AnatomyDiseasesAnalytical, Diagnostic and Therapeutic Techniques and Equipment
Musculocutaneous NerveBrachial PlexusNerve TransferSurgical FlapsCadaverRectus AbdominisRadial Nerve
Radial nerveBranchesSuprascapularAnatomyMedian nerveInfraclavicularSupraclavicularPosterior CordSensoryBlocks the brachial plexusShoulderCordsHumerusTrunksRegional anesthesiaBranchUpper extremityMedial antebAnterior to the axillaryRootsThoracicForearmBrachial plexus avulsionBrachialisSubclavian arteryAnatomicalMusclesCranialInterscaleneCoracoid processDistalParalysisProximalSacralUltrasoundPectoralisElbow flexionInferiorInjuryAvulsionPalsySpinal cordRamiLocal anesthetic
Radial nerve16
  • Occasionally it gives a filament to the pronator teres, and it supplies the dorsal surface of the thumb when the superficial branch of the radial nerve is absent. (wikipedia.org)
  • [2] ICB has less impact on pulmonary function but is more likely to spare the radial nerve distribution if a single injection is used compared with the supraclavicular approach. (asra.com)
  • An additional nerve transfer (triceps branch of the radial nerve to the axillary nerve) was planned for shoulder function. (thenerve.net)
  • For shoulder function, it is recommended to perform radial nerve transfer at the time of the first surgery. (thenerve.net)
  • The posterior cord divides and forms the radial nerve and the axillary nerve . (pondermed.com)
  • Radial nerve, which goes into muscles in the back of your arm (triceps) and in your wrists. (clevelandclinic.org)
  • The posterior cord divides into the axillary nerve and radial nerve (see Fig. 2.1 and Fig. 2.5 ). (aneskey.com)
  • The radial nerve is the largest branch of the brachial plexus and innervates the muscles in the posterior compartment of the arm and forearm. (mrimaster.com)
  • Sensory branches of the radial nerve provide sensation to the posterior arm, forearm, and dorsolateral hand. (mrimaster.com)
  • Spinal accessory nerve to suprascapular nerve transfer with or without transferring the long head of triceps branch of the radial nerve to anterior branch of the axillary nerve was used to reconstruct shoulder abduction in 2 patients. (ijssurgery.com)
  • The objective of this study was to identify common anatomical locations of densified fascia associated with axillary, musculocutaneous, median, ulnar and radial nerve entrapment. (ijmhr.org)
  • A. Transverse scan showing the radial nerve (yellow arrowhead) and the deep brachial artery (red arrowhead). (usra.ca)
  • B. The use of Color Power Doppler to identify the deep brachial artery lateral to the radial nerve (yellow arrowhead). (usra.ca)
  • The solitary radial nerve appears predominantly hyperechoic at this region. (usra.ca)
  • The radial nerve (arrowheads) becomes elliptical and linear as it divides into the superficial and deep branches. (usra.ca)
  • The radial nerve (arrowheads) is visualized below the elbow lying immediately next to the radius bone. (usra.ca)
Branches22
  • The musculocutaneous nerve also gives articular branches to the elbow joint and to the humerus. (wikipedia.org)
  • The cords then pass into the axilla and divide into nerve branches: the musculocutaneous, axillary, radial, median, and ulnar nerves (see the image below). (medscape.com)
  • Nerve branches. (medscape.com)
  • The branches from the cords go to form the terminal nerves of the upper extremity, namely the musculocutaneous, axillary, median,radial, and ulnar nerves. (asra.com)
  • The brachial plexus supplies all of the cutaneous innervation of the upper limb, except for the area of the axilla (which is supplied by the supraclavicular nerve) and the dorsal scapula area, which is supplied by cutaneous branches of the dorsal rami. (medscape.com)
  • Brachial plexus with terminal branches labeled. (medscape.com)
  • After lesioning of the dorsal root entry zone due to painful avulsion, double fascicles (flexor carpi radialis and flexor carpi ulnaris) of the median and ulnar nerve) were transferred to the biceps brachii and brachialis branches of the musculocutaneous nerve to restore elbow flexion. (thenerve.net)
  • The so-called 'double fascicular nerve transfer' entails a surgical transfer of the flexor carpi radialis (FCR) and flexor carpi ulnar (FCU) branches of the median and ulnar nerves to the biceps brachii and brachialis branches of the musculocutaneous nerve for functional restoration of elbow flexion 2 - 4 , 6 , 7 , 12 - 15 ). (thenerve.net)
  • The anterior and posterior circumflex humeral arteries , which are branches of the third part of the axillary artery, form a ring around the surgical neck of humerus. (pondermed.com)
  • The cords continue distally to form the 'branches', which are the 5 main nerves of the upper limb. (pondermed.com)
  • Branches from the lateral and medial cords combine to form the median nerve - this creates the distinctive M-shape appearance when the brachial plexus is encountered around the brachial artery in a cadaver. (pondermed.com)
  • The brachial plexus ends with five nerve branches in the arm. (janiceklaw.com)
  • It is innervated by the ventral branches of the Cx nerves. (onlinepethealth.com)
  • The complexity of the inter-communicating nerve network, known as the brachial plexus, is well described as are the referred pain patterns of the contributing terminal branches. (ijmhr.org)
  • The axillary nerve also provides articular branches to the shoulder joint itself. (neurologyneeds.com)
