brachial plexus anatomy

1. Domain –K/S
Level – SH
core - y

2. At the end of this lecture, the learners should
be able to
 Describe the formation of brachial plexus
 Eneumerate the branches of brachial plexus
 Describe the relations of brachial plexus
 Explain the variations in the formation of
brachial plexus
 Define Erb’s point
 Explain the anatomical basis of clinical features
of Erb’s palsy and Klumpkey’s paralysis.

3. I
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5. Components
Roots
Trunks
Divisions
Codes

7. Roots & trunks

8. Variations in the formation

9. Codes
Lateral code
Medial code
Posterior code

11. Branches- roots
Long thoracic nerve
Dorsal scapular nerve

12. Branches of trunks
• Suprascapular nerve
• Nerve to subclavius

13. • Lateral pectoral nerve
• Musculo cutaneous nerve
• Lateral root of median nerve
Branches- lateral code

14. Medial root of median
Medial cutaneous nerve of arm
Medial cutaneous nerve of forearm
Medial root of median nerve
Ulnar nerve
M4U
Branches- medial code

15. • Upper subscapular
• Lower subscapular
• Thoracodorsalnerve
• Radial nerve
• Axillary nerve
ULTRA
Branches- posterior code

16. Erb’s point

17. Lesions of
brachial plexus

19. Injury to upper trunk
Erb’s paralysis
Nerve root involves- C5,C6

22. Injury to lower trunk
Klumpkey’s paralysis
Nerve root involves- C8,T1
Claw hand

24. • Nerve repair. In this procedure, the surgeon reattaches the two torn edges of a
severed nerve. Nerve repair is typically performed immediately for sharp
lacerations to the nerves, such as in a knife wound.
• Nerve graft. Nerve grafting is a procedure in which a healthy nerve taken from
another part of the body is sewn in between the two ends of a lacerated nerve.
The transplanted nerve acts as a scaffold to support the injured ends as they
regenerate and grow back together. Nerve grafting can only be performed if there
is a functioning nerve stump at the spinal cord to conduct a nerve signal. The goal
is for the transplanted nerve to guide nerve regrowth and to ultimately restore
nerve signals to power the paralyzed muscles.
• Nerve transfer. A nerve transfer procedure is used when there are no functioning
nerve stumps in the neck to which nerve grafts can be connected. In this
procedure, a healthy donor nerve is cut and reconnected to the injured nerve to
provide a signal to a paralyzed muscle. In many cases, the healthy nerve is
connected closer to the affected muscle. In other cases, the healthy nerve is
connected to the damaged nerve within the brachial plexus.