Ulnar nerve Anatomy: Origin, Course, Branches, Cubital Tunnel Syndrome ||  

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Ulnar nerve Anatomy: Origin, Course, Branches, Cubital Tunnel Syndrome, Guyon's canal syndrome
Origin
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• Ulnar nerve comes from the medial cord of the brachial plexus (C8-T1)
Course
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Arm
• lies posteromedial to brachial artery in anterior compartment of upper 1/2 arm
• pierces medial IM septum at the arcade of Struthers ~ 8cm from medial epicondyle and lies medial to the triceps
• the arcade of Struthers is an aponeurotic band extending from the medial IM septum to the medial head of the triceps
Elbow
• runs behind medial epicondyle with superior ulnar collateral artery
Cubital tunnel
• roof - Osbourne’s ligament proximally (extension of deep forearm fascia between heads of FCU) and FCU aponeurosis distally
• floor - posterior and transverse bands of MCL and elbow joint capsule
• sends small sensory branch to elbow that can be sacrificed
Forearm
• enters forearm between 2 heads (humeral and ulnar heads) of FCU
• runs between FCU and FDP
Wrist
the ulnar nerve and artery pass superficial to the transverse carpal ligament
bifurcates into sensory and deep motor branches in Guyon's canal
• roof - volar carpal ligament
• floor - transverse carpal ligament, hypothenar muscles
• ulnar border - pisiform and pisohamate ligament, abductor digiti minimi muscle belly
• radial border - hook of hamate
Innervation
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Motor Innervation
forearm
• FCU
• FDP ring and small
Thenar
• adductor pollicis
• deep head of flexor pollicis brevis (FPB)
fingers
• interossei (dorsal & palmar)
• 3rd & 4th lumbricals
hypothenar muscles
• abductor digiti minimi
• opponens digiti minimi
• flexor digiti minimi
Sensory Innervation
sensory branches of ulnar nerve
• dorsal cutaneous branch
• palmar cutaneous branch
• superficial terminal branches
Clinical Anatomy
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• Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand.
• Guyon's canal syndrome is an entrapment of the ulnar nerve as it passes through a tunnel in the wrist called Guyon's canal. This problem is similar to carpal tunnel syndrome but involves a completely different nerve. Sometimes both conditions can cause a problem in the same hand.
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