  • The anterior superior alveolar nerves, branches of the infraorbital nerve (from CN V2), run in canals in the anterior wall of the maxillary sinus and innervate the upper incisors, canines, premolars, and often part of the first molar. (unboundmedicine.com)
  • The inferior alveolar nerve (from CN V3) runs in the mandibular canal, giving off branches to the lower teeth and gingivae as it passes. (unboundmedicine.com)
  • The auricular branch of the vagus nerve is a sensory nerve emerging from the superior ganglion of the vagus nerve, joined by branches from the glossopharyngeal (CN IX) and facial nerves, and innervating the lower part of the tympanic membrane and the floor of the external auditory canal. (unboundmedicine.com)
  • Branches from the medial pectoral nerve may also supply portions of the pectoralis major. (neurol.ru)
  • The axillary block is a peripheral nerve block used to anesthetize the terminal branches of the Brachial Plexus - the median, ulnar, radial and musculocutaneous nerves. (clarius.com)
  • Each spinal nerve consists of four segments from proximal to distal: (1) roots, (2) main trunk, (3) four primary branches, and (4) numerous peripheral branches ( Fig. 17-3 A ). The roots lie within the vertebral canal and consist of a dorsal root ( radix dorsalis ) with a spinal ganglion ( ganglion spinale ), and a ventral root ( radix ventralis ). (veteriankey.com)
  • At the spinal ganglion, the meninges continue on the main trunk of the spinal nerve and its branches as the epineurium. (veteriankey.com)
Suprascapular8
  • The suprascapular nerve and the nerve to the subclavius arise from the upper trunk. (medscape.com)
  • The suprascapular nerve contributes sensory fibers to the shoulder joint and provides motor innervation to the supraspinatus and infraspinatus muscles. (medscape.com)
  • Two weeks after the first transfer surgery, the distal accessory nerve was transferred to the suprascapular nerve to ensure shoulder function. (thenerve.net)
  • Motor root avulsion of the C5 and C6 roots results in Erb palsy, with loss of supply to muscles innervated by the suprascapular nerve, axillary nerve, and musculocutaneous nerve 3 ). (thenerve.net)
  • The nerves affected are those that originate solely from C5 and C6 - the musculocutaneous nerve, axillary nerve, suprascapular nerve, and nerve to subclavius. (pondermed.com)
  • The upper trunk arises from the union of the roots of C5/6, where the suprascapular nerve arises immediately as a lateral branch from the upper trunk. (aneskey.com)
  • The most commonly involved nerves are the suprascapular nerve, musculocutaneous nerve, and the axillary nerve. (standardofcare.com)
  • The suprascapular nerve arises from the superolateral aspect of the upper trunk. (brachialplexustreatment.com)
Anatomy13
  • Iatrogenic nerve injuries (for example during orthopedic surgery involving an internal fixation of the humerus) are relatively common and in a certain percentage of cases probably inevitable, though an adequate knowledge of the surgical anatomy can help to reduce its frequency. (wikipedia.org)
  • Feigl GC, Litz RJ, Marhofer P. Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy. (medscape.com)
  • Brachial plexus anatomy. (asra.com)
  • Before we go into the specifics of brachial plexus injuries in babies, it's important to first understand brachial plexus anatomy. (janiceklaw.com)
  • What is the anatomy of the shoulder nerve? (clevelandclinic.org)
  • Fig. 2.1 Anatomy of the brachial plexus. (aneskey.com)
  • Fig. 2.4 Anatomy of the brachial plexus. (aneskey.com)
  • Fig. 2.5 Anatomy of the brachial plexus. (aneskey.com)
  • There are some of the vessels and nerves that are involved with the canine shoulder joint anatomy. (anatomylearner.com)
  • Hadzic's Nerve Blocks and Anatomy for Ultrasound Guided Regional Anesthesia, 2e. (ijrajournal.com)
  • Anatomy of the lateral antebrachial cutaneous nerve in relation to the lateral epicondyle and cephalic vein. (ijrajournal.com)
  • Anatomy of the Posterior Antebrachial Cutaneous Nerve, Revisited.Scientific Article Volume 45,Issue4,April 2020. (ijrajournal.com)
  • Anatomy, Head and Neck, Brachial Plexus. (ijmhr.org)
Median nerve12
  • The musculocutaneous nerve presents frequent variations and communications with the median nerve. (wikipedia.org)
  • Median nerve, which goes into the front of your forearm, hand and most of your fingers. (clevelandclinic.org)
  • It is now positioned medial to the artery and then gives off a medial root that unites with the lateral root of the lateral cord to form the median nerve. (aneskey.com)
  • The median nerve is usually located lateral to the axillary artery. (aneskey.com)
  • The ulnar nerve, the medial cutaneous nerve of the arm and the medial nerve of the forearm, and the medial root of the median nerve arise from the medial cord. (aneskey.com)
  • After the musculocutaneous nerve has arisen from the lateral cord, it combines with parts of the medial cord to form the median nerve ( Fig. 2.6 , Fig. 2.7 , Fig. 2.8 ). (aneskey.com)
  • Note: two roots of the median nerve behind the brachial artery. (aneskey.com)
  • The median nerve supplies motor fibers to muscles in the anterior compartment of the forearm, including the flexor muscles of the wrist and fingers. (mrimaster.com)
  • Double fascicular nerve transfer (a fascicle of the ulnar nerve to biceps branch and a fascicle of the median nerve to brachialis branch of the musculocutaneous nerve) was used to reconstruct elbow flexion in 3 patients. (ijssurgery.com)
  • The lateral cord divides in to the musculocutaneous nerve and lateral root of the median nerve. (brachialplexustreatment.com)
