Ulnar nerve

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Nerve: Ulnar nerve
Click image to enlarge - ulnar nerve is visible in lower left
Nerves of the left upper extremity. (Ulnar labeled at center left.)
Latin	nervus ulnaris
Gray's	subject #210 943
Innervates	flexor carpi ulnaris flexor digitorum profundis lumbrical muscles opponens digiti minimi flexor digiti minimi abductor digiti minimi interossei adductor pollicis
From	Medial cord
MeSH	Ulnar+nerve
Dorlands / Elsevier	n_05/12566994

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In human anatomy, the ulnar nerve is a nerve which runs from the shoulder to the hand, at one part running near the ulna bone. It is the only exposed nerve in the human body (it is unprotected for a few centimeters at the elbow). When someone says "hitting their funny bone" it is the aggravation of this nerve that is being referred to.

Course

The ulnar nerve comes from the medial cord of the brachial plexus, and runs inferior on the medial/posterior aspect of the humerus down the arm, going behind the medial epicondyle at the elbow. Because of the mild pain and tingling throughout the forearm associated with an inadvertent impact of the nerve at this point, it is usually called the funny bone. (It may also have to do with its location relative to the humerus, as the name "humerus" is a homonym to the word "humorous").

It enters the anterior (front) side of the forearm and runs alongside the ulna. There it supplies one and a half muscles (flexor carpi ulnaris & medial half of flexor digiti profundus). It soon joins with the ulnar artery, and the two travel inferiorly together, deep to the flexor carpi ulnaris muscle.

After its journey down the ulna, the ulnar nerve enters the palm of the hand. Unlike the median nerve which travels below the flexor retinaculum of the hand and through the carpal tunnel, the ulnar nerve and artery pass superficial to the flexor retinaculum via the ulnar canal.

Branches and innervation

Muscular

The ulnar nerve and its branches innervate the following muscles in the forearm and hand:

An Articular branch that passes to the elbow joint while the ulnar nerve is passing between the olecranon and medial epicondyle of the femur.

• In the forearm, via the muscular branches of ulnar nerve:
  • Flexor carpi ulnaris
  • Flexor digitorum profundus (medial half)

• In the hand, via the deep branch of ulnar nerve:
  • hypothenar muscles
    • Opponens digiti minimi
    • Abductor digiti minimi
    • Flexor digiti minimi brevis
  • Adductor pollicis
  • The third and fourth lumbrical muscles
  • Dorsal interossei
  • Palmar interossei

• In the hand, via the superficial branch of ulnar nerve:
  • Palmaris brevis

Cutaneous

The ulnar nerve also provides sensory innervation to the part of the hand corresponding to the fourth and fifth digits:

• Palmar branch of ulnar nerve - anterior
• Dorsal branch of ulnar nerve - posterior

Ulnar nerve entrapment

Main article: Ulnar nerve entrapment

The Ulnar nerve can be trapped or pinched in various ways as it proceeds down the arm from the Brachial plexus to the ring and middle fingers. One common cause is cubital tunnel syndrome, where the tunnel runs the inner outside side of the elbow. Pinching of the nerve often causes tingling symptoms in the little and ring fingers. In some cases moderate to severe pain is experienced from pinching this nerve. Often such pins and needles sensations can be caused by sleeping wrongly on your arm, but sometimes the problems last for days. In severe cases, surgery is performed.

See also

• Radial artery
• Axillary nerve
• Median nerve

Additional images

Brachial plexus	Cross-section through the middle of upper arm.	Cross-section through the middle of the forearm.	Transverse section across distal ends of radius and ulna.
Transverse section across the wrist and digits.	The palmar aponeurosis.	The axillary artery and its branches.	The brachial artery.
Ulnar and radial arteries. Deep view.	The right brachial plexus (infraclavicular portion) in the axillary fossa; viewed from below and in front.	Cutaneous nerves of right upper extremity. Anterior view.	Diagram of segmental distribution of the cutaneous nerves of the right upper extremity. Anterior view.
Cutaneous nerves of right upper extremity. Posterior view.	Diagram of segmental distribution of the cutaneous nerves of the right upper extremity. Posterior view.	Superficial palmar nerves.	Deep palmar nerves.
Front of right upper extremity, showing surface markings for bones, arteries, and nerves.	Back of right upper extremity, showing surface markings for bones and nerves.

External links

• Ulnar+nerve at eMedicine Dictionary
• SUNY Figs 05:03-15 - "The major subdivisions and terminal nerves of the brachial plexus."
• SUNY Figs 07:04-04 - "Anterior view of the nerves, vessels, and superficial tendons that cross the left wrist."
• SUNY Figs 08:03-07 - "Transverse section through the carpal tunnel and distal row of the carpal bones."
• Duke Orthopedics ulnar_nerve
• Anatomy at MUN nerve/ulnerv
• Hand kinesiology at UK nerves/ulnar.htm
• Atlas of anatomy at UMich hand_plexus - "Axilla, dissection, anterior view"
• Overview at neuro.wustl.edu

v • d • e Nerves of upper limbs (primarily): the brachial plexus (C5-T1)
Supraclavicular	root (dorsal scapular, long thoracic) - upper trunk (suprascapular, to the subclavius)
Infraclavicular: lateral cord	lateral pectoral musculocutaneous (lateral cutaneous of forearm) median/lateral root: anterior interosseous - palmar - recurrent - common palmar digital (proper palmar digital)
Infraclavicular: medial cord	medial pectoral cutaneous: medial cutaneous of forearm • medial cutaneous of arm ulnar: muscular - palmar - dorsal (dorsal digital nerves) - superficial (common palmar digital, proper palmar digital) - deep median/medial root: see above
Infraclavicular: posterior cord	subscapular (upper, lower) • thoracodorsal axillary (superior lateral cutaneous of arm) radial: muscular - cutaneous (posterior of arm, inferior lateral of arm, posterior of forearm) - superficial (dorsal digital nerves) - deep (posterior interosseous)
Other	cutaneous innervation of the upper limbs

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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