The upper limb is innervated by nerves of the. Insertion : It inserts at the lesser tubercle of the humerus. • Nerve: Upper and lower subscapular nerve. major nerve supply is the cranial nerve XI. Suprascapular nerve The suprascapular nerve emerges from the superior trunk and carries fibers of the C5 and C6. What is the nerve supply to upper extremity? What is the name for the rare form of thoracic outlet syndrome, which is caused by compression of the brachial plexus and brachial vessels in the root of the neck, producing a mixture of nerve compression symptoms in the arm and shoulder including pain, pins and needles, numbness, weakness, and circulation changes (sweating, blueness . What are the 3 sections of the trapezius muscle. The supraclavicular nerves (C3, 4) overlap with cutaneous branches from the upper thoracic intercostal nerves. The upper subscapular nerve originates from the C5-C6 nerve roots and also branches from the posterior cord of the brachial plexus. The upper subscapular nerve inserts directly into the upper portion of the subscapularis muscle, thus innervating it. The commonly described nerve supply of the subscapularis includes the lower and upper subscapular nerve, which have been the subject of previous cadaveric studies [ 19 - 24 ], with only a few describing the anatomy of the nerves and their location relative to surgical landmarks like the glenoid rim and the coracoid process [ 20, 24 - 26 ]. Origin: Subscapular fossa of the scapula. Upper subscapular N. B. Thoracodorsal N. C. Lower subscapular N Mc12.5. In humans, each upper limb is divided into the arm, forearm and . The brachial artery supplies blood to much of the brachial region, . The upper subscapular nerve (C5-6) innervates the subscapularis muscle, while the lower subscapular nerve (C5-C6) innervates the subscapularis and teres major muscles. The upper (superior) subscapular nerve is the first branch of the posterior cord of the brachial plexus.The upper subscapular nerve contains axons from the ventral rami of the C5 and C6 cervical spinal nerves.It innervates the superior portion of the subscapularis muscle.The inferior portion of the subscapularis is innervated by the lower subscapular nerve. Scapular protraction describes the forward movement of the scapula about the thoracic wall (scapulothoracic joint).As the scapula moves away from the midline it can also be referred to as scapular abduction.This motion usually occurs in conjunction with some scapular lateral rotation.This movement is made possible also by forward movement of the clavicle and the acromion at the . The axillary nerve is one of two terminal branches of the posterior cord of the brachial . The plexus is formed by the anterior rami (divisions) of cervical spinal nerves C5, C6, C7 and C8, and the first thoracic spinal nerve, T1. Both . Teres Minor : The subscapularis is innervated by both the upper subscapular nerve (USN) and lower subscapular nerve (LSN). Where is the brachial plexus formed from? The upper subscapular nerve supplies the upper part of subscapularis, while the lower subscapular nerve branches into two, with one branch supplying the lower part of . The upper subscapular nerve inserts directly into the upper portion of the subscapularis muscle, thus innervating it. • *Teres major is not part of rotator cuff and appears to be a part of subscapularis. These nerves innervate both the pectoralis major and minor muscles. The subscapularis is innervated by both the upper subscapular nerve (USN) and lower subscapular nerve (LSN). Summary. Medial . Lower subscapular nerve (C 5 and 6): • Supply the lower part of subscapularis muscle and teres major muscle. Brachial Plexus. • The skin over the lateral surface of . 5 The USN and LSN receive contributions from both C5 and C6. They run posteriorly to the subscapularis and teres major (lower only) muscles. Thoracodorsal nerve (C6, C7, C8)—to latissimus dorsi (shoulder adduction) 11. Nerve Supply : It is supplied by upper and lower subscapular nerves (c5, c6). Subscapular fossa Lesser tubercle of humerus Lower and upper subscapular n C5-6 Medial rotation. The dorsal scapular artery (or descending scapular artery) is a blood vessel which supplies the levator scapulae, rhomboids, and trapezius. The lower subscapular and axillary nerves have been found to traverse m. subscapularis beneath . 