  • The medial cord gives off the medial root of the median nerve and continues as the ulnar nerve. (brachialplexustreatment.com)
  • The median nerve is formed by the union of medial and lateral cord contributions. (brachialplexustreatment.com)
Infraclavicular13
  • Venkatraman R., Matheswaran P., Sivarajan G.,. A Randomised Comparative Evaluation of Supraclavicular and Infraclavicular Approaches to Brachial Plexus Block for Upper Limb Surgery using both Ultrasound and Nerve Simulation. (medscape.com)
  • The infraclavicular block (ICB) was developed to overcome the limitations of the axillary block. (asra.com)
  • Bazy in 1917, followed by Labat in 1922 are credited with the infraclavicular approach to brachial plexus. (asra.com)
  • The infraclavicular block has several advantages that make it a preferable approach to brachial plexus blockade: comprehensive upper extremity anesthesia, lower incidence of tourniquet pain and preferable site for catheter insertion. (asra.com)
  • [2,3] The infraclavicular block in general has a higher success rate than the axillary block. (asra.com)
  • [2] Block onset time may be slightly longer for infraclavicular block when compared to other single injection brachial plexus blocks. (asra.com)
  • Indications for the infraclavicular block are the same as those for the axillary and the supraclavicular block, including surgery at the elbow, forearm, wrist, and hand. (asra.com)
  • Several techniques for infraclavicular nerve blocks have been described. (medscape.com)
  • The infraclavicular block can be considered the same block as the axillary block and has the advantage of not having to move the arm over the patient's head. (medscape.com)
  • Ultrasound-guided infraclavicular brachial plexus block. (medscape.com)
  • Nadig M, Ekatodramis G, Borgeat A. Ultrasound-guided infraclavicular brachial plexus block. (medscape.com)
  • Macfarlane A, Anderson K. Infraclavicular Brachial Plexus Blocks. (medscape.com)
  • 3. Lower brachial plexus injury - This type of injury involves the infraclavicular part of plexus. (brachialplexustreatment.com)
Supraclavicular6
  • Eventually, with the combined effect of pneumothorax fear and the introduction of the axillary approach in 1949, the supraclavicular block fell out of favor. (medscape.com)
  • Kapral et al expanded that idea with the first described ultrasound imaging of the brachial plexus in the supraclavicular position and the needle insertion under ultrasound guidance. (medscape.com)
  • The major advantage of the supraclavicular block is that the nerves are tightly packed in that area. (medscape.com)
  • Mani KV, Veerapandiyan A, Radhakrishnan S. A study on comparison between ultrasound guided technique and peripheral nerve stimulator guided technique in performing brachial plexus block (supraclavicular approach) for upper limb surgeries. (medscape.com)
  • Mudakanagoudar MS. Comparison between Ultrasound-Guided Supraclavicular Brachial Plexus Block in Upper Limb Surgeries. (medscape.com)
  • Origin of medial and lateral pectoral nerves from the supraclavicular part of brachial plexus and its clinical importance - a case report. (radiopaedia.org)
Posterior Cord2
Sensory11
  • Other differential diagnoses that can mimick the symptoms of musculocutaneous palsy are: C6 radiculopathy (pain can be produced by movement of the neck), long head of biceps tendinopathy (no motor or sensory deficits), pain of the bicipital groove (relieved by shoulder joint injection). (wikipedia.org)
  • Those with this type of lesion is presented with pain, reduced sensation, and tingling of the lateral part of forearm (lateral antebrachial cutaneous nerve - terminal sensory only branch of Musculocutaneous nerve) with reduced strength of elbow flexion. (wikipedia.org)
  • Nerves carry messages from the brain to muscles to direct movement (motor nerves) and send information about different sensations such as touch, temperature, and pain from the muscles back to the brain (sensory nerves). (orthony.com)
  • The brachial plexus is a network of nerves originating from the spinal cord in the neck region (C5-T1) and branching out to provide motor and sensory innervation to the upper extremities. (mrimaster.com)
  • Sensory innervation to the upper extremity includes most of the axilla while excluding a specific region of the medial upper extremity and axilla which is supplied by the intercostobrachial nerve [i.e. (ijmhr.org)
  • A brachial plexus injury results from the injury to the network of the nerves and manifests as impairment of motor and sensory functions of the involved upper limb. (brachialplexustreatment.com)
  • There are three broad functional classifications of nerves - sensory (afferent), intermediate and motor (efferent). (teachmeanatomy.info)
  • Sensory nerves - small axons and psuedounipolar structure. (teachmeanatomy.info)
  • The sensory component of the axillary nerve is delivered via its posterior terminal branch. (neurologyneeds.com)
  • The onset of motor and sensory block of each nerve distribution was evaluated every 10 min over a 30-min period. (londonspine.com)
  • A sensory branch of the mandibular nerve (CN V3) It passes through the parotid gland en route to the ear, where it innervates skin of the pinna, external auditory canal, and tympanic membrane. (unboundmedicine.com)
Blocks the brachial plexus2
Shoulder30
  • In indirect trauma, violent abduction and retroposition of the shoulder can stretch the nerve and result tension of the coracobrachialis with musculocutaneous nerve lesion. (wikipedia.org)
