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Encyclopedia > Brachial plexus

The brachial plexus is an arrangement of nerve fibres (a plexus) running from the spine (vertebrae C5-T1), through the neck, the axilla (armpit region), and into the arm. All nerves of the arm stem from the brachial plexus (with the exception of the intercostobrachialis nerve which supplies an area of skin near the axilla). Therefore, lesions of the plexus can lead to severe functional impairment. PLEXUS (Physics Learning EXperience Using Software) is a name of project that was started by Vibor Cipan, physics student form Croatia and it is based on utilization of usage of computer technology to enhance learning of physics. ... A diagram of a thoracic vertebra. ... The armpit (or axilla) is the area on the human body directly under the area where the arm connects to the shoulder. ...

Contents


Anatomy

The brachial plexus starts from the five ventral rami of the spinal nerves, these are the five roots. These roots merge to form three trunks: "superior" or "upper" C5-C6, "middle" C7, and "inferior" or "lower" C8-T1. Each trunk then splits to form an anterior and a posterior division, and the superior trunk splits into the suprascapular nerve. The term spinal nerve generally refers to the mixed spinal nerve, which is formed from the dorsal and ventral roots that come out of the spinal cord. ... The Nervus suprascapularis (Suprascapular nerve) is a nerve of the plexus brachialis. ...


These six divisions will regroup to become the cords. The cords are named by their position in respect to the axillary artery. Axillary artery and its branches - anterior view of right upper limb and thorax. ...

  • The posterior cord is formed from the three posterior divisions of the trunks.
  • The lateral cord is the anterior divisions from the upper and middle trunks.
  • The medial cord is simply a continuation of the lower trunk.

From the cords come the terminal branches, or nerves of the arm. The Posterior cord is a division of the brachial plexus. ... The Lateral cord is a division of the brachial plexus. ... The Medial cord is a division of the brachial plexus. ...

The terminal branches can be remembered using the following mnemonic (from lateral to medial cord): My Aunt Raped My Uncle, for Musculocutaneous nerve, Axillary nerve, Radial nerve, Median nerve, Ulnar nerve. The axillary nerve is a nerve of the human body, that comes off the posterior cord of the brachial plexus at the level of the axilla (armpit) and carriers nerve fibers from C5 and C6. ... The radial nerve is a nerve in the human body, that supplies the arm, the forearm and the hand. ... Diagram from Grays anatomy, depicting the peripheral nerves of the upper extremity, amongst others the median nerve The median nerve is a nerve that runs down the arm and forearm. ... The major end branch of the lateral cord, courses inferiorly within the anterior arm, supplying motor fibers to the arm muscles that flex the forearm (the biceps brachii and brachialis). ... The ulnar nerve is a nerve that in humans runs down the arm and forearm, and into the hand. ...


Anesthesia of the Brachial Plexus

The fact that the nerves of the brachial plexus are grouped together acts as a benefit as well. Local anesthetics such as lidocaine or bupivacaine can be injected in close proximity to these nerves, rendering an entire arm insensate and immobile. The process of injecting local anesthetic for this purpose is called regional nerve blockade or more simply, a nerve block, and it is a common procedure in anesthesia. After an onset time of approximately 10 to 15 minutes, the targeted arm will be fully anesthetized and ready for surgery. The patient can remain awake during the ensuing surgical procedure, or he can be sedated with medications or fully anesthetized with general anesthesia as the situation requires. A local anesthetic is a drug that reversibly inhibits the propagation of signals along nerves. ... Lidocaine (INN) or lignocaine (former BAN) is a popular local anesthetic often used in dentistry or topically. ... Also known as Marcaine and Sensorcaine. ... Injection has multiple meanings: In mathematics, the term injection refers to an injective function. ... Nerves (yellow)    Nerves redirects here. ... Regional nerve blockade, or more commonly nerve block, is a general term used to refer to the injection of local anesthetic onto or near nerves. ... For the song (Anesthesia) Pulling Teeth by Metallica, go here. ... A typical modern surgery operation For other meanings of the word, see Surgery (disambiguation) Surgery (from the Greek cheirourgia meaning hand work) is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. ... In modern medical practice, general anaesthesia is a complex procedure involving: preanaesthetic assessment administration of general anaesthetic drugs cardirespiratory monitoring analgesia airway management fluid management Contents // Categories: Anesthesia | Medicine stubs ...


