Dorsal hand nerves !
The dorsal hand nerves are skin branches, mainly of the ulnar nerve, on the back of the hand; they give feeling to the back of the hand and fingers.
Official name: Dorsal branch of the ulnar nerve and dorsal digital nerves
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What it is
Skin nerves on the back of the hand on the little-finger side.
What it does
Feeling on the back of the hand.
Key facts
- Roots
- Dorsal branch of the ulnar nerve (leaves ~5 cm above the wrist)
- Moves
- None
- Feeling from
- Dorsum of the medial hand, little and half the ring finger
Relations
- Course
- Leaves the ulnar nerve in the distal forearm, passes backward between the flexor carpi ulnaris tendon and the ulna, crosses the ulnar side of the wrist near the ulnar styloid and divides into dorsal digital nerves for the little finger and the ulnar side of the ring finger
- Superficial
- The flexor carpi ulnaris tendon as it turns backward; then only skin over the dorsoulnar wrist
- Deep
- The distal ulna and the sheath of the extensor carpi ulnaris tendon
- Lateral
- The territory of the superficial radial nerve on the radial half of the dorsum, with variable overlap in the middle
How to find it
Not reliably palpable. Its branches cross the dorsoulnar wrist close to the ulnar styloid and the extensor carpi ulnaris tendon, the area used for ulnar-sided wrist arthroscopy portals and approaches to the TFCC.
Examination
- Pinprick on the dorsum of the hand over the fifth metacarpal: loss with ulnar finger numbness places the lesion above the wrist; normal feeling here with ulnar finger numbness points to Guyon's canal
- Tinel's sign over the dorsoulnar wrist after surgery suggests a neuroma of this branch
On imaging
Not seen on radiographs. Ultrasound can trace the dorsal branch of the ulnar nerve as it winds around the ulnar side of the wrist near the ulnar styloid, and the superficial radial nerve over the first dorsal compartment. It shows a neuroma after surgery or arthroscopy portals there, or a nerve swollen by external compression, and can guide a diagnostic block.
Clinical notes
- At risk in ulnar-sided wrist arthroscopy (the 6U portal lies closest), TFCC repair, ulnar styloid fixation and distal ulna fractures
- Tight handcuffs can compress it, as well as the superficial radial nerve
- Isolated numbness of the dorsoulnar hand after a wrist injury suggests damage to this branch rather than to the ulnar nerve trunk
Anatomical variants
- The border with the superficial radial nerve territory varies; either nerve may supply the dorsum of the ring and middle fingers
Test yourself
Think of the answer, then tap the question to see it.
Why is dorsoulnar hand numbness present in cubital tunnel lesions but absent in Guyon canal lesions?
The dorsal branch of the ulnar nerve leaves in the distal forearm, above Guyon's canal.
Which wrist procedures put the dorsal branch of the ulnar nerve at risk?
Ulnar-sided wrist arthroscopy (the 6U portal lies closest), TFCC repair and ulnar styloid fixation; it winds round the wrist near the ulnar styloid.
Which nerves supply the dorsal skin over the distal phalanges?
The palmar digital nerves, not the dorsal hand branches.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- ramus dorsalis nervi ulnaris TA2 6451
- Official Spanish (DeCS)
- Ramo dorsal del nervio ulnar y sus ramos digitales dorsales
- English (TA2)
- Dorsal branch of the ulnar nerve and dorsal digital nerves
Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Hand Cutaneous Innervation.
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Representative model, for educational purposes only.