  • The diagnosis of brachial plexus avulsion is often delayed by concomitant trauma to the arm and shoulder. (thenerve.net)
  • Therefore, nerve transfer surgery to restore elbow and shoulder function is rarely reported. (thenerve.net)
  • Six months after the nerve transfers, elbow flexion recovered to Medical Research Council grade 3, but shoulder function did not show any improvement. (thenerve.net)
  • Loss of shoulder and elbow function is typical of upper brachial plexus avulsion 3 , 13 ). (thenerve.net)
  • In the case of root avulsion, the absence of proximal nerve stump prevents nerve graft reconstruction and no spontaneous recovery of the shoulder and elbow function is anticipated 13 ). (thenerve.net)
  • Therefore, nerve transfer should be considered for restoration of the elbow and shoulder function. (thenerve.net)
  • Brachial plexus avulsion causes characteristic pain and paralysis in the upper extremities but often goes undiagnosed for years due to trauma to the shoulder and arm 5 , 9 , 10 ). (thenerve.net)
  • Despite pain surgery for neuropathic pain in brachial plexus avulsion 5 , 9 , 10 ), no surgical restoration of the function of the elbow and shoulder was possible because it was referred to the authors one year after a shoulder injury. (thenerve.net)
  • It usually occurs from an excessive increase in the angle between the neck and shoulder (lateral flexion of the head) - this stretches/tears the nerve roots. (pondermed.com)
  • The nerves of the arm pass through the shoulder joint from the neck. (orthony.com)
  • These nerves form a bundle at the region of the shoulder called the brachial plexus. (orthony.com)
  • For example, if a difficult birth injures the nerve roots that are higher up in the baby's neck, then they will likely suffer shoulder pain and mobility issues. (janiceklaw.com)
  • The axillary nerve starts in your neck and extends to your shoulder. (clevelandclinic.org)
  • Your axillary nerve, also known as the circumflex nerve, is one of five peripheral nerves that run through your shoulder. (clevelandclinic.org)
  • Axillary nerves start in your neck at the brachial plexus (a network of nerves in your shoulder). (clevelandclinic.org)
  • The axillary nerve helps you move muscles in your upper limbs, near your shoulder. (clevelandclinic.org)
  • What conditions affect shoulder nerve functioning? (clevelandclinic.org)
  • Arm paralysis due to a brachial plexus (network of nerves in your shoulder) injury. (clevelandclinic.org)
  • This can provide valuable information about the integrity of deep shoulder structures, including your nerves. (clevelandclinic.org)
  • I will show the involvement of the vessels and nerves in the canine shoulder lateral with the labeled diagram. (anatomylearner.com)
  • All these nerves and arteries from the shoulder will describe later with a diagram. (anatomylearner.com)
  • The axillary nerve controls the deltoid and teres minor muscles, which are involved in shoulder abduction and external rotation, respectively. (mrimaster.com)
  • If the scanner allows a rectangular FOV, please use an FOV of 200x300mm to cover the entire brachial plexus from the right shoulder joint to the left shoulder joint. (mrimaster.com)
  • 8,9 In the setting of the iatrogenic cervical nerve root injuries, restoration of the elbow flexion and the shoulder function has higher priority to control antigravity movements. (ijssurgery.com)
  • Following trauma to the head and shoulder, an injury can cause the nerves of the plexus to violently stretch, with the upper trunk of the plexus sustaining the greatest injury. (standardofcare.com)
  • 1. Upper brachial plexus injury - It involves the C5, C6 spinal nerves and presents with a weak shoulder and elbow. (brachialplexustreatment.com)
  • CONCLUSIONS: During USG ISB placement, injection below the C6 level provided the same efficiency in analgesia after shoulder surgery as an injection cranial to the C5 nerve root but a greater success rate of anesthesia in all distal nerve areas. (londonspine.com)
  • Ultrasound-guided interscalene brachial plexus block (US-ISB) has been reported to be effective postoperative analgesia for arthroscopic shoulder surgery. (anesth-pain-med.org)
  • Interscalene brachial plexus block (ISB) is one of the most effective methods for anesthesia and postoperative analgesia after shoulder arthroscopic surgery [ 1 - 8 ]. (anesth-pain-med.org)
Cords6
  • The divisions undergo yet another level of reorganization into the three cords as the brachial plexus emerges from under the clavicle. (asra.com)
  • These cords are defined by their spatial relationship to the axillary artery, and are designated as the lateral, posterior, and the medial cord. (asra.com)
  • The cords are referred to as the lateral, posterior, and medial cord, according to their relationship with the axillary artery, as seen in the image below. (medscape.com)
  • The cords are named according to their arrangement around the axillary artery. (pondermed.com)
  • Here, the cords rotate by about 90° around the axillary artery, with the medial cord passing under the artery. (aneskey.com)
  • Sternocostal part: Innervation is via the lateral and medial pectoral nerves, lateral and medial cords, middle and lower trunks, and roots C7, C8, T 1. (neurol.ru)
Humerus2
Trunks5
  • The roots combine above the first rib to form the superior, middle, and inferior trunks of the brachial plexus, between the anterior and middle scalene muscles, in the interscalene groove. (asra.com)
  • The trunks of the brachial plexus pass between the anterior and middle scalene muscles. (medscape.com)