The use of peripheral nerve blockade (in this case, a "brachial plexus nerve block") offers several advantages when compared to general anesthesia or local anesthesia:

  • The patient can remain awake and breathing on their own, thus protecting themselves from aspiration of stomach contents into the lungs. By avoiding general anesthesia, patients with adverse reactions to general anesthetics (viz. malignant hyperthermia, severe post-operative nausea and vomiting, known hypersensitivity to agents) can be successfully treated. Similarly, patients who experience nuisance side effects from general anesthesia such as nausea, vomiting, or excessive sleepiness can minimize these symptoms.
  • There is no need to perform an endotracheal intubation, the procedure of inserting a breathing tube into the trachea. Occasionally, such intubation is unexpectedly difficult to perform, causing injury to the patient.
  • The affected limb's sympathetic nerves are anesthetized, leading to vasodilation. This improves blood flow to the affected limb and makes microvascular surgical procedures technically simpler.
  • The limb can remain numb for several hours after surgery, providing excellent pain relief.
  • Deep and superficial structures of the limb are similarly anesthetized, allowing extensive surgical exploration and correction to occur. This is in contrast to locally injected local anesthetics, which tend only to numb superficial structures in the immediate vicinity of the injection.

Brachial plexus blockade is the preferred anesthetic technique when: Intubation being practiced on a dummy (conventional technique using a laryngoscope) In medicine, intubation is the placement of a tube into an external or internal orifice of the body. ... Anatomy and Physiology of the A.N.S. In contrast to the voluntary nervous system, the involuntary or autonomic nervous system is responsible for homeostasis, maintaining a relatively constant internal environment by controlling such involuntary functions as digestion, respiration, and metabolism, and by modulating blood pressure. ... The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Blood flow is the flow of blood in the cardiovascular system. ...

  • Surgery is expected to be limited either to a region between the midpoint of the humerus and the fingers (in which case the brachial plexus block should be either a supra-clavicular, infra-clavicular, subcoracoid, or axillary block), OR surgery is expected to be limited to a region between the midpoint of the humerus and the shoulder (in which case the brachial plexus block should be an interscalene block). Because of the distribution of the local anesthetics on the various portions of the brachial plexus, surgeries crossing the midpoint of the humerus often reveal patchy, unanesthetized portions of the arm. Such procedures probably should not be performed under regional nerve block alone.

AND The humerus is a long bone in the arm or fore-legs (animals) that runs from the shoulder to the elbow. ... Fingers of the human left hand The finger is any of the digits of the hand in humans and other species such as the great apes. ...

  • There are no contra-indications to a block such as infection at the intended injection site, significant anti-coagulation, allergy or hypersensitivity to local anesthetic medications, or disproportionate risk in the event of a local anesthetic toxic reaction (seizure) such as gastric aspiration in a patient who has not adequately fasted,

AND An allergy or Type I hypersensitivity is an immune malfunction whereby a persons body is hypersensitised to react immunologically to typically nonimmunogenic substances. ... Hypersensitivity is the name given to a state in which an immune response damages the bodys own tissues. ... This article is about the medical term, epileptic seizure, as distinct from psychogenic non-epileptic seizure. ...

  • There will not be a need to perform a neurologic examination immediately following the surgical procedure,

AND

  • Patient prefers this technique over other available and reasonable approaches.

Injuries

Brachial plexus avulsion is a common neurologic injury from trauma (such as being hit by a car). The brachial plexus is susceptible to injuries that produce abduction of the thoracic limb from the body wall or a direct blow to the lateral surface of the scapula. The cardinal signs of brachial plexus avulsion are a monoplegia and/or sensory loss of one upper limb. The nerve roots are stretched or torn from their origin by this trauma, since the meningeal coverings of the nerve roots are thinner than those in the peripheral nerve. The epineurium of the peripheral nerve is contiguous with the dural mater, providing extra support to the peripheral nerves. In cases where the nerve roots have been torn, recovery in unlikely without new experimental surgical techniques. The diagnosis may be confirmed by an EMG examination in 5-7 days. The evidence of denervation will be evident. If there is no nerve conduction 72 hours after the injury, then avulsion is most likely. Left scapula - front view () Left scapula - rear view () In anatomy, the scapula, or shoulder blade, is the bone that connects the humerus (arm bone) with the clavicle (collar bone). ... In medicine, a Monoplegia is a paralysis of a single limb. ... Neurolemma (spelled also neurolema, neurilemma and neurilema, and used interchangeably with epineurium) is the insulating myelin layer that surrounds an individual peripheral nerve fiber. ... Electromyography (EMG) is a medical technique for measuring muscle response to nervous stimulation. ...


