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THE INTRANEURAL TOPOGRAPHY OF THE RADIAL, MEDIAN AND ULNAR NERVES
Abstract
SYDNEY SUNDERLAND; THE INTRANEURAL TOPOGRAPHY OF THE RADIAL, MEDIAN AND ULNAR NERVES, Brain, Volume 68, Issue 4, 1 December 1945, Pages 243–298, https://doi.org
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“Peripheral nerves, however, have a highly branched structure, and there is a high degree of person-to-person variability in the anatomy of those nerves, both in branching structure and in the location of fascicles that innervate specific muscles [7,8].”
From Optimization of selective stimulation parameters for multi-contact electrodes (2013) · cites this paper as [7]
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“Sunderland in 1945 [16, 17] made anatomical maps for the motor or sensory fascicle patterns within major limb nerves.”
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“They concluded that the findings pointed to a mechanical rather than an ischaemic cause for the fibre damage.”
BackgroundSelf-citationElectrophysiological findings in entrapment of the median nerve at wrist and elbow
Buchthal, F., Rosenfalck, A. M., & Trojaborg, W. (1974) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.37.3.340 · Cited by 281
“The cutaneous fibres from digit I and from the first, second, and third interspace lie in separate funiculi within the median nerve up to 2 cm proximal to the radial styloid line (Sunderland, 1945).”
BackgroundInternal topography of major nerves of the forearm and hand: A current view
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“Least commonly involved are the ulnar, radial, and median nerves [61, 74, 76, 78].”
BackgroundUltrasound of nerve and muscle
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“Sunderland has published detailed investigations of the intraneural topographies of the human sciatic nerve and its popliteal divisions [30] and the human median and ulnar nerves [28].”
BackgroundNeuralgic amyotrophy: An increasingly diverse entity
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“At spinal cord level these two somatic populations are anatomically separated, but intermingle once the axons leave the cord to form the spinal nerve(6).”
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“In interpreting observations such as these it is necessary to consider the division of the nerve into funiculi, which has been investigated by Sunderland (1945), and which makes it possible with weak stimuli to excite alone either motor responses from the thenar muscles or sensations from the…”
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Dumitru, D., Amato, A. A., & Zwarts, M. J. (2002) · Elsevier eBooks · doi:10.1016/b978-1-56053-433-4.50013-4 · Cited by 157
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“The size, number and configuration of these fascicles (such as myelination status and conduction velocity) can vary between and throughout these nerves 10,11 .”
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“According to Sunderland [21], at this “lacertus tunnel,” the median nerve is organized such that the branches to the pronator teres and FCR are located anteriorly, and the branches to the FPL and FDP II, medially.”
BackgroundMethodCryoneurolysis and Percutaneous Peripheral Nerve Stimulation to Treat Acute Pain
Ilfeld, B. M., & Finneran, J. J. (2020) · Anesthesiology · doi:10.1097/aln.0000000000003532 · Cited by 119
“Whether this represents a spurious finding remains unknown, but considering that the relative intraneural fascicular orientation greatly impacts the functional results of stimulation,(211) the fascicular organization in the subgluteal location may be preferred to the popliteal region when the stimulation of sensory fi…”
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“Sunderland extensively studied the fascicular anatomy of the radial, medial, and ulnar nerves of the forearm and concluded that none of these nerves have a characteristic fascicular pattern because of the repeated divisions, mergers, and migration of fiber bundles [25].”
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“Sunderland [9] reported that the internal topography of peripheral nerves became increasingly more organized as they progressed distally (Fig.”
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“To this end recent anatomical studies are done in cadaveric preparations of median [66] and sciatic nerve [67], revisiting the traditional Sunderland’s work [68].”
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Anterior interosseous nerve syndrome: retrospective analysis of 14 patients
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“The detailed anatomy and its normal variation have been discussed by Sunderland [36, 37], Mangini [20], and Spinner [33].”
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“Sunderland (1945) showed that there was no consistent fascicular pattern for the main arm nerves.”
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“The locations of functional groups with de fi nite motor or sensory targets in humans have been studied for decades, providing a useful body of information, especially for large nerves such as the median 33,35,37,39,40,44,45 and sciatic 36,38,41,46 – 48 nerves.”
BackgroundThe musculocutaneous nerve and its branches to the biceps and brachialis muscles
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Neuralgic amyotrophy manifesting as anterior interosseous nerve palsy
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Dahlin, L. B., Zimmerman, M., Calcagni, M., Hundepool, C. A., van Alfen, N., & Chung, K. C. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00521-1 · Cited by 76
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Natural History and Conservative Management of Cubital Tunnel Syndrome
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“Sunderland [32] studied the topography of the ulnar nerve at the level of the elbow and noted that the fascicles innervating the flexor carpi ulnaris and flexor digitorum profundus to the fourth and fifth digits are more central whereas the sensory fascicles and hand muscles are distributed more peripherally.”
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“, within the peroneal nerve) makes it difficult for regenerating axons to grow into empty perineural tubes (122).”
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“In the latter, the posterior fasciculi of the median nerve supply the pronator teres, flexor digitorum superficialis and the anterior interosseous fibres, as well as sensory fibres to the forearm (Sunderland, 1945).”