  • The anterior divisions of the upper and middle trunks unite to form the lateral cord, which is the origin of the lateral pectoral nerve (C5, C6, C7). (medscape.com)
  • BACKGROUND: During interscalene block (ISB) placement, ultrasound guidance (USG) enables the practitioner to measure the spread of local anesthetic around the nerve trunks or roots, and to adjust the needle position in order to optimize diffusion. (londonspine.com)
  • The lateral pectoral nerve is larger than the medial and arises from the upper and middle trunks or by a single branch from the lateral cord of the brachial plexus. (neurol.ru)
Regional anesthesia1
  • Originally, surgical procedures performed on the elbow and distal upper extremity utilizing regional anesthesia were done under axillary block. (asra.com)
Branch14
  • The musculocutaneous nerve is a mixed branch of the lateral cord of the brachial plexus derived from cervical spinal nerves C5-C7. (wikipedia.org)
  • Its terminal branch, the lateral cutaneous nerve of the forearm, supplies the sensation of the lateral side of the forearm from the elbow to the wrist. (wikipedia.org)
  • less frequently the reverse is the case, and the median sends a branch to join the musculocutaneous. (wikipedia.org)
  • Identify and shield the dorsal cutaneous branch of the ulnar nerve in the distal incision. (dnahelix.com)
  • 8 ) reported the technique of nerve transfer from a redundant fascicle of the ulnar nerve to the biceps brachii branch of the musculocutaneous nerve for restoration of elbow function due to upper brachial plexus avulsion. (thenerve.net)
  • It curves anteriorly to lie between the axillary artery and vein then, after receiving a communicating branch from the lateral pectoral nerve (the ansa pectoralis) enters the deep surface of the pectoralis minor muscle. (radiopaedia.org)
  • Along its course it receives a communicating branch from the lateral pectoral nerve to form a loop (ansa pectoralis) which runs anteriorly to both the axillary artery and vein. (radiopaedia.org)
  • The muscle is innervated the posterior terminal branch of the axillary nerve. (neurologyneeds.com)
  • After the posterior terminal branch of the axillary nerve has innervated the teres minor, it continues as the upper lateral cutaneous nerve of the arm. (neurologyneeds.com)
  • The posterior auricular nerve is a motor branch of the facial nerve (CN VII) that innervates the posterior and intrinsic auricular muscles. (unboundmedicine.com)
  • It sends a small branch to the medial pectoral nerve, forming a loop in front of the first part of the axillary artery, to supply fibers of the pectoralis minor. (neurol.ru)
  • It curves forward to join the branch from the lateral pectoral nerve, entering the deep surface of the pectoralis minor to supply it. (neurol.ru)
  • Within the intervertebral foramen, the spinal nerve gives off a small and variable meningeal branch ( ramus meningeus ). (veteriankey.com)
  • After emerging from the intervertebral foramen, the spinal nerve gives off a dorsal branch ( ramus dorsalis ), then a communicating branch ( ramus communicans ), and continues as a larger ventral branch ( ramus ventralis ). (veteriankey.com)
Upper extremity4
  • All upper extremity blocks involve the brachial plexus. (medscape.com)
  • The plexus, depicted in the images below, is responsible for the motor innervation of all of the muscles of the upper extremity, with the exception of the trapezius and levator scapula. (medscape.com)
  • 5) Jordan M.Brown, Corrie M. Yablon , Yoav Morag, Catherine J. Brandon, Jon A. Jacobson.Ultrasound of the Peripheral Nerves of the Upper Extremity: A Landmark Approach. (ijrajournal.com)
  • Thoracic outlet syndrome is a condition that causes compression of nerves and/or blood vessels where the thorax outlets into the upper extremity. (learnmuscles.com)
Medial anteb1
  • The anterior division of the lower trunk forms the medial cord, which gives off the medial pectoral nerve (C8, T1), the medial brachial cutaneous nerve (T1), and the medial antebrachial cutaneous nerve (C8, T1). (medscape.com)
Anterior to the axillary2
  • The medial pectoral nerve lies posterior to the axillary artery and anterior to the axillary vein. (radiopaedia.org)
  • It crosses anterior to the axillary artery and vein, pierces the clavipectoral fascia, and supplies the deep surface of the pectoralis major. (neurol.ru)
Roots9
  • The roots of the brachial plexus represent the ventral rami of these spinal nerves. (asra.com)
  • The brachial plexus (plexus brachialis) is a somatic nerve plexus formed by intercommunications among the ventral rami (roots) of the lower 4 cervical nerves (C5-C8) and the first thoracic nerve (T1). (medscape.com)
  • The brachial plexus communicates with the sympathetic trunk via gray rami communicantes, which join the roots of the plexus. (medscape.com)
  • The ventral rami of spinal nerves C5 to T1 are referred to as the "roots" of the plexus. (medscape.com)
  • The roots are the anterior rami of the C5-T1 cervical spinal nerves . (pondermed.com)
  • The roots of the spinal nerves exit from the spinal canal behind the vertebral artery and cross the transverse process of the corresponding vertebra. (aneskey.com)
  • The medial pectoral nerve arises from the medial cord of the brachial plexus with fibers arising from the eighth cervical and first thoracic nerve roots. (radiopaedia.org)
  • Union of the dorsal and ventral roots forms the main trunk of the spinal nerve, which is located largely within the intervertebral foramen. (veteriankey.com)