5. 4. The musculocutaneous, axillary, radial, ulnar, and median nerves are the most important sensorimotor nerves of the upper limb. nerve to subclavius m. is one of two nerves to arise from the superior trunk of the brachial plexus; suprascapular n. is the other one: subscapular, lower: posterior cord of the brachial plexus (C5, C6) unnamed muscular brs. How to Memorize Muscles and Innervations Associating muscles to a common nerve group is an excellent way to memorize muscle innervations. Upper subscapular nerve (C5 and 6): Supplies the upper part of the subscapularis muscle. subscapularis and teres major (ordinarily from the lower subscapular) sometimes proceeds separately from the brachial plexus. Suprascapular Nerve, C5 & C6. The upper subscapular nerve contains axons from the ventral rami of the C5 and C6 cervical spinal nerves. Results: 14/20 specimens showed an innervation of the subscapularis with an upper, middle and lower subscapular nerve branch. upper ( descending) Middle ( transverse) Lower (Ascending) Actions of the 3 trapezius muscles. Where does the dorsal scapular artery come from? Ventral rami of C5-T1. Biceps brachii; Coracobrachialis; Triceps brachii; Biceps Brachii: The biceps brachii is a two-headed muscle that lies on the upper arm connecting the shoulder and the elbow. Action : It acts as medial rotator and adductor of arm. The parenthesis around (8) means the nerve root at C8 may contribute to the innervation of this muscle, but the primary nerve roots are C 5,6,7. 2). The mean distance from the insertion of the upper subscapular nerve to the myotendinous junction with the arm adducted and externally rotated was 53.0 ± 14.7 mm (range, 32-85 mm). The suprascapular nerve originates from the upper trunk of the brachial plexus, the ventral rami of the fifth and sixth cervical nerves from the upper trunk of the brachial plexus join to form the suprascapular nerve, and in approximately 18% of the population, the ventral ramus of the fourth cervical nerve is also involved. How to Memorize Muscles and Innervations Associating muscles to a common nerve group is an excellent way to memorize muscle innervations. The upper subscapular nerve originated from posterior cord and supplies subscapularis muscle, which are a medial rotator and adductor of the humerus (Infraspinatus and teres minor are lateral rotators of humerus). Upper subscapular nerve (C5 and 6): Supplies the upper part of the subscapularis muscle. Course In the posterior triangle of the neck these rami form three trunks from which fibers enter the axilla region (armpit) to innervate the muscles of the anterior and posterior compartments of the limb. The lower subscapular nerve (C5-C6) innervates teres major; and both the upper and lower subscapular nerves innervate the subscapularis, the third muscle of the rotator cuff apparatus. Nerve supply lower subscapular nerve. The subscapularis is supplied by the upper and lower subscapular nerves, branches of the posterior cord of the brachial plexus. nerve to subclavius m. is one of two nerves to arise from the superior trunk of the brachial plexus; suprascapular n. is the other one: subscapular, lower: posterior cord of the brachial plexus (C5, C6) unnamed muscular brs. It innervates the superior portion of the subscapularis muscle. The motor and sensory supply of the upper limb is provided by the brachial plexus which is formed by the ventral rami of spinal nerves C5-T1. The branch to m. teres major may also arise from the axillary (circumflex) nerve. What nerve supplies most ot the muscles that attach to the medial epicondyle of the humerus? To remember the muscles that participate in it, use the mnemonic "SITS" : S upraspinatus, I nfraspinatus, T eres minor, S ubscapularis. Nerve supply Upper and lower subscapular. The axillary nerve innervates the deltoid and provides a sensory branch to the skin overlying this muscle. The subscapular nerves are innervated by the posterior division of the brachial plexus. Subscapularis