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Motor and sensory conduction in different segments of the radial nerve in normal subjects.
Trojaborg, W., & Sindrup, E. (1969) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.32.4.354 · Cited by 70
“The sensory fibres can be stripped nearly 7 cm above the division of the radial nerve into the posterior interosseous and the superficial branches without interfering with the fibre architecture of the nerve, and in the main trunk at the level of the intermuscular furrow sensory fibres are localized to the anteromedia…”
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Cartwright, M. S., Baute, V., Caress, J. B., et al. (2017) · Muscle & Nerve · doi:10.1002/mus.25617 · Cited by 68
Levinthal, R., Brown, W. J., & Rand, R. W. (1977) · Journal of neurosurgery · doi:10.3171/jns.1977.47.5.0744 · Cited by 68
Peripheral nerve ultrasound in amyotrophic lateral sclerosis phenotypes
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The Importance of Internal Anatomy of the Peripheral Nerves to Nerve Repair in the Forearm and Hand
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“This finding may have been because of the nonhomogenous distribution of motor, sensory, and connective tissue in nerve roots (8,9), such that a needle may have been proximate to one fiber type Figure 2.”
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“Sunderland [10] classified nerve injuries into first, second, third, fourth and fifth degree nerve injury in order of severity of the injury.”
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Central course of digital axons within the median nerve of macaca mulatta
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“ings of the sensory signals contained in afferent fibers can provide information about variables such as pressure, joint angle, muscle force, or length [11]–[13], [16], [31].”
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“2 Historically, the main approach has been the painstaking analysis of multiple serial sections which has permitted identification of somatotopic organisation in the principal human limb nerves [3, 4].”
BackgroundPartial median nerve entrapment in the distal arm because of an accessory bicipital aponeurosis
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“The similar behaviors between CMAP and SNAP in the present study may be related to the mixed organization of motor and sensory fibers in median nerve fascicles (Sunderland, 1945; Schady et al., 1983).”
ResultHagert, E. M., Jedeskog, U., Hagert, C.-G., et al. (2023) · International Orthopaedics · doi:10.1007/s00264-023-05709-w · Cited by 52
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Revista Española de Anestesiología y Reanimación
Macaya, M. B. (2016) · Cited by 52
Neuromuscular stimulation selectivity of multiple-contact nerve cuff electrode arrays
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Cambon‐Binder, A., & Leclercq, C. (2014) · Surgical and Radiologic Anatomy · doi:10.1007/s00276-014-1371-x · Cited by 51
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Nerve injuries associated with supracondylar fractures of the humerus in children
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“It is important to recognize the possibility of sole FPL involvement, as thumb flexion weakness can be mistakenly attributed to FPL rupture.(34-39) In fact, the possibility of individual fascicle involvement should be considered in PTS more generally.”
BackgroundFunicular suture and funicular exclusion in the repair of severed nerves
Sunderland, S. (1953) · British journal of surgery · doi:10.1002/bjs.18004016412 · Cited by 51
Self-citationSurgical significance of the motor fascicular group of the ulnar nerve in the forearm
Chow, J. A., Van Beek, A. L., Meyer, D. L., & Johnson, M. C. (1985) · The Journal of Hand Surgery · doi:10.1016/s0363-5023(85)80164-7 · Cited by 50
Clustering of Pacinian corpuscle afferent fibres in the human median nerve
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“Yet prevailing orthodoxy has rather emphasized the lack of such an organisation in the peripheral part of the neuraxis, in particular within individual nerve fascicles ( Sunderland 1945; Schady et al. 1983).”
BackgroundMethodPeripheral Nerve Surgery Today: Turning Point or Continuous Development?
Millesi, H. (1990) · Journal of Hand Surgery (European Volume) · doi:10.1016/0266-7681(90)90004-n · Cited by 50
Reina, M. Á., Arriazu, R., Collier, C. B., et al. (2013) · Revista Española de Anestesiología y Reanimación · doi:10.1016/j.redar.2013.06.006 · Cited by 49
[Morphology of peripheral nerves, their sheaths, and their vascularization].
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“Previous studies indicated that the increased amount of collagen fibers is a consequence of compression rather than a protective mechanism (Sunderland, 1945).”
Background
Metadata
- Authors
- SUNDERLAND, S.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- SUNDERLAND, SYDNEY
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 1945
- Volume
- 68
- Issue
- 4
- Pages
- 243-298
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2057392205
- Cited by
- 426
- References
- 0
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 21 · 2023: 16 · 2022: 9 · 2021: 10 · 2020: 13 · 2019: 18 · 2018: 11 · 2017: 14 · 2016: 17 · 2015: 12 · 2014: 14 · 2013: 14 · 2012: 10
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Peripheral Nerve Disorders
- Health Sciences › Medicine › Anatomy › Classical Anatomy and Histology
- Life Sciences › Neuroscience › Neurology › Neurology and Historical Studies
- Keywords
- radial nerve, median nerve, ulnar nerve, nerve anatomy
- MeSH terms
- Humans, Median Nerve, Radial Nerve, Ulnar Nerve
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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