6. BRANCHES OF SUPRACLAVICULAR PART OF
BRACHIAL PLEXUS
Branches of roots - Dorsal scapular nerve(C5)
Long thoracic nerve (C5,C6,C7)
muscular branches to longus colli &
scaleni
Branch to phrenic nerve
Branches of upper- Nerve to subclavius (C5,C6)
Trunk Suprascapular nerve (C5,C6)
7. BRANCHES OF INFRACLAVICULAR PART OF BRACHIAL PLEXUS
• Lateral cord Musculocutaneous nerve(C5,C6)
Lateral pectoral nerve (C5,C6)
Lateral root of median nerve (C5,C6)
• Medial cord Medial cutaneous nerve of arm (C8,T1)
Medial cutaneous nerve of forearm(C8,T1)
Medial root of median nerve(C8,T1)
Medial pectoral nerve (C8,T1)
Ulnar nerve(C7,C8,T1)
• Posterior cord Upper subscapular nerve(C5,C6)
Lower subscapular nerve(C5,C6)
Nerve to latissimus dorsi (C6,C7,C8)
Axillary nerve(C5,C6)
Radial nerve(C5,C6,C8,T1)
8. BRANCHES OF ROOTS
DORSAL SCAPULAR NERVE
• Root value- C5
• Supply – Rhomboid major &
minor muscle
Posterior view
24. LONG THORACIC NERVE
Causes - carrying Heavy load on shoulder
Sudden pressure on shoulder
from above
Deformity – Winging of scapula
Overhead abduction not possible
30. AXILLARY NERVE
• Causes
crutch pressing upward into the
armpit,
Downward shoulder dislocations
fractures of the surgical neck of
the humerus.
• Motor effects:
• Sensory effects:
• Deformity:
34. DIAGNOSIS
• Relies mainly on clinical examination
• No specific lab. Studies
• CT myelography
• MRI
• Nerve conduction studies
35. TREATMENT
• Most injuries recover without any Rx
• Rx is done in very highly specialized
centers
• Surgical options
a. nerve transfers
b. nerve graft
c. muscle transfers
d. neurolysis of scar around the
brachial plexus in incomplete lesions.
40. Roots join to form Trunks! (in neck)
Ventral Rami Trunks
• C5 Upper Trunk
• C6
• C7 Middle Trunk
• C8
• T1 Lower Trunk
41. Trunks Split to form Divisions! (in neck)
• Trunks Divisions
• Upper Anterior
Posterior
• Middle Anterior
Posterior
• Lower Anterior
Posterior
42. Divisions Join to form Cords! (in axilla)
Trunks Divisions Cords
U A LATERAL CORD
P
M A
P
MEDIAL CORD
L A
P POSTERIOR CORD
43. Musculocutaneous Nerve
Course
• Motor components
• Sensory: Skin along lateral
surface of forearm
44. Effects:
Motor: paralysis of
the supraspinatus,
infraspinatus,
subclavius,
biceps brachii,
part of brachialis,
coracobrachialis;
deltoid
teres minor.
Sensroy: sensory loss on the lateral side of the arm.
Deformity:
waiter tip postion
a. limb will hang by the side,
b. medially rotated by sternocostal part of the pectoralis
major;
c. pronated forearm (biceps paralysis)
45. • Motor effects:paralysis of
triceps
Anconeus
extensors of the wrist
Extensors of fingers.
Brachioradialis
supinator muscle
• Deformity: Wrist and finger drop
• Sensory effects :
small area of sensation loss at arm and forearm
sensory loss over lateral part of the dorsum of the
hand (lat. 3.5 fingers without distal phalynges)
46.
47.
48. Test for ulnar nerve
Card test
Froment’s sign
Egawa’s test
49. AXILLA
CONTENT
• Axillary artery & its
branches
• Axillary vein & its tributaries
• Infraclavicular part of
brachial plexus
• Axillary lymph nodes
• Axillary fat
52. Radial Nerve
Injury in axilla
• Causes of injury
Motor effects:paralysis of
triceps,anconeus
extensors of the wrist
Extensors of fingers.
Brachioradialis
supinator muscle
• Deformity: Wrist and finger drop
Sensory effects -small area of sensation loss at arm andforearm
sensory loss over lateral part of the dorsum of the
hand (lat. 3.5 fingers without distal phalynges)
53. Injuries at Spiral Groove
Caused by fracture shaft of humerus.
• Motor effects: paralysis of
extensors of the wrist
Extensors of fingers
• Deformity:
Wrist and finger drop
• Sensory effects:
anesthesia is present over the dorsal
surface of the hand (lat. 3.5 fingers)