Date post: | 28-Dec-2015 |
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Learning Outcomesafter this session you should be able to…
• Describe the basic anatomy and course of the brachial plexus
• Describe the distribution of all branches of the plexus
• Describe the course of the major nerves and identify where each is vulnerable to injury
• Identify the dermatomes of the upper limb
• Predict the effects of damage to nerve roots, the plexus and peripheral nerves based on anatomical knowledge
Brachial plexus in contextRef: Drake et al (2005), Gray’s Anatomy for Students Flash Cards, Elsevier
Course of the brachial plexus
• Trunks– Emerge between anterior & middle scalenes– Palpable between the clavicle and lower part of the
posterior border of SCM
• Divisions– Posterior to clavicle, between clavicle & 1st rib
• Cords– Lie around the axillary artery; initially between 1st ICS
& clavicular ehad of pec major; then between subscapularis & pectoral muscles
– Palpable in the axilla
Supraclavicular branches
• Dorsal scapular n
• Long thoracic n (of Bell)
• N to subclavius
• Suprascapular n
Infraclavicular branches
• Lateral pectoral n• Medial pectoral n• Superior subscapular n• Inferior subscapular n• Thoracodorsal n• Medial cutaneous n of
the arm• Medial cutaneous n of
the forearm
• Axillary n• Musculocutaneous n• Radial n• Ulnar n• Median n
“minor” nerves – know distribution“major” nerves – course & distribution
Key Words• Dermatome• Myotome• Cutaneous nerve• Prefixed brachial plexus• Postfixed brachial plexus• Roots• Trunks• Divisions• Cords• Supraclavicular branches • Infraclavicular branches
• Course• Distribution• Carpal tunnel syndrome• Palsy• Paraesthesia• Anaesthesia• Paresis• Paralysis• Erb’s palsy• Klumpke’s palsy