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    Brachial Plexus

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    tiiandi
    The brachial plexus is formed by the anterior rami of cervical nerve roots C5-T1. It originates in the neck, passes over the first rib and enters the axilla. It is made up of roots, trunks, divisions, cords, and branches. The roots form trunks which divide into anterior and posterior divisions. The divisions then form medial, lateral, and posterior cords. Major nerves of the upper limb originate from these cords. Injuries can occur to the roots, trunks, divisions or cords, resulting in loss of function of the upper limb.

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    Brachial Plexus

    Uploaded by

    tiiandi
    40 views26 pages
    The brachial plexus is formed by the anterior rami of cervical nerve roots C5-T1. It originates in the neck, passes over the first rib and enters the axilla. It is made up of roots, trunks, divisions, cords, and branches. The roots form trunks which divide into anterior and posterior divisions. The divisions then form medial, lateral, and posterior cords. Major nerves of the upper limb originate from these cords. Injuries can occur to the roots, trunks, divisions or cords, resulting in loss of function of the upper limb.

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    The brachial plexus is formed by the anterior rami of cervical nerve roots C5-T1. It originates in the neck, passes over the first rib and enters the axilla. It is made up of roots, trunks, divisions, cords, and branches. The roots form trunks which divide into anterior and posterior divisions. The divisions then form medial, lateral, and posterior cords. Major nerves of the upper limb originate from these cords. Injuries can occur to the roots, trunks, divisions or cords, resulting in loss of function of the upper limb.

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    © All Rights Reserved
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    40 views26 pages

    Brachial Plexus

    Uploaded by

    tiiandi
    The brachial plexus is formed by the anterior rami of cervical nerve roots C5-T1. It originates in the neck, passes over the first rib and enters the axilla. It is made up of roots, trunks, divisions, cords, and branches. The roots form trunks which divide into anterior and posterior divisions. The divisions then form medial, lateral, and posterior cords. Major nerves of the upper limb originate from these cords. Injuries can occur to the roots, trunks, divisions or cords, resulting in loss of function of the upper limb.

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    Brachial Plexus

    There are 31 pairs of spinal


    nerves.
    These are segmental in
    distribution and emerge
    from the vertebral canal
    between the pedicles of
    adjacent vertebrae.
    There are 8 pairs of
    cervical, 12 thoracic, 5
    lumbar, 5 sacral and one
    coccygeal.

    After exiting the vertebral canal, each spinal nerve branches


    into:
    A posterior ramus, collectively the small posterior rami
    innervates the back.
    An anterior ramus, the much larger anterior rami innervate
    most regions of the body except the head, which is
    innervated by cranial nerves
    nerves.

    The Brachial Plexus


    Formation:
    Anterior rami of C5, C6, C7, C8 and T1.
    Course:
    It originates in the neck, passes over the first rib then enters
    the axilla.
    axilla
    Parts:
    From medial to lateral are:
    1. Roots
    2. Trunks
    3. Divisions
    4 Cords
    4.
    C d

    Roots
    Enter the posterior
    triangle of the neck by
    passing between the
    anterior scalene and
    middle
    iddl scalene
    l
    muscles.
    Lie superior and
    posterior to the
    Subclavian artery.
    y

    Trunks
    The three trunks (superior, middle and inferior) originate from
    the roots.
    They pass laterally over the first rib.
    The superior trunk is formed by the union of C5 and C6 roots
    roots.
    The middle trunk is a continuation of C7 roots.
    The inferior trunk is formed by the union of the C8 and T1
    roots.
    The inferior trunk lies on rib 1 posterior to the subclavian artery.
    The middle and superior trunks are more posterior in position.

    Divisions
    Each of the trunks of the brachial plexus divides into an anterior
    and posterior
    The three anterior divisions form parts of the brachial plexus that
    give rise to peripheral nerves associated with the anterior
    compartment
    t
    t off the
    th arm and
    d forearm.
    f
    The three posterior divisions combine to form parts of the
    brachial plexus that give rise to nerves associated with the
    posterior compartments.
    No peripheral nerves emerge directly from the divisions.

    Cords
    The three cords of the brachial plexus originate from the
    divisions and are related to the second part of axillary
    artery.
    t

    The lateral cord results from the union of the anterior


    divisions of the upper and middle trunks and therefore
    has contribution from C5 to C7. It is positioned lateral
    to the second part of the axillary artery.
    The medial cord is medial to the second part of the
    axillary artery and is the continuation of the anterior
    division of the inferior trunk. It contains contribution
    from C8 and T1.
    The posterior cord occurs posterior to the second part
    of the axillary artery and originates from the union of
    all three posterior divisions. It contain contributions
    from all the roots of the brachial plexus.

    Most of the major nerves of the upper limb originates from


    the cords.
    The nerves associated with the anterior compartments of the
    upper limb arise from the medial and lateral cords.
    The nerves associated with the posterior compartments
    originate from the posterior cord.

    Branches
    Branches of the roots ((2))
    The roots of the brachial plexus give rise to the
    dorsal scapular and long thoracic nerves.

    Branches
    Branches of the roots ((2))
    The roots of the brachial plexus give rise to the
    dorsal scapular and long thoracic nerves.

    Branches of the trunks


    The onlyy branches from the trunks are two nerves that
    originate from the superior trunk (upper trunk), these are:
    The suprascapular nerve
    The nerve to subclavius muscle.

    Roots (ventral rami):


    C4
    C5

    Dorsal scapular
    Nerve to
    subclavius
    Suprascapular

    Cords

    C6

    Posterior
    divisions

    C7

    Lateral

    C8

    Posterior

    T1

    Medial
    Axillary
    Musculocutaneous
    Radial
    Median
    Ulnar
    (a) Roots (rami C5 T1), trunks, divisions, and cords

    Anterior
    divisions

    Posterior
    divisions

    Trunks

    Upper
    Middle

    Trunks

    Lower
    Long thoracic
    L
    th
    i
    Medial pectoral
    Lateral pectoral
    Upper subscapu
    Uppe
    subscapular
    a
    Lower subscapular
    Thoracodorsal
    Medial cutaneous
    nerves off the
    th arm
    and forearm

    Roots
    Figure 13.9 (a)

    Branches of the cords


    Branches of the lateral cord
    Three nerves originate from the lateral cord:
    The lateral pectoral nerve
    The musculocutaneous nerve
    The lateral root of the median nerve
    Branches of the medial cord
    The medial cord has five branches:

    The medial pectoral nerve


    The medial cutaneous nerve of the arm
    The medial cutaneous nerve of the forearm
    The medial root of median nerve
    The ulnar nerve.

    Branches of the p
    posterior cord
    Five nerves originate from the posterior cord of the
    brachial plexus:
    1.
    2.
    3.
    4.
    5.

    The superior scapular nerve


    The thoracodorsal nerve
    The inferior scapular nerve
    The axillary nerve
    The radial nerve

    All these nerves except the radial innervates muscles


    associated with the axilla: the radial nerve passes into the
    arm and forearm.

    Injuries to the brachial plexus


    Spinal cord injuries in the cervical region and direct pulling
    injuries tend to affect the roots of the brachial plexus. Severe
    trauma to the first rib usually affects the trunks.
    The divisions and cords can be injured by dislocation of the
    shoulder joint.
    Brachial plexus injuries are usually the result of blunt trauma
    producing nerve avulsions and disruption.
    These injuries are usually devastating for the function of the
    upper limb and require many months of dedicated
    rehabilitation for even small amount of function to return.

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