is innervated by the upper and lower subscapular nerves (C5-C6), that stem from the superior and posterior cords of the brachial plexus, respectively. The rotator cuff is formed by four tendons which blend with the capsule of the shoulder joint which it strengthens and holds the humeral head in position. Upper Subscapular (C5-C6; subscapular) Lower Subscapular (C5-C6; subscapular AND teres major) Middle Subscapular AKA Thoracodorsal (C6-C8, Latissimus Dorsi) Side Note: even though posterior, not all the minor branches include all the roots. * N.B. Upper and lower subscapular nerves Branches: Posterior cord = 5 branches Lateral cord = 3 branches Medial cord = 5 branches Anterior divisions supply flexors Posterior divisions supply extensors The Clavicle Long thoracic nerve Thoracodorsal nerve . Nerve supply from lower &upper subscapular nerves C5C6C7 from posterior cord of brachial plexus. The parenthesis around (8) means the nerve root at C8 may contribute to the innervation of this muscle, but the primary nerve roots are C 5,6,7. It arises from the upper portion of the brachial plexus, which is a network of nerves that stretches across your check from your neck down to your armpit. The main trunk continues distally, terminating as the axillary and radial nerves. Although it does branch and supply blood to the axillary region, most of the vessel continues into the upper arm, or brachium, and becomes the brachial artery. Action Medial rotator of the arm. Lower subscapular nerve (C5, C6)—to teres major (adducts the humerus) 12. References Supply It supplies the subscapularis muscle and contributes fibers to teres major. subscapularis m., teres major m. no cutaneous branches The major clinically significant terminal branches of the brachial plexus and . upper- elevation of the scapula , upward rotation of the scapula. Even though the nerve branches were in average more than 2 cm medial to the musculotendinous junction, minimal distances of 1.1-1.3 cm were found. cervical nerves C3 and C4 receive information about pain in this muscle. • Lesser tubercle of humerus • Upper and lower subscapular nerves . [Updated 2021 May 8]. 5 However, there is a significant amount of anatomical variation with regard to these nerves . What nerve Innervates subscapularis? Thoraco-dorsal nerve (Nerve to Latissimus Dorsi): (C6,7&8) • Arises from the posterior cord between upper and lower subscapular nerves. The dorsal divisions of T6 to T12 provide the sensory innervation of the skin of the latissimus dorsi muscle. Arch Orthop Trauma Surg (2017) 137:135-140 DOI 10.1007/s00402-016-2585-7 HA ND SU RGER Y Nerve supply of the subscapularis during anterior shoulder surgery: definition of a potential risk area 1,2 1,2 4 2,3 • • • • Tim Leschinger Michael Hackl Felix Zeifang Martin Scaal 1,2 1,2 Lars Peter Mu¨ller Kilian Wegmann Received: 9 August 2016 / Published online: 28 October 2016 Springer . The mean length of the upper subscapular nerve was 51.4 ± 12.8 mm (range, 31-89 mm), and that of the lower subscapular nerve was 50.5 ± 14 mm (range, 30-86 mm). From inferior angle & lower axillary lateral border of scapula to medial lip of bicipital groove. Upper subscapular and lower subscapular nerves: These nerves branch from the posterior cord, with the upper branching proximal to the thoracodorsal nerve and the lower branching distal to the thoracodorsal nerve in most cases. medial two-thirds of the costal surface of the scapula (subscapular fossa) lesser tubercle of the humerus: medially rotates the arm; assists extention of the arm: upper and lower subscapular nerves (C5,6) subscapular a. subscapularis, supraspinatus, infraspinatus, and teres minor are the rotator cuff muscles: supinator Nerve Supply to The Upper Limb • It Receives all its Nerve Supply from The Spinal Cord • Most of Its Supply is derived from the Cervical Spinal Segments (C5-T1) • The rest comes from T2 Roots • Spinal Nerves (except T2) to the Upper Limb form a Network of nerves • The Brachial Plexus Gross anatomy Origin The upper subscapular nerve branches from the posterior cord of the brachial plexus with fibers arising from the fifth and sixth cervical nerves. 