  • Because the caudal part of the spinal cord (S-1 caudally) and the nerves that leave it resemble a horse's tail, this part of the spinal cord (the conus medullaris), with the spinal roots coming from it, is called the cauda equina (see Chapter 16 ). (veteriankey.com)
Thoracic10
  • The brachial plexus starts as the union of the ventral primary rami of cervical nerves 5 through 8 (C5-C8) and the thoracic nerve T1 (Figure 1). (asra.com)
  • The brachial plexus is basically a group of nerves that begin in the cervical and thoracic regions of the spinal cord. (janiceklaw.com)
  • The upper trunk C5-C6 nerves form part of the brachial plexus, comprising the ventral rami of spinal nerves C5-C8 and thoracic nerve T1. (standardofcare.com)
  • The medial pectoral nerve , also known as the medial anterior thoracic nerve arises from the medial cord of the brachial plexus and supplies both the pectoralis minor and major muscles. (radiopaedia.org)
  • The brachial plexus is a network of nerves that originate from the spinal cord (5th to 8th cervical (C5-C8), and 1st thoracic (T1) spinal nerves) and control the movement and sensation in the upper limb. (brachialplexustreatment.com)
  • The brachial plexus is formed by a union of anterior rami of the lower four cervical (C5 through C8) and the first thoracic (T1) spinal nerves between the anterior and middle scalene muscles. (brachialplexustreatment.com)
  • Some nerve fibers to the plexus may originate from the fourth cervical (C4, prefixed) or from the second thoracic (T2, post fixed) nerves. (brachialplexustreatment.com)
  • dorsal scapular nerve (C5,C6) supplying the levator scapulae and the rhomboid muscles, long thoracic nerve( C5,C6,C7) which supplies the serratus anterior muscle, and phrenic nerve (C3,C4,C5). (brachialplexustreatment.com)
  • The medial pectoral nerve is derived from the eighth cervical and first thoracic cervical rami. (neurol.ru)
  • From the second thoracic segment through the thirteenth thoracic segment there are two dorsal and two ventral filaments that form each thoracic nerve root. (veteriankey.com)
Forearm9
  • citation needed] after passing the lateral edge of the tendon of biceps brachii it is becomes known as the lateral cutaneous nerve of the forearm. (wikipedia.org)
  • at 2 cm above the elbow it pierces the deep fascia lateral to the tendon of the biceps brachii and is continued into the forearm as the lateral cutaneous nerve of the forearm. (wikipedia.org)
  • Ulnar nerve, which goes into your forearm and hand. (clevelandclinic.org)
  • Forearm blocks (FAB) are implemented to provide anaesthesia for hand surgeries, as a rescue block for failed or patchy proximal brachial plexus block and to provide postoperative analgesia after a regional or a general anaesthetic [1]. (ijrajournal.com)
  • Distal nerve blocks do not prevent tourniquet pain since the lateral antebrachial cutaneous nerve of forearm (musculocutaneous nerve), the medial cutaneous nerve of the arm, the posterior cutaneous nerve of the arm, and the intercostobrachial nerve that provide cutaneous innervation of the upper arm are not blocked [4]. (ijrajournal.com)
  • 2) Liebmann O, Price D, Mills C, Gardner R, Wang R, Wilson S, et al.Feasibility of forearm ultrasonography guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department.Ann Emerg Med 2006,48:558-62. (ijrajournal.com)
  • 12) M Lurf et al.Ultrasound guided ulnar nerve catheter placement in the forearm for postoperative pain relief and physiotherapy. (ijrajournal.com)
  • The medial cord gives off medial pectoral nerve, medial cutaneous nerve of arm and medial cutaneous nerve of forearm. (brachialplexustreatment.com)
  • A cutaneous nerve of the forearm. (unboundmedicine.com)
Brachial plexus avulsion3
Brachialis3
  • Overuse of coracobrachialis, biceps, and brachialis muscles can cause the stretching or compression of musculocutaneous nerve. (wikipedia.org)
  • However, the importance of the brachial muscle in elbow flexion was subsequently confirmed and the technique for the transfer of double fascicular nerves to both the biceps brachii and brachialis muscles was introduced 7 ). (thenerve.net)
  • The musculocutaneous nerve innervates the muscles in the anterior compartment of the arm, including the biceps brachii, brachialis, and coracobrachialis. (mrimaster.com)
Subclavian artery4
  • The goal is to get around the subclavian artery, where the nerves are located, and stay away from the dome of the lung, avoiding a pneumothorax. (medscape.com)
  • Diagram showing basic relationships of the brachial plexus to the pectoralis minor muscle and the axillary artery, which is a continuation of the subclavian artery. (medscape.com)
  • The axillary artery is a continuation of the subclavian artery. (pondermed.com)
  • The subclavian artery and brachial plexus pass into the axillary cavity medial to the coracoid process ( Fig. 2.2 , Fig. 2.3 , Fig. 2.4 , Fig. 2.5 ). (aneskey.com)
Anatomical5
  • The basic anatomical relationships of the brachial plexus (BP). (medscape.com)
  • Fig. 2.7 Brachial plexus in the axillary region: anatomical overview. (aneskey.com)
  • 4. Kg P, K S. Anatomical study of pectoral nerves and its implications in surgery. (radiopaedia.org)
  • Ultrasound guidance, compared with anatomical landmark and paresthesia techniques, can provide direct visualization of the target nerve, surrounding tissue, and injectate spread, and may lead to improvement in patient safety for decreased nerve injury or other serious complications including local anesthetic systemic toxicity and pneumothorax [ 5 , 7 , 8 - 11 ]. (anesth-pain-med.org)
