The Brachial Plexus - Medical Notes PDF

The brachial plexus Dr. Hameed H. Hameed cerebrum Second year Medical collage / university of Warith Al-Anbiaa Outline brachial plexus definition and its branches. Important rel...

The brachial plexus Dr. Hameed H. Hameed cerebrum Second year Medical collage / university of Warith Al-Anbiaa Outline brachial plexus definition and its branches. Important relationships. Important plexopathies. Clinical applications of this knowledge.  Cervical roots 8 roots. 7 vertebrae. Usually emerge above the vertebra with the same number.  Dermatomes and myotomes Brachial plexus Network of nerves. Lies in neck and axilla. Formed by the ventral rami of C5-T1. Innervate the upper limbs.  Component Roots C5-T1. Trunks superior C5-C6, middle C7, inferior C8-T1. Division anterior and posterior. Cords medial, lateral and posterior. Nerves axillary, radial, median, ulnar, musculocutaneous. branches  Roots branches Dorsal scapular nerve long thoracic nerve Medial winging of scapula due to long thoracic nerve pulsy  medial and lateral pectoral nerve supply pectoralis minor and major Thoracodorsal nerve supply teres major. Course and relation  Brachial plexus plexopathies Injury. Thoracic outlet syndrome. Brachial plexitis. Radiation plexopathies. Metastatic. Brachial plexus injury Two age group adult and neonates.  Erb’s palsy occurs with upper brachial plexus injury at C5 and C6. With Erb’s Palsy the typical clinical presentation is as follows. *bird winging of scapula *forward rotated shoulder *waiter-tip deformity at wrist Klumpke’s Palsy Occurs with lower brachial plexus injury at C8 and T1. With Klumke’s Palsy the typical clinical presentation is as follows: *claw-like hand- involved intrinsic *forearm is usually supinated *wrist and MCPs are typically hyperextended Injury either avulsion complete cut or stretching only. Stretching usually resolve in weeks. Avulsion usually irreversible and may include surgical option to restore part of functions. Both need physiotherapy and rehabilitation sometime short course of steroids.  Thoracic outlet syndrome Thoracic outlet syndrome (TOS) is a group of conditions in which there's pressure on blood vessels or nerves in the area between the neck and shoulder. This space is known as the thoracic outlet. Compression of the blood vessels and nerves can cause shoulder and neck pain. It also can cause numbness in the fingers. Etiology: Trauma Pregnancy Cervical rib unkown Diagnosis: clinical assessments. Laboratory investigation. Nerve conduction study. Imaging. X-ray, MRI  Differential diagnosis Cervical spine spondylosis or disc. Frozen shoulder, impingement. Fibromyalgia, MND, stroke.