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Radial Nerve : Course, Motor, Sensory & Common Injuries

Radial Nerve: The radial nerve is a major peripheral nerve of the upper limb. It originates from the brachial plexus, carrying fibers from the ventral roots of spinal nerves C5, C6, C7, C8 & T1.

Radial Nerve Common Injuries

Course of the Radial Nerve

  •  It passes behind the axillary artery next through the triangular interval to access posterior compartment of the arm
  •  It then turns around the spiral groove of the humerus among profunda brachii artery, between the heads of the triceps
  • It enters antecubital fossa in front of the lateral epicondyle of humerus, within brachialis and brachioradialis muscles. Next its branches in the proximal forearm into two terminal branches:
  • Next its branches in the proximal forearm into two terminal branches:

Deep branch (motor supply) – pierces supinator muscle and descends along posterior interosseous membrane with the posterior interosseous artery

Superficial branch (sensory supply) – descends under the brachioradialis muscle to end in dorsum of the hand.

Sensory Supply of the Radial Nerve

  • Posterior aspect of arm and forearm
  • Lateral ⅔ of the dorsum of the hand
  • Proximal dorsal aspect of lateral 3½ fingers (thumb, index, middle and half of the ring finger)

Motor Supply of the Radial Nerve

  • Posterior compartment of the arm muscles
  • Triceps muscle –adducts and extends shoulder, extends the elbow
  • Posterior compartment of the forearm muscles
  • Brachioradialis muscle- elbow flexes
  • Anconeus muscle – elbow extends, stabilizes the elbow joint
  • Supinator muscle – supination of the forearm
  • Extensor carpi radialis longus and brevis muscles– abduct and extend the wrist
  • Extensor carpi ulnaris muscle – extends and adducts the wrist
  • Extensor digitorum, extensor indicis, extensor pollicis brevis and longus and extensor digiti minimi muscles – extend the thumb and fingers at MCPJs and IPJs
  • Abductor pollicis longus muscle – abducts the thumb

Common Radial nerve injuries

  • Pressure of crutches on armpits (“crutch palsy“)
  • Somebody else falling asleep with their head lying on patient’s arm ( “honeymoon palsy“)
  • The patient falling asleep with hanging arm over the back of the chair, classically whilst drunk (“Saturday night palsy“)

Upper Extremity Muscle Atlas

  • Abductor Pollicis Longus
  • Abductor Digiti Minimi
  • Abductor Pollicis Brevis
  • Adductor Pollicis
  • Anconeus
  • Biceps Brachii
  • Brachioradialis
  • Brachialis
  • Coracobrachialis
  • Deltoid
  • Extensor Carpi Radialis Longus
  • Extensor Carpi Radialis Brevis
  • Extensor Carpi Ulnaris
  • Extensor Digitorum
  • Extensor Digiti Minimi
  • Extensor Indicis
  • Extensor Pollicis Longus
  • Extensor Pollicis Brevis
  • Flexor Carpi Radialis
  • Flexor Carpi Ulnaris
  • Flexor Digitorum Profundus
  • Flexor Digitorum Superficialis
  • Flexor Digiti Minimi Brevis
  • Flexor Pollicis Brevis
  • Flexor Pollicis Longus
  • Infraspinatus
  • Interosseous Muscles, Dorsal
  • Interosseous Muscles, Palmar
  • Levator Scapulae
  • Latissimus Dorsi
  • Opponens Digiti Minimi
  • Opponens Pollicis
  • Pectoralis Major
  • Pectoralis Minor
  • Palmaris Longus
  • Pronator Quadratus
  • Pronator Teres
  • Rhomboid Major and Minor
  • Subscapularis
  • Supinator
  • Serratus Anterior
  • Supraspinatus
  • Trapezius
  • Triceps Brachii
  • Teres Major
  • Teres Minor
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