Ulnar nerve

Last revised by Assoc Prof Craig Hacking on 02 Feb 2022

The ulnar nerve is one of the terminal branches of the brachial plexus and has motor and sensory supply to the forearm and hand.

The ulnar nerve originates as a terminal branch of the medial cord of the brachial plexus with nerve root fibers from the ventral rami of C8-T1.

In the arm, the ulnar nerve runs medial to the axillary artery and subsequently the brachial artery on the coracobrachialis muscle in the anterior compartment of the arm.  The nerve passes into the posterior compartment through the medial intermuscular septum, piercing the Arcade of Struthers running distally with the superior ulnar collateral artery. Further on, it runs between the medial head of the triceps brachii muscle and the medial intermuscular septum to pass posterior to the medial humeral epicondyle in the superficial condylar groove (cubital tunnel).

The ulnar nerve enters the forearm from the arm in between the two heads of the flexor carpi ulnaris (FCU) muscle. It subsequently lies superficial to flexor digitorum profundus, deep to FCU and medial to the ulnar artery. It courses distally along the ulnar aspect of the forearm and at the wrist, the ulnar nerve runs lateral to the tendon of FCU.

The ulnar nerve enters the hand superficial to the flexor retinaculum and inside Guyon's canal traveling with the ulnar artery and vein. Then it divides into its terminal branches at the level of the pisiform bone.

Prior to passing the flexor retinaculum at the wrist, the ulnar nerve gives off the dorsal cutaneous branch. 

  • dorsal cutaneous branch
  • palmar cutaneous branch
  • branch to palmaris brevis
  • superficial terminal branch
  • deep terminal branch

The ulnar nerve has both sensory and motor supply:

  • may arise from the 7th and/or 8th cervical nerve roots only
  • prefixed or postfixed formations involving C7 or T2, respectively. 
  • may pass in front of the medial epicondyle of the distal humerus
  • Riche-Cannieu anastomosis: communication between the recurrent branch of median nerve and deep branch of ulnar nerve in hand
  • Martin-Gruber anastomosis: communicating nerve branch between the median nerve and the ulnar nerve in the forearm
  • may supply all the thenar muscles
  • branch to the dorsum may be absent 

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Cases and figures

  • Figure 1: ulnar nerve
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  • Figure 2: brachial plexus
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  • Figure 3: anterior arm anatomy (Gray's illustration)
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  • Figure 4: anterior forearm deep anatomy (Gray's illustration)
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  • Figure 5: anterior forearm anatomy (Gray's illustration)
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  • Figure 6: Gray's illustrations
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  • Figure 7: Gray's illustrations
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  • Figure 8: palmar nerves (Gray's illustrations)
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  • Figure 9: palmar nerves (Gray's illustrations)
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  • Figure 10: upper limb nerves (Gray's illustrations)
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