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    Brachial Plexus: DR Muthoka Mativo

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    Gish Kioi
    The brachial plexus is formed by the ventral rami of spinal nerves C5-T1. It divides into roots, trunks, divisions, and cords. The cords accompany the axillary artery and each give off branches that innervate muscles and skin of the upper limb. Injuries to different parts of the brachial plexus result in characteristic syndromes like Erb's palsy (C5-C6 injury) seen as shoulder adduction and medial rotation, or Klumpke's palsy (C8-T1 injury) with hand muscle weakness.

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    Brachial Plexus: DR Muthoka Mativo

    Uploaded by

    Gish Kioi
    20 views30 pages
    The brachial plexus is formed by the ventral rami of spinal nerves C5-T1. It divides into roots, trunks, divisions, and cords. The cords accompany the axillary artery and each give off branches that innervate muscles and skin of the upper limb. Injuries to different parts of the brachial plexus result in characteristic syndromes like Erb's palsy (C5-C6 injury) seen as shoulder adduction and medial rotation, or Klumpke's palsy (C8-T1 injury) with hand muscle weakness.

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    BRACHIAL PLEXUS

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    The brachial plexus is formed by the ventral rami of spinal nerves C5-T1. It divides into roots, trunks, divisions, and cords. The cords accompany the axillary artery and each give off branches that innervate muscles and skin of the upper limb. Injuries to different parts of the brachial plexus result in characteristic syndromes like Erb's palsy (C5-C6 injury) seen as shoulder adduction and medial rotation, or Klumpke's palsy (C8-T1 injury) with hand muscle weakness.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    20 views30 pages

    Brachial Plexus: DR Muthoka Mativo

    Uploaded by

    Gish Kioi
    The brachial plexus is formed by the ventral rami of spinal nerves C5-T1. It divides into roots, trunks, divisions, and cords. The cords accompany the axillary artery and each give off branches that innervate muscles and skin of the upper limb. Injuries to different parts of the brachial plexus result in characteristic syndromes like Erb's palsy (C5-C6 injury) seen as shoulder adduction and medial rotation, or Klumpke's palsy (C8-T1 injury) with hand muscle weakness.

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    BRACHIAL PLEXUS

    Dr Muthoka Mativo

    01/29/2022 1
    OBJECTIVES
     Formation of a spinal nerve
     What is brachial plexus
     Formation of the plexus
     Branches
     Applied anatomy

    01/29/2022 2
    SPINAL NERVE

    01/29/2022 3
    FORMATION OF THE BRACHIAL PLEXUS
     Roots
     The ventral rami of spinal nerves C5 to T1 are referred to as the
    roots of the plexus.
     Trunks
     Shortly after emerging from the intervertebral foramina , these 5
    roots unite to form three trunks.
     The ventral rami of C5 & C6 unite to form the Upper Trunk.
     The ventral ramus of C 7 continues as the Middle Trunk.
     The ventral rami of C 8 & T 1 unite to form the Lower Trunk.
     Divisions
     Each trunk splits into an anterior division and a posterior division.
     The anterior divisions usually supply flexor muscles
     The posterior divisions usually supply extensor muscles

    01/29/2022 4
    CORDS OF BRACHIAL PLEXUS
     Formed from divisions.

     Accompany axillary artery.

    01/29/2022 5
    CORDS OF BRACHIAL PLEXUS
     Named for relationship to artery.
    Lateral: From anterior divisions of upper and middle
    trunks.

    Posterior: From posterior divisions of all trunks.

    Medial: From anterior divisions of lower trunk.

    01/29/2022 6
    LATERAL CORD
     Branches:
    Lateral pectoral nerve, C5-7
    - innervates pectoralis major muscle
    Musculocutaneous, C5-7
    -Innervates biceps brachii and other muscles of
    anterior arm
    Lateral root of median nerve, C5-7

    01/29/2022 7
    MEDIAL CORD:BRANCHES
     Medial pectoral nerve:
    C8-T1

     Medial cutaneous nerve to arm (brachium)

     Medial cutaneous nerve to forearm (antebrachium)

     Ulnar
    C8-T1
     Medial root of median nerve
    C8-T1
    01/29/2022 8
    POSTERIOR CORD
     Upper subscapular nerve:
    C5-6
    To subscapularis muscle
     Thoracodorsal nerve:
    C6-7
    To latissimus dorsi muscle
     Lower subscapular nerve:
    C5-6
    To subscapularis and teres major
    muscles

    01/29/2022 9
    POSTERIOR CORD CONT’D
     Axillary nerve:
    C5-6
    Motor:
    To deltoid and teres minor muscles.
    Sensory:
    Skin on arm over deltoid muscle:
    Upper lateral cutaneous nerve

    01/29/2022 10
    POSTERIOR CORD CONT’D
     Radial nerve:
    C5-T1
    Motor:
    Posterior compartments of arm and
    forearm.
    Brachioradialis muscle
    Sensory:
    Back of arm, forearm, hand

    01/29/2022 11
    01/29/2022 12
    BRACHIAL PLEXUS

    01/29/2022 13
    RELATION WITH AXILLARY ARTERY

    01/29/2022 14
    APPLIED ASPECTS
     Post-fixed and pre-fixed plexus

     Erb’s palsy

     Klumpke’s palsy

    01/29/2022 15
    Postfixed Brachial Plexus

    01/29/2022 16
    ERB- DUCHENNE PALSY
     Injury to Superior part of Plexus.

    Due to excessive increase in the angle


    between neck and the shoulder.

     Roots Involved:
     C5 and C6

     Muscles Involved:
     Shoulder
     Arm

    01/29/2022 17
    01/29/2022 18
    What is
    Waiter’s tip or Porter’s tip
    position?

    01/29/2022 19
    ERB- DUCHENNE PALSY
    Clinical Appearance:
    Motor Loss:
     Adducted Shoulder
     Medially Rotated Arm
     Extended Elbow
    Sensory Loss:
    Lateral aspect of Upper Limb (uncommon)

    01/29/2022 20
    WAITER’S TIP POSITION

     Characteristic position - adduction and


    internal rotation of the arm with forearm
    pronated

     Forearm extension normal

     Biceps reflex absent

    01/29/2022 21
    01/29/2022 22
    01/29/2022 23
    KLUMPKE PARALYSIS OR PALSY
     Injury to Inferior part of Plexus.

     Excessive abduction of arm.

    Less common then Injury to Superior part of


    Plexus.

     Roots Involved:
     C8 and T1
    01/29/2022 24
    KLUMPKE PARALYSIS OR PALSY

     Clinical Appearance:

     Motor Loss:
     Small muscles of Hand

     Sensory Loss:
     Medial aspect of Upper Limb

    01/29/2022 25
    PERSON GRASPING SOMETHING TO PREVENT A FALL

    01/29/2022 26
    BABY’S UPPER LIMB IS PULLED EXCESSIVELY
    DURING DELIVERY

    01/29/2022 27
    CLAW HAND

    Aetiology:

    brachial plexus lesion (C8-


    T1),Ulnar, and/ or Median
    nerve injury

    This occurs when all


    fingers are clawed. It is the
    result of hyperextension at
    the metacarpophalangeal
    joints and flexion of the
    interphalangeal joints.

    01/29/2022 28
    CERVICAL RIB

    Involves
    Inferior part
    of Plexus

    01/29/2022 29
    THANK YOU

    ‘BETTER THE END THAN THE BEGINNING..’

    01/29/2022 30

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