Nervous Communications In The Upper Limb. A Cadaveric Study

  • Humberto Ferreira Arquez Colombian Association Morphology.


Background: Anatomical variations of the terminal branches of the brachial plexus in terms of communication between nerves at the level of upper limb have been reported, these communications were median and musculocutaneous nerve, median and ulnar nerve, radial and ulnar nerve (at level humeral), but communications between the radial and ulnar nerve at level of the forearm are very rare.

Methods and Findings: 34 upper extremities of 15 male and 2 females embalmed adults cadavers in the laboratory of Morphology of the University of Pamplona. The upper limbs were studied serially during the years 2013-2016. Of the 34 upper limbs studied in the Laboratory of Mor­phology of the University of Pamplona, in a 75 year-old male cadaver anatomical variations were found, dissected carefully and morphological details were photographed, these variations consisted of nervous communications between median and musculocutaneous nerve in the arm, median and ulnar nerve in the forearm, radial and ulnar nerve in the forearm.

Conclusions: Knowledge of these communications is of clinical significance. Surgical, therapeutic and diagnostically invasive procedures require extreme caution to prevent lesions of the anastomotic branches.

Author Biography

Humberto Ferreira Arquez, Colombian Association Morphology.
Professor Human Morphology, Medicine Program, University of Pamplona
Morphology Laboratory Coordinator- University of Pamplona


1. Gopalan DH, Devi C. Multiple neurovascular variations in the upper limb – a rare case report. IJAV. 2014; 7: 103–5. Available from:
2. Ferreira H, Arias DK. An anatomical study of formation of the median nerve. Journal of Chemical and Pharmaceutical Research. 2016; 8(5):22-6. Available from:
3. Aktan ZA, Öztürk L, Bilge O, Özer MA, Pinar YA. A cadaveric study of the anatomic variations of the brachial plexus nerves in the axillary region and arm. Turk. J. Med.Sci. 2001; 31:147-50. Available from:
4. Pandey SK, Shukla VK. Anatomical variations of the cords of brachial plexus and the median nerve. Clin. Anat. 2007; 20(2):150-6. Available from:
5. Casadiego JT, Ferreira H. Anastomosis between median and ulnar nerve in forearm and hand. Journal of Chemical and Pharmaceutical Research. 2016; 8(8):675-80. Available from:
6. Ferreira-Arquez H. Anastomosis between ulnar and radial nerve. A cadaveric study. International Archives Of Medicine. 2017; 10. DOI: . Available from:
7. Roberts, W. H. Anomalous course of the median nerve medial to the trochlea and anterior to the medial epicondyle of the humerus. Ann. Anat. 1992; 174(4):309-11. Available from:
8. Bergman RA, Afifi AK, Miyauchi R. Radial nerve. Illustrated Encyclopedia of Human Anatomic Variation: Opus III: Nervous System: Plexuses. Available from:
9. Dogan NU, Uysal II, Seker M. The communications between ulnar and median nerves in upper limb. Neuroanat. 2009;8:15‑9. Available from:
10. Swamy RS, Kumar N, Nayak SB, Shetty SD, Aithal A. Presence of communication between radial and ulnar nerve at high humeral level and its distribution to triceps brachii muscle. Int J Health Allied Sci. 2015;4:39-41. Available from:;year=2015;volume=4;issue=1;spage=39;epage=41;aulast=Swamy
11. Ferreira H. Communication between the median and musculocutaneous nerve. An anatomical study. Int J Pharm Bio Sci. 2015; April 6(2): (B) 951-7. Available from:
12. Uysal II, Seker M, Karabulut AK, Büyükmumcu M, Ziylan T. Brachial plexus variations in human fetuses. Neurosurgery. 2003; 53: 676–84. Available from:
13. Choi D, Rodriguez-Niedenfuhr M, Vazquez T, Parkin I, Sanudo JR. Patterns of connections between the musculocutaneous and median nerves in the axilla and arm. Clin Anat. 2002; 15: 11–7. Available from:
14. Loukas M, Aqueelah H. Musculocutaneous and median nerve connections within, proximal and distal to the coracobrachialis muscle. Folia Morphol (Warsz). 2005; 64: 101–8. Available from:
15. Venieratos D, Anagnostopoulou S. Classification of communications between the musculocutaneous and median nerves. Clin Anat. 1998; 11: 327–31. Available from:
16. Kazakos KJ, Smyrnis A, Xarchas KC, Dimitrakopoulou A, Verettas DA. Anastomosis between the median and ulnar nerve in the forearm. An anatomic study and literature review. Acta Orthop Belg.2005;71: 29–35.Available from:
17. Loukas M, Louis RG Jr, Wartmann CT, Tubbs RS, Turan-Ozdemir S, Kramer J. The clinical anatomy of the communications between the radial and ulnar nerves on the dorsal surface of the hand. Surg Radiol Anat. 2008; 30: 85–90. Available from:
18. Leis AA, Wells KJ. Radial nerve cutaneous innervation to the ulnar dorsum of the hand. Clin Neuropysiol. 2008; 119: 662–6. Available from:
19. Ozguner G, Desdicioglu K, Albay S. Connection between radial and ulnar nerves at high humeral level. International Journal of Anatomical Variations. 2010; 3: 49–50. Available from:
20. Chiarapattanakom P, Leechavengvons S, Witoonchart K, Uerpairojkit C, Thuvasethakul P. Anatomy and internal topography of the musculocutaneous nerve: The nerves to the biceps and brachialis muscle. J Hand Surg 1998; 23A: 250-5. Available from:
21. Ajayi NO, Lazarus L, Satyapal KS. Multiple variations of the branches of the brachial plexus with bilateral connections between ulnar and radial nerves. Int. J. Morphol 2012; 30(2):656-60. Available from:
22. Guru A, Kumar N, Shanthakumar SR, et al. “Anatomical Study of the Ulnar Nerve Variations at High Humeral Level and Their Possible Clinical and Diagnostic Implications,” Anatomy Research International 2015; Article ID 378063, doi:10.1155/2015/378063. Available from:
How to Cite
FERREIRA ARQUEZ, Humberto. Nervous Communications In The Upper Limb. A Cadaveric Study. International Archives of Medicine, [S.l.], v. 10, nov. 2017. ISSN 1755-7682. Available at: <>. Date accessed: 24 mar. 2018. doi:
Human Anatomy