Hilton's law

Hilton's law, espoused by John Hilton in a series of medical lectures given in 1860–1862,[1] is the observation that in the study of anatomy, the nerve supplying the muscles extending directly across and acting at a given joint not only supplies the muscle, but also innervates the joint and the skin overlying the muscle.[2][3][4][5] This law remains applicable to anatomy.[6]

John Hilton

For example, the musculocutaneous nerve supplies the elbow joint of humans with pain and proprioception fibres. It also supplies coracobrachialis, biceps brachii, brachialis, and the forearm skin close to the insertion of each of those muscles. Hilton's law arises as a result of the embryological development of humans (or indeed other animals). Hilton based his law upon his extensive anatomical knowledge and clinical experiences. As with most British surgeons of his day (1805–1878), he intensely studied anatomy.

The knee joint is supplied by branches from femoral nerve, sciatic nerve, and obturator nerve because all the three nerves are supplying the muscles moving the joint. These nerves not only innervate the muscles, but also the fibrous capsule, ligaments, and synovial membrane of the knee joint.[7]

Extensions of the law

Hilton's law is described above. Similar observations can be made, to extend the theory; often a nerve will supply both the muscles and skin relating to a particular joint. The observation often holds true in reverse - that is to say, a nerve that supplies skin or a muscle will often supply the applicable joint.

See also

References

  1. Hilton, J. (1863). On Rest and Pain: a Course of Lectures on the Influence of Mechanical and Physiological Rest in the Treatment of Accidents and Surgical Diseases, and the Diagnostic Value of Pain, delivered at the Royal College of Surgeons of England in the years 1860, 1861, and 1862
  2. Krishna, Garg (2010). "Front of the thigh (Chapter 3)". BD Chaurasia's Human Anatomy (Regional and Applied Dissection and Clinical) Volume 2 - Lower limb, abdomen, and pelvis (Fifth ed.). India: CBS Publishers and Distributors Pvt Ltd. p. 56. ISBN 978-81-239-1864-8.
  3. Moore, Keith L. et al. (2010) Clinically Oriented Anatomy, 6th Ed, p.633
  4. Tasker, Dain L. (2006). Principles of Osteopathy: (1903). JOLANDOS eK. p. 135. ISBN 9783936679106.
  5. Peltier, Leonard F. (1993). Orthopedics: a history and iconography. Norman Pub. ISBN 9780930405175.
  6. HÉbert-Blouin, Marie-NoËlle; Shane Tubbs, R.; Carmichael, Stephen W.; Spinner, Robert J. (May 2014). "Hilton's law revisited: Hilton's Law Revisited". Clinical Anatomy. 27 (4): 548–555. doi:10.1002/ca.22348. S2CID 26601686.
  7. "Joint - skeleton - Articular nerves". Encyclopedia Britannica. Archived from the original on 12 March 2016. Retrieved 19 February 2018.
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