Brachial plexus

gross anatomy

1. Lecture 26 The Brachial Plexus Cleyson Mupfiga

2. Spinal Nerves Dorsal branch Ventral branch Spinal nerve Spinal nerve 2 Cleyson Mupfiga HUB117 2011

3. Spinal Nerves 31 pairs of spinal nerves are attached to the spinal cord. 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal Each spinal nerve divides into a dorsal and ventral ramus . 3 Cleyson Mupfiga HUB117 2011

4. Brachial Plexus The brachial plexus is a network of nerves formed by the union of the anterior rami (branches) of C5 – C8 & T1 spinal nerves. It originates in the neck, passes laterally & inferiorly over the first rib & enters the axilla (arm pit). All major nerves of the upper limb originate from parts of the brachial plexus. Divided into ROOTS, TRUNKS, DIVISIONS, and CORDS. BRANCHES emerge to supply the upper limb. 4 Cleyson Mupfiga HUB117 2011

5. Brachial Plexus Brachial Plexus Lateral Cervical Region ( Posterior Triangle ) ROOTS DIVISIONS TRUNKS CORDS BRANCHES R obert T rucker D rinks C old B eer

6. ROOTS C7 TRUNKS DIVISIONS CORDS MEDIAL POSTERIOR LATERAL MIDDLE LOWER UPPER C5 C6 C8 T1

7. Upper Middle Lower Lateral Medial Radial Posterior Median T1 C8 C7 C5 C6 Ulnar Axillary Musculocutaneous ROOTS DIVISIONS TRUNKS CORDS BRANCHES

8. Brachial Plexus Cleyson Mupfiga HUB117 2011 8 Brachial Plexus Clavicle Arm

9. Brachial Plexus 9 Major nerves: Axillary Radial Musculocutaneous Ulnar Median Cleyson Mupfiga HUB117 2011

10. Axillary Nerve 10 Cleyson Mupfiga HUB117 2011

11. Radial Nerve 11 Cleyson Mupfiga HUB117 2011

12. Musculocutaneous Nerve 12 Cleyson Mupfiga HUB117 2011

13. Ulnar Nerve 13 Cleyson Mupfiga HUB117 2011

14. Median Nerve 14 Cleyson Mupfiga HUB117 2011

15. Upper Middle Trunks Lower Roots (ventral rami): Upper subscapular Lower subscapular Thoracodorsal Medial cutaneous nerves of the arm and forearm Long thoracic Medial pectoral Lateral pectoral Nerve to subclavius Suprascapular Dorsal scapular Posterior divisions Anterior divisions Lateral Posterior Cords Medial Axillary Musculo - cutaneous Radial Median Ulnar Posterior divisions Trunks Roots C 4 C 5 C 6 C 7 C 8 T 1 (a) Roots (rami C 5 – T 1 ), trunks, divisions, and cords

16. Brachial Plexus Injuries 16 Cleyson Mupfiga HUB117 2011 Upper brachial plexus injuries: “waiter’s tip position” Lower brachial plexus injuries: short muscles of the hand are affected > “ clawhand ”

17. Nerve Injury 17 Anaethesia : loss of sensation; may be pathological or induced to facilitate surgery or other medical treatment. Paraesthesia : abnormal sensation e.g. tingling or burning. Cleyson Mupfiga HUB117 2011

18. 18 Questions… Cleyson Mupfiga HUB117 2011