  • Technical skills, such as needle manipulation during ISB using a nerve stimulator, as well as anatomical landmarks and the types of local anesthetic drug used for ISB, are important neurological risk factors [ 1 ]. (anesth-pain-med.org)
Muscles9
  • This type of reconstruction offers unique advantages including the potential for a faster reconnection of nerve tissue and associated re-education of the muscles. (hss.edu)
  • Ultrasound orientation of the muscles, arteries, and nerves in a transverse view. (medscape.com)
  • This is the most functionally significant rearrangement of nerve fibres in the brachial plexus, as all the anterior divisions are destined to innervate anterior compartment (flexor) muscles, and all the posterior divisions will innervate posterior compartment (extensor) muscles. (pondermed.com)
  • This nerve begins in the C5, C6, and C7 vertebrae and it controls muscles in the upper arm. (janiceklaw.com)
  • This nerve begins in the C5-T1 vertebrae and allows you to move muscles in your hands, forearms, upper arms, and elbow. (janiceklaw.com)
  • Musculocutaneous nerve, which goes into muscles in the front of your upper arm and near your elbow. (clevelandclinic.org)
  • Which muscles are innervated by the axillary nerve? (clevelandclinic.org)
  • When inflammation in the muscles of your quadrilateral space press on your axillary nerve. (clevelandclinic.org)
  • The ulnar nerve controls the muscles of the hand involved in fine motor movements, such as the flexor muscles of the ring and little fingers. (mrimaster.com)
Cranial4
  • From the meninges to the brainstem, we will explore the major structures of the cerebrum and cerebellum, and their extensions into the cranial nerves. (anatomytrains.com)
  • Symptoms of nerve injury include paresthesias, loss of sensation and position sense, impaired motor function, cranial nerve malfunction, changes in reflexes, and impairments in glandular secretion. (unboundmedicine.com)
  • cranial nerve for illus. (unboundmedicine.com)
  • The components of the eighth cranial nerve (CN VIII) carrying axons that convey information regarding sound and balance between the spiral ganglion in the inner ear and the cochlear nuclei in the brainstem. (unboundmedicine.com)
Interscalene1
  • This approach has less chance of blocking the phrenic nerve than the interscalene approach. (medscape.com)
Coracoid process2
  • A cadaveric study showed that the exit point of the musculocutaneous nerve is typically distal to the coracoid process. (asra.com)
  • They are lateral to the axillary artery proximally and rotate to surround the artery as it approaches the coracoid process. (medscape.com)
Distal3
  • It follows the course of the third part of the axillary artery (part of the axillary artery distal to the pectoralis minor) laterally and enters the frontal aspect of the arm where it penetrates the coracobrachialis muscle. (wikipedia.org)
  • The advantage of these distal blocks is preservation of proximal motor function and avoidance of central structures such as the pleura, subclavian or axillary artery and the phrenic nerve. (ijrajournal.com)
  • 4) Herman Sehmbi,Caveh Madjdpour,Ushma Jitendra Shah,Ki Jinn Shin.Ultrasound guided distal peripheral nerve block of the upper limb: A technical review.JOACP 2015.Volume 31,issue3,296-307. (ijrajournal.com)
Paralysis4
  • In this regard, a variety of nerve transfers based on the pattern of paralysis are introduced ( Figure 1 ). (ijssurgery.com)
  • Erb's palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5-C6 nerves. (standardofcare.com)
  • Other Injuries as a result of direct violence, including gunshot wounds and traction on the arm can cause nerves related paralysis. (standardofcare.com)
  • Brachial plexus injury leads to weakness or a partial or complete paralysis of the involved upper limb depending on the nerves injured. (brachialplexustreatment.com)
Proximal2
  • Given the proximal take off of the musculocutaneous nerve, the lateral proximal arm would often be spared. (asra.com)
  • It will not anesthetize the axilla or the proximal medial arm, missing the intercostal and medium cutaneous brachii nerves. (medscape.com)
Sacral1
  • thus the last several lumbar, the sacral, and the caudal nerves have to run increasingly longer distances before they reach the corresponding intervertebral foramina to exit from the vertebral canal. (veteriankey.com)
Ultrasound4
  • Vincent Chan then described the use of both ultrasound and nerve stimulation to perform the block. (medscape.com)
  • Ultrasound image of the needle in plane with local anesthetic posterior to the axillary artery. (medscape.com)
  • Ultrasound-guided nerve blocks in the emergency department Journal of emergencies trauma and shock.Jan-Mar 2010. (ijrajournal.com)
  • In several literatures, the use of ultrasound significantly enables low volumes of brachial plexus block to reduce the incidence and intensity of hemidiaphragmatic paresis (HDP), but has still no significant effect on the incidence of postoperative neurologic symptoms (PONS) [ 12 , 13 ]. (anesth-pain-med.org)
Pectoralis2
  • The medial pectoral nerve perforates the pectoralis minor muscle and enters the deep surface of pectoralis major supplying the lower sternocostal fibers of the muscle. (radiopaedia.org)
  • The medial pectoral nerve supplies both the pectoralis minor muscle and sternocostal portions of the pectoralis major muscle. (radiopaedia.org)
Elbow flexion2
