Key Points:

  • You must know the anatomy of the peripheral nervous system to effectively evaluate and treat patients with these disorders.
  • It helps you pinpoint the location and extent of injury.
  • It helps you figure out how to treat–using nerve transfer, nerve decompression, nerve repair and other techniques

In this section we will discuss the following:

  • Macro anatomy–course of the nerve as it extends from the spinal nerve roots to the periphery.  This includes the structures nearby, the layer it travels in and the branches it forms.
  • Micro anatomy–course of the fibers within the nerves as the nerve extends from the spinal nerve roots to the periphery.  This is the internal topography of the nerve–knowledge of the organization of the nerve fibers quite proximal to the branch points allows us to do nerve transfer procedures among other things.
  • Anatomical variation–note that think first of a straightforward explanation for the pathology at hand before assuming that an anatomic anomaly or variation is at play.
    • There are agreed upon norms and there are exceptions.
    • Variation in the nerve roots that contribute to various nerves.
    • Variation in the course and branching pattern of the nerves.
    • Anomalies that might confuse the diagnosis.

We will also provide information on the anatomy of peripheral nerves through the use of anatomic dissections with text, photos, illustration and video.

Note, that variation exists and we are providing one example of this information–other anatomic sources may differ and, more importantly, the patients you treat may differ.  Nothing can substitute for good judgement and close observation as well as individualized patient care.