Brachial plexus 1.pdf
- 1. BRACHIAL PLEXUS 1 Dr B Subhash Assistant Professor
- 2. Spinal nerve Ventral ramus Cervical : Cervical plexus, Brachial plexus Thoracic : Intercostal nerves Lumbar : Lumbar plexus Sacral (Lumbar) : Lumbosacral plexus Coccyx (Sacrum) : Coccygeal plexus Dorsal ramus Sympathetic chain Ventral rami-Network 2
- 3. ❖ Lies in the neck and axilla ❖ Formed by ventral rami of C5 to T1 ❖ Prefixed/ Postfixed Brachial plexus ❖ Five major components of the Plexus ▪ ROOTS – Five ventral rami (C5-T1) ▪ TRUNKS – Upper, Middle, and Lower ▪ DIVISIONS – Anterior & Posterior ▪ CORDS – Lateral, Medial & Posterior ▪ BRANCHES – From the cords 3 Divisions E
- 5. C5 C6 C7 C8 T1 Upper T Middle T Lower T Roots Trunks Divisions Cords Branches A A A P P P Suprascapular N N to subclavius Dorsal scapular N Phrenic N Long thoracic N Lateral cord Medial cord Posterior cord Medial Lateral Brachial plexus 5
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- 7. Branches of brachial plexus Lateral cord (LML) Lateral pectoral Musculocutaneous Lateral root of median C5,C6,C7 Medial cord (UM4) Ulnar Median pectoral Medial cutaneous of forearm Medial cutaneous of arm Medial root of median nerve C8,T1 Ulnar (C7,C8,T1) Posterior cord (ULTRA) Upper subscapular Lower subscapular Thoracodorsal N Radial Axillary C5,C6 C5,C6 C5,C6,C7,C8 C5,C6, C7,C8,T1 C5,C6 Branches from roots Branches from trunks Dorsal scapular Phrenic Long thoracic nerve (N of Bell) Suprascapular N to subclavius C5 C5 C5,C6,C7 C5,C6 C5,C6 7
- 8. Supraclavicular: Roots and trunks (branches) Retroclavicular: Divisions Infraclavicular: Cords and branches Brachial plexus 8
- 9. Relation of cords with Axillary artery 9 1st 2nd
- 10. 10 Lateral & Medial cord
- 13. AXILLARY NERVE Innervates Deltoid &Teres Minor Sensory innervation to Shoulder joint and to skin over part of the shoulder 13 Origin: Posterior Cord of Brachial Plexus(C5-C6)
- 14. MUSCULOCUTANEOUS NERVE Origin: Lateral Cord of Brachial Plexus (C5-C7) 14
- 15. RADIAL NERVE Origin: Posterior Cord of Brachial Plexus(C5-T1) Radial Nerve Damage “Crutch Paralysis……… Wrist drop” The extensor muscles of the wrist & fingers, which are innervated by radial nerve, fail to function. 15
- 16. MEDIAN NERVE Origin: Medial and Lateral cords of Brachial Plexus(C5-T1)- LABOURER NERVE Median nerve damage Damage occurs where the medial nerve enters the CARPAL TUNNEL “Carpal Tunnel Syndrome” Inflammation in the wrist or increase in the size of tendons compresses the medial nerve People attempting suicide by cutting wrists, cuts the medial nerve proximal to the carpal tunnel 16
- 17. 17 ULNAR NERVE Origin: Medial Cord of Brachial Plexus(C8-T1)- MUSICIAN NERVE Ulnar Nerve Damage Most easily damaged of all the peripheral nerves “Funny Bone or Crazy Bone” Causes painfull tingling sensations radiating from ulnar side of the forearm and hand.
- 18. 18 • During the fifth week of development, the peripheral nerves grow into the mesenchyme of the limb buds • The spinal nerves are distributed in segmental bands • Orderly sequence of distribution Dermatomal pattern changes during growth of the limbs Cutaneous Innervation: upper limb C8
- 19. Cutaneous Innervation: upper limb Posterior Anterior 19
- 20. 20 1 supraclavicular n. 2 axillary n. 3 intercostobrachial n. 4 medial cutaneous n. arm 5 radial n. 6 medial cutaneous n. forearm 7 musculocutaneous n. 8 radial n. 9 ulnar n. 10 median n. Cutaneous nerves: upper limb 5
- 21. 21 1. All are true about brachial plexus EXCEPT(NEET pattern 2014) a. Lower trunk is formed by root C8 and T1 b. Lateral cord is formed by upper and middle trunk c. Posterior cord is formed by posterior divisions of all three trunks d. C4 root is post fixed to plexus Ans: d 2. Erb’s point in brachial plexus? (NEET 2016) a. Upper trunk b. Middle trunk c. Lower trunk d. Lateral trunk Ans:a
- 22. 22 Root value of cutaneous innervation thumb and index finger (AIIMS 2015) A) C5, C6 B) C6, C7 C) C8, T1 D) C6,C6 Ans: B
- 23. 23 Identify the marked structure (NEET 2017) Long Thoracic nerve
- 24. 24 THANK YOU