  • Differential diagnosis includes C5 and C6 nerve root lesions of the brachial plexus where the abduction, external rotation, and elbow flexion is lost. (wikipedia.org)
  • If reconstruction of the motor function of the musculocutaneous nerve (elbow flexion) is needed then there are several options, depending on the injury pattern and timeframes. (wikipedia.org)
Inferior3
Injury25
  • Injury to the musculocutaneous nerve can be caused by three mechanisms: repeated microtrauma, indirect trauma or direct trauma on the nerve. (wikipedia.org)
  • To diagnose traumatic nerve injury, operative exploration should be performed without delay. (wikipedia.org)
  • At the HSS Center for Brachial Plexus and Traumatic Nerve Injury, patients are cared for by a multidisciplinary team with extensive experience in every aspect of their treatment, from diagnosis to long-term follow-up. (hss.edu)
  • These surgeries include a range of primary nerve reconstruction procedures, which are optimally performed three to six months following the injury, as well as secondary reconstructive procedures, which include free muscle transplants, pedicle muscle transfers, tendon transfers, and fusions. (hss.edu)
  • Recovery from nerve injury and reconstructive surgery is a lengthy process. (hss.edu)
  • Nerve reconstruction is the umbrella term given to the various surgical and microsurgical techniques used to treat nerve injury. (hss.edu)
  • Ideally, nerve reconstruction should begin between 3 and 6 months after the injury is sustained. (hss.edu)
  • Erb's Palsy results from injury to the superior part of the brachial plexus - C5 and C6. (pondermed.com)
  • Superior brachial plexus injury produces the characteristic ' waitor's tip position ' - the arm hangs limply by the side in medial rotation so that the palm faces posteriorly instead of medially. (pondermed.com)
  • Any wrong move could result in major birth injuries, such as a brachial plexus injury. (janiceklaw.com)
  • What is a Brachial Plexus Injury? (janiceklaw.com)
  • A brachial plexus injury is a common birth injury that can completely prevent movement of the arms, hands, or fingers. (janiceklaw.com)
  • The severity of the injury and the symptoms depend on which nerves are damaged. (janiceklaw.com)
  • This type of injury occurs when the brachial plexus nerves are partially or completely torn. (janiceklaw.com)
  • This type of injury occurs when an injured brachial plexus nerve attempts to heal itself by forming scar tissue. (janiceklaw.com)
  • This is the most severe brachial plexus injury. (janiceklaw.com)
  • A brachial plexus injury can have devastating effects on both babies and adults. (janiceklaw.com)
  • Should I be concerned if I have an axillary nerve injury? (clevelandclinic.org)
  • Background Iatrogenic cervical nerve root injury may occur during cervical spine surgeries, which leads to upper limb palsy. (ijssurgery.com)
  • Conclusion In our view, these results represent an excellent initial step toward the treatment of iatrogenic nerve root injury after spine surgery. (ijssurgery.com)
  • Brachial plexus injury is usually sustained in high speed motor bike accidents. (brachialplexustreatment.com)
  • The magnitude of injury may vary in severity from a mild stretch to the nerve root tearing away from the spinal cord. (brachialplexustreatment.com)
  • Involvement of C7 nerve is termed as an extended upper plexus injury. (brachialplexustreatment.com)
  • The assessment of nerve injury includes a careful neurological examination, sometimes accompanied by tests, e.g., electromyography or nerve conduction studies. (unboundmedicine.com)
  • In particular, the most common misconception is that a nerve block is associated with an increased risk of nerve injury [ 14 ]. (anesth-pain-med.org)
Avulsion1
Palsy5
  • This study outlines a new reconstructive approach forupper limb palsy following cervical spine surgery using nerve transfer. (ijssurgery.com)
  • Methods In an attempt to reconstruct iatrogenic upper limb palsy, we performed nerve transfer in 4 patients with permanently lost functions. (ijssurgery.com)
  • In addition, we have addressed the question of how nerve transfer can help patients with iatrogenic cervical root palsy. (ijssurgery.com)
  • The most common nerve transfers that can be performed to treat patients with permanent upper limb palsy after cervical spine surgery. (ijssurgery.com)
  • The three most common treatments for Erb's palsy are nerve transfers from the opposite arm, subscapularis releases and latissimus dorsi tendon transfers. (standardofcare.com)
Spinal cord6
  • Musculocutaneous nerve arises from the lateral cord of the brachial plexus with root value of C5 to C7 of the spinal cord. (wikipedia.org)
  • The typical spinal nerve root results from the confluence of the ventral nerve rootlets originating in the anterior horn cells of the spinal cord and the dorsal nerve rootlets that join the spinal ganglion in the region of the intervertebral foramen. (medscape.com)
  • It occurs when the nerves completely separate from the spinal cord due to physical trauma. (janiceklaw.com)
  • 2. Rupture - The nerve is torn but maintains its attachment to the spinal cord. (brachialplexustreatment.com)
  • The neuronal cell bodies of a nerve's axons are in the brain, the spinal cord, or ganglia, but the nerves run only in the peripheral nervous system. (unboundmedicine.com)
  • A nerve that conducts impulses toward the brain or spinal cord. (unboundmedicine.com)
Rami2
Local anesthetic1
  • Arrows = block needle, AA = axillary artery, LA = local anesthetic posterior to the artery. (medscape.com)