External links

Major nerves (also see Peripheral nervous system)

Cranial nerves: I olfactory | II optic | III oculomotor | IV trochlear | V trigeminal (V1 ophthalmic - supraorbital, V2 maxillary - sphenopalatine ganglion, V3 mandibular - auriculotemporal - buccal - inferior alveolar ) | VI abducens | VII facial | VIII vestibulocochlear (cochlear, vestibular) | IX glossopharyngeal | X vagus (recurrent laryngeal, Alderman's nerve) | XI accessory | XII hypoglossal Nerves (yellow)    Nerves redirects here. ... The peripheral nervous system or PNS, is part of the nervous system,and I have no clue what it does. ... Cranial nerves are nerves that emerge from the brainstem instead of the spinal cord. ... The olfactory nerve is the first of twelve cranial nerves. ... The optic nerve is the nerve that transmits visual information from the retina to the brain. ... The oculomotor nerve () is the third of twelve paired cranial nerves. ... The fourth of twelve cranial nerves, the trochlear nerve controls the function of the superior oblique muscle, which rotates the eye towards the nose and also moves the eye downward. ... The trigeminal nerve is the fifth (V) cranial nerve, and carries sensory information from most of the face, as well as motor supply to the muscles of mastication (the muscles enabling chewing), tensor tympani (in the middle ear) and other muscles in the floor of the mouth, such as the... The Ophthalmic nerve is one of the three branches of the trigeminal nerve, one of the cranial nerves. ... The supraorbital nerve arises from the orbit by the supraorbital foramen and supplies the upper eyelid and forehead integuments. ... The Maxillary nerve is one of the three branches of the trigeminal nerve, one of the cranial nerves. ... The sphenopalatine ganglion is a parasympathetic ganglion found in the spheno-maxillary fossa. ... The mandibular nerve is the third branch (V3) of the trigeminal nerve. ... The auriculotemporal nerve is a branch of the mandibular nerve (Viii) and supplies motor fibres to the temporomandibular joint and parasympathetic fibres to the parotid glands. ... A branch of the mandibular nerve (which is itself a branch of the trigeminal nerve), the buccal nerve transmits sensory information from skin over the buccal membrane (in general, the cheek) and from the second and third molar teeth. ... The inferior alveolar nerve is a branch of the mandibular nerve, which is itself the third branch (V3) of the fifth cranial nerve, the trigeminal nerve (cranial nerve V). ... The sixth out of twelve cranial nerves, the abducens nerve controls the lateral rectus muscle - this means that the action of this nerve controls each eyes ability to look laterally (away from the midline). ... The facial nerve is seventh of twelve paired cranial nerves. ... The vestibulocochlear nerve is the eighth of twelve cranial nerves and also known as the auditory nerve. ... The Cochlear nerve (n. ... The Vestibular nerve is one of the two branches of the Vestibulocochlear nerve (the cochlear nerve is the other. ... The glossopharyngeal nerve is the ninth of twelve cranial nerves. ... The vagus nerve is tenth of twelve paired cranial nerves and is the only nerve that starts in the brainstem (somewhere in the medulla oblongata) and extends all the way down past the head, right down to the abdomen. ... The recurrent laryngeal nerve is a branch of the vagus nerve (the tenth cranial nerve) which supplies motor function and sensation to the larynx (voice box). ... The Auricular branch of the tenth cranial or vagus nerve is often termed the Aldermans nerve. ... The accessory nerve is the eleventh of twelve cranial nerves. ... The hypoglossal nerve is the twelfth cranial nerve. ...


