having passed through this inter muscular gap, the radial nerve continues
posteriorly in a medial to lateral fashion on the arm while in conjunction with
the deep artery of arm.
The nerve will first give off branches to the medial head of the triceps brachii and
then enter a groove on the humerus, the radial sulcus (AKA spiral groove), where it
innervates the lateral head of the triceps. It is commonly believed that the radial
nerve also provided motor innervation to the long head of the triceps. However, a
study conducted in 2004 determined that, in 20 cadaveric specimens and 15

surgical dissections on participants, the long head was innervated by a branch of

the axillary nerve in all cases.[1]
With the lateral and medial heads of the triceps innervated, the radial nerve
emerges from the radial groove on the lateral aspect of the humerus.
At this point, it pierces the lateral intermuscular septum and enters theanterior
compartment of the arm.
It then courses inferiorly between the brachialis and brachioradialismuscles.
When the radial nerve reaches the distal part of the humerus, it passes anteriorly to
the lateral epicondyle and continues in the forearm.
In forearm[edit]
In the forearm, it branches into a superficial branch (primarily sensory) and a deep
branch (primarily motor).

The superficial branch of the radial nerve descends in the forearm under
the brachioradialis. It crosses brachioradialis to enter posterior of forearm
near the back of the wrist and supply dorsum of hand. It gives nerve supply
to dorsal aspect of thumb, index finger,middle finger and radial side of ring
finger except the nail beds, which are supplied by proper digital branches of
median nerve.

The deep branch of the radial nerve pierces the supinator muscle, winds
around the radius under the cover of supinator to reach posterior of forearm
where it again pierces supinator and after which it is known as the posterior
interosseous nerve of forearm.It pierces the posterior extensor muscles and
comes to lie on posterior interosseous membrane just below extensor pollicis
brevis. It continues to move along with posterior interosseous artery(a deep
branch of common interosseous artery which is a branch of ulnar artery), and
ends as a pseudoganglion below extensor retinaculum.

Function[edit]
The following are branches of the radial nerve (including the superficial branch of
the radial nerve and the deep branch of the radial nerve/posterior interosseous
nerve).
Cutaneous[edit]

Cutaneous innervation of the right upper extremity. Areas innervated by the radial
nerve are colored in pink.
Cutaneous innervation by the radial nerve is provided by the following nerve
branches:

Posterior cutaneous nerve of arm (originates in axilla)

Inferior lateral cutaneous nerve of arm (originates in arm)

Posterior cutaneous nerve of forearm (originates in arm)

The superficial branch of the radial nerve provides sensory innervation to much of
the back of the hand, including the web of skin between the thumb and index finger.
Motor[edit]

Muscles of the posterior forearm. All the labelled muscles (that is, all the visible
muscles except the ones on the dorsal hand and one at top left) are innervated by
the radial nerve, and represent all muscles innervated by the radial nerve except for
the supinator.
Muscular branches of the radial nerve:

Triceps brachii (lateral and medial heads)

Anconeus

Brachioradialis

Extensor carpi radialis longus

Deep branch of the radial nerve:

Extensor carpi radialis brevis

Supinator

Posterior interosseous nerve (a continuation of the deep branch after the supinator):

Extensor digitorum

Extensor digiti minimi

Extensor carpi ulnaris

Abductor pollicis longus

Extensor pollicis brevis

Extensor pollicis longus

Extensor indicis

The radial nerve (and its deep branch) provides motor innervation to the muscles in
theposterior compartment of the arm and forearm, which are mostly extensors.
Clinical significance[edit]
Injury[edit]
Injury to the radial nerve at different levels causes different syndromes with varying
motor and sensory deficits.
At the axilla

Common mechanisms of injury: Saturday night palsy, crutch palsy

Motor deficit:

Loss of extension of forearm, weakness of supination, and loss of

extension of hand and fingers.

Presence of wrist drop, due to inability to extend the hand and fingers.

Sensory deficit: Loss of sensation in lateral arm, posterior forearm, the radial
half of dorsum of hand, and dorsal aspect of radial 3 12digits, excluding their
nail beds.

At mid-arm

Common mechanism of injury: Mid-shaft humeral fracture

Motor deficit:

Weakness of supination, and loss of extension of hand and fingers.

Presence of wrist drop, due to inability to extend the hand and fingers.

Sensory deficit: Loss of sensation in posterior forearm, the radial half of

dorsum of hand, and dorsal aspect of radial 3 12 digits, excluding their nail
beds.

Just below the elbow

Common mechanism of injury: Neck of radius fracture, elbow dislocation or

fracture, tight cast, rheumatoid nodules, injections due to tennis elbow,
injuring the deep branch of the radial nerve that pierces the radial head,
causing posterior interosseous nervesyndrome

Motor deficit:

Weakness in extension of hand and loss of extension of fingers.

Presence of finger drop, and partial wrist drop, since theextensor carpi
radialis longus and brachioradialis muscles are working.

Sensory deficit: None, as sensation is supplied by the superficial radial nerve

Within the distal forearm:

Common mechanism of injury: Wartenberg's syndrome, (not to be confused

with Wartenberg's sign), due to nerve entrapment beneath the tendinous
insertion of brachioradialis, tight jewellery, and watch bands.

Motor deficit: None

Sensory deficit: Numbness and tingling in radial half of dorsum of hand, and
dorsal aspect of radial 3 12 digits, excluding their nail beds.

In Wartenberg's syndrome, there is significant radial wrist pain, and close

resemblance to symptoms in de Quervain's tenosynovitis. Finkelstein's test
may be positive.[2]