Upper Limb

Dr. Gamal Taha, Lecturer of Anatomy

Brachial Plexus

Brachial Plexus

The brachial plexus is a somatic plexus formed by the Ventral Rami of C5 to C8, and Ventral Ramus of T1.

Its site :-

*It starts at the neck, passes Infrolateraly over 1st rib, behind the clavicle and then enters the axilla.

Relations of Brachial plexus

The Parts Of Brachial Plexus

It s like a tree.

( how )!!!

Like that

Branches

Divisions

Cords Trunks

Roots

So the parts of brachial plexus include :1.

2. 3. 4. 5.

Roots Trunks Cords Divisions Branches

Parts of the Brachial Plexus

Roots of brachial plexus :1. The Ventral rami of C5,C6,C7, C8 & T1 with a small contribution by vent. rami of C4 & T2. 2. Trunks of brachial plexus :a) Upper trunk: formed by union of vent. rami of C5 & C6. b) Middle trunk: formed by vent. ramus of C7 only. c) Lower trunk: formed by union of vent. Rami of C8 & T1.

Post-fixed Brachial Plexus

23-13

Parts of the Brachial Plexus

3.

Divisions of brachial plexus :Cords of brachial plexus :-

Each trunk divides into anterior and posterior divisions.

4.
a)

b) c)

Lateral cord: Formed by union of anterior divisions of upper and middle trunks (C5, 6 & 7). Medial cord: Formed by anterior division of lower trunk only (C8, T1). Posterior cord: Formed by union of posterior divisions of the 3 trunks (C 5, 6, 7, 8 &T1).

Parts of the Brachial Plexus

I.

Branches of the roots:Dorsal scapular nerve (C 5). Long thoracic nerve (C5, 6, 7). Branch to phrenic nerve from (C 5).

a)

b)

c)

Parts of the Brachial Plexus

II.

Branches from upper trunk :Suprascapular nerve (C 5, 6). Nerve to subclavius (C 5, 6).

a)

b)

Parts of the Brachial Plexus

III. a) b) c) IV. a)

Branches of lateral cord:Lateral pectoral nerve (C5, 6, 7). Musculocutaneous nerve (C 5, 6, 7). Lateral root of median nerve (C 5, 6, 7). Branches of medial cord:Medial pectoral nerve (C8, T1). Medial cutaneous nerve of arm (C8, T1). Medial cutaneous nerve of forearm (C8,T1). Ulnar nerve (C7, C8, T1). Medial root of median nerve (C8, T1).

b)
c) d) e)

Parts of the Brachial Plexus

V.
a) b) c) d) e)

Branches of posterior cord :Upper subscapular nerve (C5, 6). Lower subscapular nerve (C 5, 6). Thoracodorsal nerve (C6, 7, 8). Axillary nerve (C 5, 6). Radial nerve (C 5,6,7,8, T1).

*Things to Notice*
1)

2)

3)

4)

Root value of lateral cord & all its branches is C5,6,7 with NO EXCEPTION. Root value of medial cord & all its branches is C8 & T1 with ONE EXCEPTION; Ulnar nerve; whose root value is C7,8 & T1. Root value of posterior cord branches is C5,6 with TWO EXCEPTIONS : @ Thoracodorsal nerve; C6,7,8. @ Radial nerve; C5,6,7,8 & T1. Root value of upper trunk & its branches is

C5,6.

**Important Relations of Brachial Plexus **

1. Roots & trunks : are in the neck. Roots
receive grey rami communicans from sympathetic chain to provide them with sympathetic fibers.

2. Divisions : are present behind clavicle in the

cervico-axillary canal ( Apex of axilla ).

3. Cords : are related to 1st & 2nd parts of axillary

Terminal branches :

Median n. is lat. To 3rd part of axillary A. Ulnar n. is med. To 3rd part of axillary A. Radial n. is post. To 3rd part of axillary A. Axillary n. is post. To 3rd part of axillary A. Musculocutaneous n. is lat. To 3rd part of axillary A.

M shape formed by

1 2 3

1. Musculocutaneous N. 2. Lat. & Med. Root of median N. of both lat. & med. Cords. 3. Ulnar N.