1,6 Both the USN and LSN arise from the posterior cord of the brachial plexus. What are the branches of the axillary artery. 1,6 Both the USN and LSN arise from the posterior cord of the brachial plexus. latissimus dorsi. The upper subscapular nerve, also known as the short or superior subscapular nerve, arises from the posterior cord of the brachial plexus and supplies the subscapularis muscle. A. median B. anterior interosseus C. superficial radial D. deep radial E. ulnar Answer = A The serratus anterior muscle is innervated by the A. lateral pectoral nerve. The suprascapular nerve is a peripheral nerve of the shoulder and arm. Upper Subscapular Nerve: C5-C6: 2). Negative ulnar variance describes a state where the ulna is abnormally shortened compared to the radius and plays an important role in wrist pathology.. Medial . Nerve Supply. View Notes - 300-29 Muscles, Nerves, Blood Supply of the Upper Limb from ANATOMY 300 at University of Toronto. Medial rotator. These nerves are part of a group of nerves that innervate the muscles that move the scapula. Musculocutaneous nerve supplies coracobrachialis, biceps brachii, and the greater part of the brachialis. Figure9: Subscapularis. Subscapularis is innervated by both the upper and lower subscapular nerves which come from the posterior cord of the brachial plexus.The upper subscapular nerve supplies the upper part of subscapularis, while the lower subscapular nerve branches into two, with one branch supplying the lower part of subscapularis. origin: posterior cord of the brachial plexus course: passes out of axilla through the quadrangular space to the upper arm major branches: superior lateral cutaneous nerve of the arm motor supply: deltoid and teres minor muscles sensory supply: skin overlying deltoid muscle Gross anatomy Origin. There is a significant association between negative ulnar variance and Kienböck disease, although the majority of people with negative ulnar variance do not have this condition.A causal association is difficult to prove, however the . Abductor pollicis brevis is supplied by Median nerve . • Innervation Route: C5, C6, C7 → upper and lower subscapular nerve → subscapularis. Subscapularis is innervated by both the upper and lower subscapular nerves which come from the posterior cord of the brachial plexus. At the end of this topic, you should be able to: a) understand the formation of the brachial plexus and identify its component parts b) identify and state the distribution of the direct branches of the brachial plexus c) identify and state the sensory (cutaneous, articular) and motor distribution of the major . The upper (superior) subscapular nerve is the first branch of the posterior cord of the brachial plexus. 5. B. upper and lower subscapular nerves. It receives contributions from nerve roots C6-C8, but the predominant contribution is from C7.It originates near the apex of the axilla, between the superior and inferior subscapular nerves and posterior to the subscapular artery pon originating, it descends down the posterior axillary wall . (C5-C6) Function The subscapularis rotates the head of the humerus medially (internal rotation) and adducts it; when the arm is raised, it draws the humerus forward and downward. This nerve originates from the posterior cord of the brachial plexus [11] Maruvada S, Madrazo-Ibarra A, Varacallo M. Anatomy, Rotator Cuff. The lower subscapular and axillary nerves have been found to traverse m. subscapularis beneath . C. suprascapular nerve. Long thoracic nerve The nerve supply to the lower part of Mm. The middle subscapular nerve (C6-C8), also known as the thoracodorsal nerve, innervates the latissimus dorsi muscle and travels with the thoracodorsal artery. 14 NERVE SUPPLY TO THE UPPER LIMB. These nerves are part of a group of nerves that innervate the muscles that move the scapula. 5 The USN and LSN receive contributions from both C5 and C6. D. long thoracic nerve. Deltoid & teres minor muscles supplied by Axillary nerve (C5,6). Anterior surface of this muscle is related to subscapular vesseles , nerves & lymph nodes. They may exhibit referred pain from the area of the diaphragm, since they have similar origins from the spinal cord as the phrenic nerves (C3, 4, 5). The branch to m. teres major may also arise from the axillary (circumflex) nerve. Medial rotator. The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. 