Spinal nerves C2-C5: greater occipital, lesser occipital, greater auricular, lesser auricular, phrenic The term spinal nerve generally refers to the mixed spinal nerve, which is formed from the dorsal and ventral roots that come out of the spinal cord. ... The greater occipital nerve is a spinal nerve arising between the first and second cervical vertebrae, along with the lesser occipital nerve. ... The lesser occipital nerve is a spinal nerve arising between the first and second cervical vertebrae, along with the greater occipital nerve. ... The greater auricular nerve originates from the cervical plexus, composed of branches of spinal nerves C2 and C3. ... The lesser auricular nerve originates from the cervical plexus, composed of branches of spinal nerves C2 and C3. ... The phrenic nerve arises from spinal nerves C3, C4 and C5. ...


Spinal nerves C5-T1 (brachial plexus) --- before forming cords (dorsal scapular, long thoracic, suprascapular) --- lateral cord (musculocutaneous, median) --- posterior cord (axillary, radial) --- medial cord (median, ulnar) The term spinal nerve generally refers to the mixed spinal nerve, which is formed from the dorsal and ventral roots that come out of the spinal cord. ... The dorsal scapular nerve arises from the brachial plexus, specifically from spinal nerves C4 and C5. ... The long thoracic nerve supplies motor innervation to the serratus anterior muscle. ... The Nervus suprascapularis (Suprascapular nerve) is a nerve of the plexus brachialis. ... The Lateral cord is a division of the brachial plexus. ... The major end branch of the lateral cord, courses inferiorly within the anterior arm, supplying motor fibers to the arm muscles that flex the forearm (the biceps brachii and brachialis). ... Diagram from Grays anatomy, depicting the peripheral nerves of the upper extremity, amongst others the median nerve The median nerve is a nerve that runs down the arm and forearm. ... The Posterior cord is a division of the brachial plexus. ... The axillary nerve is a nerve of the human body, that comes off the posterior cord of the brachial plexus at the level of the axilla (armpit) and carriers nerve fibers from C5 and C6. ... The radial nerve is a nerve in the human body, that supplies the arm, the forearm and the hand. ... The Medial cord is a division of the brachial plexus. ... Diagram from Grays anatomy, depicting the peripheral nerves of the upper extremity, amongst others the median nerve The median nerve is a nerve that runs down the arm and forearm. ... The ulnar nerve is a nerve that in humans runs down the arm and forearm, and into the hand. ...


Spinal nerves T2-S5: intercostal | sacral plexus | sciatic (tibial, common peroneal) | pudendal The term spinal nerve generally refers to the mixed spinal nerve, which is formed from the dorsal and ventral roots that come out of the spinal cord. ... The thoracic spinal nerves T3 through T12. ... In human anatomy, the Sacral plexus refers to the nerve plexus emerging from the sacral vertebrae (S1-S4), and which provides nerves for the pelvis and lower limbs. ... The sciatic nerve is a large nerve that runs down the lower limb. ... The Tibial Nerve The tibial nerve passes through the popliteal fossa to pass below the arch of soleus. ... The Common peroneal nerve is a branch of the Sciatic nerve. ... The pudendal nerve is responsible for orgasm, urination, and defecation in both sexes. ...


  Results from FactBites:
 
Brachial Plexus Palsy, New York Birth Injury Attorney, NY Medical Malpractice Lawyer, Erbs Palsy (487 words)
Brachial Plexus Palsy occurs when the brachial plexus, a network of nerves emerging from the spinal cord, is damaged.
Since the brachial plexus conducts signals from the spine, through the neck, across the shoulders, along the arms, into the hand and ultimately, to the fingers tips, when it is damaged a limp arm can result.
In cases of brachial plexus palsy the upper part of the brachial plexus is involved.
Brachial plexus - Wikipedia, the free encyclopedia (906 words)
The brachial plexus is an arrangement of nerve fibres (a plexus) running from the spine (vertebrae C5-T1), through the neck, the axilla (armpit region), and into the arm.
The brachial plexus is susceptible to injuries that produce abduction of the thoracic limb from the body wall or a direct blow to the lateral surface of the scapula.
The cardinal signs of brachial plexus avulsion are a monoplegia of one front leg, Horner's syndrome on the affected side, lack of panniculus response on the side of the lesion and a Babinski's sign in the ipsilateral rear leg.
  More results at FactBites »

 
 

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