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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

C8 Neurologic Level


- Nerves:
    - Median nerne                 C5      C6     C7      C8      T1
    - Radial Nerve                 C5      C6     C7      C8      T1
    - Ulnar Nerve                                         C8      T1
    - Medial Antebrachial                                 C8      T1

- Wrist & Hand Extensors:
    - Extensor Indicis                     C6     C7      C8
    - Ext Carpi Radialis Brevis            C6     C7      C8
    - Extensor Carpi Ulnaris               C6     C7      C8
    - Extensor Digiti Minimi               C6     C7      C8
    - Extensor Digitorum                   C6     C7      C8
    - Extensor Indicis                     C6     C7      C8
    - Extensor Pollicis Longus             C6     C7      C8
    - Iliocostalis Cervicis                C6     C7      C8
    - Lumbricals                           C6     C7      C8
    - Abductor Digiti Minimi                              C8
    - Flexor Pollicis Brevis               C6     C7      C8     T1
    - Flexor Pollicis Longus               C6     C7      C8     T1
    - Triceps Brachii                      C6     C7      C8     T1
    - Pronator Quadratus                          C7      C8     T1
    - Flex. Dig. Superficialis                    C7      C8     T1
    - Flex. Dig. Profundus                        C7      C8     T1
    - Opponens Digiti Minimi                      C7      C8     T1
    - Flexor Digiti Minimi Brevis                         C8     T1
    - Interossei                                          C8     T1


- Anatomy:
    - C-8 & T-1 anterior nerve roots convey preganglionic sympathetic fibers for innervation of head & neck to
           corresponding spinal nerves, from which they pass to ganglionated sympathetic chain;
    - further laterally these 2 spinal nerves acquire bulk of postganglionic fibers for the hand and arm;
    - consequently, injury of the C-8 & T-1 nerve roots or of corresponding spinal nerves close to vertebral column does not
           affect sympathetic innervation of arm but interrupts those to same side of head causing vasodilatation,
           anhydrosis, & dilated pupil (Horner's syndrome)


- C8 Radiculopathy:
    - rare occurance;
    - unlikely to cause pain;
    - interossie motor weakness is consistent finding;
    - Diff Dx: Anterior Interosseous Nerve Syndrome
           - the correct diagnosis is made by determining the function of the muscles innervated by the C-8 portion of the ulnar nerve;



- C8 Cord Lesion:
     - care of the spine injured patient:
     - splits:
            - opposition and Intrinsic muscle function absent;
            - possible to use static hand orthosis with MP stop;
            - person will use their own natural tenodesis action;
            - oppens hand splint for C8 functional levels;
                    - used to abduct the thumb into position so that one can flex the fingers against it and use it as a post;
                    - not used for C5 or C6 injuries since finger flexors are out



Long-term results of the Steindler flexorplasty.

Rerouting of the biceps brachii for paralytic supination contracture of the forearm in tetraplegia due to trauma.

Clinical diagnosis testing and electromyographic study in brachial plexus traction injuries.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, April 11, 2012 12:31 pm