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


(1) G.J.Romanes. Cunningham’s Manual of Practical Anatomy, vol 3. 15th ed.Oxford.Oxford university press;2014.Side of the Neck; 26-8.
(2) Henry Gray F.R.S. Gray’s Anatomy: Descriptive and Surgical. London. Parragon . book;2001( Reprint). Brachial plexus; 521-2.
(3) Lanz T, Wachsmuth W. Praktische Anatomie. Berlin, Heidelberg, New York: Springer, 2004.
(4) Hafferl A. Lehrbuch der topographischen Anatomie. Berlin, Heidelberg, New York : Springer, 1969
(5) Feigl GC, Litz RJ, Marhofer P. Reg Anesth Pain Med 1-8; doi:10.1136/rapm-2020- 101435
(6) Singal , T. Gupta, D. Sahni , A. Aggarwal Anatomy of scalenovertebral triangle: A vade mecum for clinicians Anatomie du triangle scalénovertébral : un vade mecum pour les cliniciens A. Morphologie 2020 104 174-181
(7) Reiner A, Kasser R. Relative frequency of a subclavian vs. a transverse cervical origin for the dorsal scapular artery in humans. Anat Rec 1996;244:265–8.
(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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