Origin and Topography of the Main Trunk
The radial nerve is formed by fibers from spinal nerves C₅–Th₁ and is the continuation of the posterior cord of the brachial plexus (fasciculus posterior).
As it courses down the arm, the nerve travels through the humeromuscular canal (canalis humeromuscularis), after which it heads toward the cubital fossa (fossa cubitalis). Along this path, muscular and cutaneous branches arise from the main trunk to supply the triceps brachii muscle and the skin of the posterior arm.
Branches Prior to Division (At the Arm Level)
Several important branches arise from the main trunk of the nervus radialis in the arm:
- Muscular branches (rr. musculares). These supply the long, lateral, and medial heads of the triceps brachii muscle (m. triceps brachii), as well as the anconeus muscle (m. anconeus).
- Posterior cutaneous nerve of the arm (n. cutaneus brachii posterior). Provides sensory innervation to the skin on the posterior aspect of the arm.
- Inferior lateral cutaneous nerve of the arm (n. cutaneus brachii lateralis inferior). Innervates the skin of the lower lateral part of the arm.
- Posterior cutaneous nerve of the forearm (n. cutaneus antebrachii posterior). Provides sensation to the skin of the posterior forearm.
Terminal Branches: Superficial and Deep
Upon reaching the level of the lateral epicondyle of the humerus, the radial nerve divides into two major terminal branches:
- Superficial branch (r. superficialis n. radialis). This is an exclusively sensory branch. It runs down the forearm deep to the brachioradialis muscle (m. brachioradialis). Descending onto the hand, this branch innervates the skin of the dorsal radial side of the hand, the thumb, and partially the proximal phalanges of digits II and III.
- Deep branch (r. profundus n. radialis), also known as the posterior interosseous nerve (n. interosseus posterior). This branch is predominantly motor and passes to the posterior compartment of the forearm to innervate the distal group of extensors.
Innervation Zones of the Deep Branch
The deep branch of the radial nerve performs a substantial amount of work innervating the forearm muscles and upper limb joints.
Muscular innervation includes the following muscles:
- Supinator muscle (m. supinator);
- Extensor digitorum (m. extensor digitorum);
- Extensor digiti minimi (m. extensor digiti minimi);
- Extensor carpi ulnaris (m. extensor carpi ulnaris);
- Abductor pollicis longus (m. abductor pollicis longus);
- Extensor pollicis brevis (m. extensor pollicis brevis);
- Extensor pollicis longus (m. extensor pollicis longus).
In addition to muscles, the deep branch gives off articular branches to the elbow joint (articulatio cubiti), radiocarpal joint (articulatio radiocarpalis), and metacarpophalangeal joints (articulationes metacarpophalangeae).