Brachial plexus

4.8
(4)

A plexus formed by ventral ramus of corresponding spinal nerves:

  • Roots, trunks & divisions are supraclavicular
  • Cords & branches are infraclavicular.

Branches from the roots:

  1. C5: Dorsal scapular nerve/ Nerve to Rhomboideus
  2. C5, C6, C7: Long thoracic nerve/ Nerve to Serratus anterior.

 

Branches from the trunk:

  1. Suprascapular nerve: Supplies supraspinatus & infraspinatus
  2. Nerve to subclavius.

 

.Branches of lateral cord (C5, C6, C7):

  1. Lateral pectoral nerve
  2. Lateral root of median nerve
  3. Musculocutaneous nerve.

Note: Coracobrachialis is supplied by C5,6,7 roots of musculocutaneous nerve.

 

Branches of medial cord (C8, T1):

  1. Medial pectoral nerve
  2. Medial root of median nerve
  3. Medial cutaneous nerve of arm
  4. Medial cutaneous nerve of forearm
  5. Ulnar nerve (C7, C8, T1) receives branch from lateral cord too.

 

Branches of posterior cord:

  1. Upper subscapular nerve (supplies subscapularis)
  2. Lower subscapular nerve (supplies subscapularis and teres major)
  3. Axillary nerve
    • These 3 nerves have root value of C5, C6
  4. Nerve to Latissimus dorsi/ Thoracodorsal nerve (C6, C7, C8)
  5. Radial nerve (C5-T1) Continuation of posterior cord.

 

Integration with Anesthesia:

Supraclavicular approach:

  • Injection site: 1 cm above the midpoint of clavicle
  • We know that roots, trunks & divisions are supraclavicular
  • So, supraclavicular approach causes dense block.

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