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Nerves of Forearm LO6 6. Apply principles NP3, NP6 & NP7 to describe the course and distribution of the following nerves median, anterior interosseous, ulnar, radial, posterior interosseous and superficial branch of radial. On the basis of the course of each nerve identify potential sites for injury in the forearm. For any structure passing through the forearm you should be able to talk about its relationships to other structures it travels through or with! Median Nerve Course: Enters cubital fossa with brachial artery Exits by passing between heads of pronator teres Passes between FDS and FDP as it travels down forearm Enters carpal tunnel as it passes under the flexor retinaculum Branches: Muscular branch: innervates all superficial and intermediate anterior compartment muscles except FCU and medial half of FDP. Major nerve of anterior compartment of forearm. Palmar Cutaneous branch: innervates skin of lateral 3 digits and ½ of 4th digit. Anterior interosseous nerve: Ulnar Nerve Major branch of median nerve in forearm Travels with the anterior interosseous branch of the ulnar artery Innervates the deep muscles of the anterior compartment of the forearm except the medial half of FDP. Course: Between the medial epicondyle of humerus and olecranon process of ulnar Travels between FCU and FDP Travels with ulnar artery and vena comitantes Branches: Muscular: only innervates FCU and medial half of FDP. Articular: elbow and wrist joints. Cutaneous: palmar branches to digit 5 and ½ of digit 4 on both the palmar and dorsal surface of the hand. Vascular: ulnar artery. Radial Nerve Course: Sneaks in the cubital fossa laterally from posterior compartment of arm. Divides into two branches (deep and cutaneous) as soon as it enters cubital fossa. Deep branch pierces the supinator and descends into the posterior compartment of the arm where it is referred to as the posterior interosseous branch. The superficial branch travels with the brachioradialis. Branches: The superficial branch of the radial nerve: Cutaneous branch Gives rise to articular branches as well. Distributed to skin on the dorsum of the hand Branching soon after the radial nerve pierces the intermuscular septum into the anterior compartment of the arm Crosses the roof of the anatomical snuff box Posterior interosseous nerve (deep branch of radial nerve) Also known as deep branch of the radial nerve Pierces the supinator Runs between superficial and deep extensor muscles with the posterior interosseous artery (from ulnar artery) Supplies motor innervation to the muscles of both the deep and superficial posterior compartments of the arm The posterior cutaneous nerve of the forearm: Arises from the radial nerve in the posterior compartment of the arm Runs along the radial groove of the humerus Reaches the forearm independent of the radial nerve descending in the subcutaneous tissue of the posterior aspect of the forearm to the wrist, supplying the skin