Brachial Plexus

10/03/2014

Upper limb is going to be supplied by the brachial plexus.

Mixed nerves, sensory and motor innervations.
Innervation to the joints proprioception (joint sense information)
Sympathetic fibers from the cervical ganglion will serve the function
of sweating.
C5,6 pick up sticks, C7,8 lay them straight.
Abduction and adduction of fingers is done by T1.
PAd- Palma interossii will adduct
DAbRoots are from C5 to T1 (VENTRAL RAMI)
Dorsal branch supplies the erector spinae.
Dorsal horn of spinal cord contain primarily the sensory neurons
that are going to be involved with the ascending tracks of the spinal cord.
Lower motor neurons????
Roots of the brachial plexus are located between scalenous anterior and
scalenous medius. Scalenous anterior is covered by prevertebral fascia
and lying on it are two important arteries suprascapular and transverse
cervical.
Brachial plexus is wrapped in an axillary sheath formed from prevertebral
fascia.
Trunks are located in the posterior triangle of the neck boundaries are
posterior boarder sternocleidomastoid (anterior), anterior boarder
trapezius (posterior), base is clavicle and the roof deep cervical/investing
fascia covered by skin. In the triangle is the spinal root of the
accessory nerve which supplies the trapezius. It arises from C1- C5,
ascends from the foramen magnum and leads to the jugular foramen in
the skull. It passes through the middle third of the sternoclastoid so If it is
damaged there will be problems with lateral rotation of the scapula.
Trapezius and serratus anterior laterally rotate the scapula so if these are
damaged there will be a problem in abducting. Dorsal scapular nerve
supplies the rhomboids. Levator scapulae is supplied from C1-C4.
Erbs point can end up with erbs palsy.
Divisions of the brachial plexus are located retroclavicularly (behind the
clavicle). They are such that each trunk is going to supply an anterior and
posterior division.
3 posterior posterior chords. Gives rise to radial nerve (supplies the
extensors and triceps) and axillary nerve (supplies the deltoid muscle and
teres minor). Deltoid cannot adduct.
Pec major and lattisimus dorsi are the two powerful ADDUCTORS.

Lateral and medial roots of the median nerve.

Ulnar nerve (C8,T1)- main function is to supply the intrinsic muscles of
the hand.
Medial side of the arm right down to the medial epicondyle is supplied by
the intercostaobrachial nerve.
Suprascapular nerve is below suprascapular artery in the suprascapular
notch.
Omohyoid artery???
SECOND PART OF AXILLARY ARTERY- Named according to the SECOND
part of the axillary artery the will be lateral is lateral, posterior will be
posterior and the medial will be medial.
FIRST PART OF AXULLARY ARTERY- First part however lateral and poster
is LATERAL and the medial chord is POSTERIOR.
Branches of axillary artery is SALSA.
Axillary artery begins on the outer boarder of the first rib.
Inner boarder of scalenous anterior is where subclavian artery begins.
Axilly ends on the lower boarder of the teres major in relation to the fifth
rib.
Subclavian vein is in front of scalenous anterior and the artery is behind
it. THE VEIN IS OUTSIDE THE ARTERY IS WITHIN THE AXILLARY SHEATH.
THE FIRST RIB IS ALWAYS IN THE EXAM.
Apex of axilla cervicoaxillary tunnel
Frenic nerve 345 keeps you alive
567 long thoracic nerve to serratus anterior.
678 nerve to lattisimus dorsi.
Radial and median nerve takes all.
Lower subscapular supplies the teres major and subscapularis.
Lateral pectoral nerve will pierce the clavi-pectoral fasica lympatics,
thyrocervical and cephalic vein.