3. upper and lower subscapular nerves (C5,6) The rotator cuff is a musculotendinous cuff around the glenohumeral joint. The upper and lower subscapular nerves come from the posterior cord. The subscapular nerves are innervated by the posterior division of the brachial plexus. The suprascapular nerve's roots emerge from the fifth and sixth cervical vertebrae (C5 and C6) in your neck. Branches of the posterior cord: (1) The upper subscapular nerve is derived from the Blood Supply Subscapular artery. 43. It donates a branch to the teres major muscle which courses in the angle between the subscapular and circumflex scapular arteries. Lesion of long thoracic nerve . Nerve supply lower subscapular nerve. upper subscapular nerve o Lower subscapularis lower subscapular nerve Radial nerve pierces through lateral intermuscular septum Ulnar nerve pierces through medial intermuscular septum -Nerve roots: o Dorsal sensory o Ventral motor -Brachial plexus rami anterior and posterior -Brachial plexus: o 5 roots (C5-T1) The roots refer to the ventral . Muscles, Nerves and Blood Vessels of the Upper Limb Images from Human Anatomy 6th ed., . Insertion- posterior aspect of lateral 1/3 of the clavicle. The subscapularis is innervated by both the upper subscapular nerve (USN) and lower subscapular nerve (LSN). Three terminal branches arise directly from the cord at this level: the upper subscapular nerve, thoracodorsal nerve, and lower subscapular nerve. The nerve supply to the lower part of Mm. The upper subscapular nerve and lower subscapular nerve (C5, C6, C7) innervate the subscapularis muscle. The major clinically significant terminal branches of the brachial plexus and . The thoracodorsal nerve is a motor nerve that arises from the posterior cord of the brachial plexus. 4. Arch Orthop Trauma Surg (2017) 137:135-140 DOI 10.1007/s00402-016-2585-7 HA ND SU RGER Y Nerve supply of the subscapularis during anterior shoulder surgery: definition of a potential risk area 1,2 1,2 4 2,3 • • • • Tim Leschinger Michael Hackl Felix Zeifang Martin Scaal 1,2 1,2 Lars Peter Mu¨ller Kilian Wegmann Received: 9 August 2016 / Published online: 28 October 2016 Springer . Retraction and elevation of scapula. Nerve supply from lower &upper subscapular nerves C5C6C7 from posterior cord of brachial plexus. to providing the motor nerve supply to all muscles of the upper extremities and shoulder girdle, the brachial plexus supplies upper extremity cutaneous sensation (Fig. From inferior angle & lower axillary lateral border of scapula to medial lip of bicipital groove. Rotator cuff. The rotator cuff is formed by the: 1) Subscapularis . The posterior cord of the brachial plexus gives off the upper subscapular nerve, thoracodorsal nerve and lower subscapular nerve. The primary blood supply of the latissimus dorsi muscle is the thoracodorsal artery. • The skin over the lower half of the deltoid is supplied by the upper lateral cutaneous nerve of the arm, a branch of the axillary nerve (C5 and 6). 5 However, there is a significant amount of anatomical variation with regard to these nerves . Thoraco-dorsal nerve (Nerve to Latissimus Dorsi): (C6,7&8) • Arises from the posterior cord between upper and lower subscapular nerves. Upper Ex 2: Arm and forearm The upper arm Sensory nerve supply of the upper arm • Skin over the point of the shoulder to halfway down the deltoid muscle is from the supraclavicular nerves (C3 and 4). brachial plexus. Anterior rami of C5-T1 spinal nerves (i.e., five roots) Dorsal scapular nerve: arises directly from C5 and innervates the rhomboid major, rhomboid minor, and levator scapulae muscles ITTEHAD ADIL BPT 1st Year 19th JANUARY 2022 2/2/22 07:03 AM2/2/22 07:03 AM 1 Nerve supplying upper limb Supraclavicular branches of cervical plexusC4 Brachial Plexus C5-8, T1 Intercostobrachial branch of 2nd intercostal nerve Sympathetic nerves 2/2/22 07:03 AM 2 Brachial Plexus: 5Parts

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