Anatomy of Brachial Plexus Above The Clavicle
Vol 2 | Issue 1 | January-June 2021 | Page 29-34 | Shivaprakash S, Georg Feigl, Sandeep M. Diwan
Authors: Shivaprakash S [1], Georg Feigl [2], Sandeep M. Diwan [3]
[1] Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
[2] Private Universitat Witten/Herdecke gGmbH Alfred-Herrhausen-StraBe 50, D-58448 Witten.
[3] Department of Anaesthesia, Sancheti Hospital, Pune, Maharashtra, India.
Address of Correspondence
Dr. Sandeep Diwan,
Department of Anaesthesia, Sancheti Hospital, Pune, Maharashtra, India.
E-mail: sdiwan14@gmail.com
Introduction
The neck is a compact structure which hosts the aero-digestive and neurovascular structures. Nerve roots arising from the spinal cord form an important network of nerves the ‘Brachial Plexus (BP)’ that innervates the upper limb and lies partly in the posterior triangle of neck and partly in the axilla. The BP is complex matrix sandwiched between muscles proximally and muscles and vessels distally at and above the level of clavicle. It consists of roots, trunks, cords & branches (figure 1). Roots and trunks are supraclavicular, divisions are retro clavicular, cords and their branches are infraclavicular. The position of the plexus relative to the clavicle varies, it is higher in the erect position and lower when recumbent [1]. It is broad and presents little of a plexiform arrangement at its commencement, is narrow opposite the clavicle, divides opposite the coracoid process into numerous branches and becomes broad and forms a denser interlacement in the axilla [2]. Brachial plexus is formed by the ventral rami of lower four cervical nerves and the first thoracic spinal nerves with variable contribution (slender twigs) from the fourth cervical and second thoracic nerve.
References
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(2) Henry Gray F.R.S. Gray’s Anatomy: Descriptive and Surgical. London. Parragon . book;2001( Reprint). Brachial plexus; 521-2.
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(8) Murata, Hiroaki Sakai, Akiko ; Hadzic, Admir; Sumikawa, Koji The Presence of Transverse Cervical and Dorsal Scapular Arteries at Three Ultrasound Probe Positions Commonly Used in Supraclavicular Brachial Plexus Blockade; Anesthesia & Analgesia: August 2012 – Volume 115 – Issue 2 – p 470-473,
| How to Cite this Article: Shivaprakash S, Feigl G, Diwan SM | Anatomy of Brachial Plexus Above The Clavicle | International Journal of Regional Anaesthesia | January-June 2021; 2(1): 29-34. |
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Cadaveric Workshop and Implications in Regional Anaesthesia
Vol 2 | Issue 1 | January-June 2021 | Page 22-28 | Ramkumar Mirle, Sajana Mukundan
Authors: Ramkumar Mirle [1], Sajana Mukundan [1]
[1] Department of Anaesthesia, Columbia Asia Referral Hospital, Yeshwanthpur, Bangalore, Karnataka, India.
Address of Correspondence
Dr. Ram Kumar M. M,
Consultant Anaesthesiologist, Columbia Asia Referral Hospital, Yeshwanthpur, Bangalore, Karnataka, India.
E-mail: mirleram@gmail.com
Introduction
The human cadavers have always been an immense source of knowledge from time immemorial and have been aptly termed as “Silent teachers” [1]. Cadaver dissection has been the basis of teaching anatomy to aspiring anaesthesiologist to develop their skills in regional anaesthesia. The practice of regional anaesthesia has evolved from the landmark based technique eliciting paraesthesia to peripheral nerve stimulation-guided technique and in the recent times to use of ultrasound guided (USG) technique alone or a combination of (PNS) and USG – Dual Modality. Successful regional nerve block technique can be a combination of any of these techniques with the most reliable modality depending on the expertise of the performer. In order to excel we need to be appropriately trained akin to a real-life scenario. The cadaver workshop has not only facilitated understanding anatomy but also helped in acquiring practical clinical skills.
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18. Barrington MJ, Ivanusic JJ, Rozen WM, Hebbard P. Spread of injectate after ultrasound-guided subcostal transversus abdominis plane block: A cadaveric study. Anaesthesia. 2009;64(7):745–50.
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| How to Cite this Article: Mirle R, Mukundan S | Cadaveric Workshop and Implications in Regional Anaesthesia | International Journal of Regional Anaesthesia | January-June 2021; 2(1): 22-28. |
Acknowledgment: M S Ramaiah Advanced Learning Centre, Bangalore, Karnataka, India.
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