A 23-year-old male medical student fell asleep in his chair with Netter's Atlas wedged into his axilla. When he awoke in the morning, he was unable to extend the forearm, wrist, or fingers. Movements of the ipsilateral shoulder joint appear to be normal. Which of the following nerves was most likely compressed, producing the symptoms described?
The radial nerve is the most likely nerve compressed to cause these symptoms. This type of nerve palsy is often called "Saturday night palsy." One reason for this nickname is that people would supposedly fall asleep after being intoxicated on a Saturday night with their arm over the back of a chair, thereby compressing the nerve in the spiral groove. The radial nerve innervates all of the extensors of the elbow, wrist, and fingers. Paralysis of the lateral cord of the brachial plexus would result in loss of the musculocutaneous nerve and the pectoral nerves, which do not mediate extension of the forearm or hand. The medial cord of the brachial plexus branches into the median nerve and ulnar nerve. Neither of these nerves innervates muscles that control extension. The median nerve innervates flexors of the forearm and the thenar muscles. The lateral and median pectoral nerves do not extend into the arm and innervate the pectoralis major and minor muscles.
Lateral cord of the brachial plexus
Medial cord of the brachial plexus
Radial nerve
Median nerve
Upper Extremity