The Brachial Plexus (Plexus brachialis) of the Cat (Felis domesticus)

1972 ◽  
Vol 1 (1) ◽  
pp. 6-13 ◽  
Author(s):  
N. G. Ghoshal ◽  
J. H. Magilton
Keyword(s):  
Brachial Plexus ◽  
Plexus Brachialis ◽  
Felis Domesticus

Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position

2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Rare Complication ◽  
Patient Positioning ◽  
Sensory Innervation ◽  
Plexus Brachialis ◽  
Clinical Anatomy ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Endometriosis Surgery

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.

scholarly journals ANALYSIS OF THE ANATOMIC VARIATIONS OF THE BRACHIAL PLEXUS AND ITS BRANCHES AT THE LEVEL OF FORMATION AND BRANCHING OF ITS TRUNCI

2018 ◽  
pp. 001
Author(s):  
Milutin Mrvaljević ◽  
Srbislav Pajić ◽  
Pavle Popović ◽  
Jovan Grujić ◽  
Marko Petrović ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Traffic Accidents ◽  
Anterior Part ◽  
Nerve Fibers ◽  
Plexus Brachialis ◽  
Systematic Research ◽  
Upper Arm ◽  
Anterior Edge ◽  
Wide Range ◽  
Spinal Roots

Although the terminal branches of brachial plexus that originate from lateral and medial fasciculus are well protected by muscle mass and vascular-neuronal petal of axilla and upper arm, the number of traumatic damage and injuries increases, according to the published reports of neurosurgeons working on pathology of peripheral nerves, as well as traumatologists, orthopedics, microsurgeons and plastic surgeons. This is certainly contributed by urbanization, industrialization, migration and increased number of traffic accidents. Knowing the microstructure of the peripheral nerve truncus leads to the possibility of applying various techniques of nerve grafting, as well as possibility of re-implantation of detached spinal roots, seen in traction injuries of brachial plexus, in which the mechanism of injury needs to be considered. Considering frequent injuries of terminal branches of lateral and medial fasciculus and a substantial pathology of plexus brachialis, the aim of our research was to study surgical-anatomical relations between terminal branches of medial and lateral fasciculus and substantial morphology of terminal branches of both fasciculi, particularly regarding the place and way of formation, as well as the number of their anastomoses. The studies of the terminal branches of medial and lateral fasciculus on our preparation materials are based on the dissection of axilla and anterior part of the upper arm, on 50 cadavers, adults of both genders, at Institute of Anatomy and Institute of Forensic Medicine at School of Medicine in Belgrade. The way of formation of the terminal branches of lateral fasciculus on our preparation materials was always the same. These branches were usually formed after the bifurcation or diverging of lateral fasciculus to radix lateralis nervi mediani and musculocutaneous nerve. Exceptionally, after fusion of lateral fasciculus and medial root of nervus medianus, there is no bifurcation, and formed nervous truncus is a result of existence of the pre- or postfixational type of brachial plexus. Analyzing our preparation materials, we determined that high bifurcation of lateral fasciculus (LF) exists in 18% of cases and that it is projected in the line of anterior edge of clavicle. Medium high bifurcation of LF is projected in the line of the top of the acromion of scapula and is seen in 61% of all cases. Low bifurcation is usually placed in the line of inferior edge of pectoral minor muscle, in 8% of cases. Fasciculus without bifurcation is noticed in 13% of cases. Measuring the shortest distance between anterior edge of clavicle and the point of bifurcation of LF resulted in a wide range from 0.5 to 9.7 cm, with 4.2 cm average. In cases of transplantation, implantation and re-implantation of nervous trunci of plexus brachialis, it is very important to consider the shape and the thickness of nervous truncus, the number of fasciculi, the number of nerve fibers, as well as the quantity and schedule of peri- and intrafascicular connective tissue, providing the normal irrigation of the nerve. Finally, we can conclude that mentioned facts prompted us to undertake a systematic research of great terminal branches of plexus brachialis that originate from lateral and medial fasciculus, trying to ensure that our anatomical findings receive a comprehensive clinical confirmation.

scholarly journals Gross morphological features of plexus brachialis in the chinchilla (Chinchilla lanigera)

2007 ◽  
Vol 78 (1) ◽  
Author(s):  
A. Cevik-Demirkan ◽  
V. Ozdemir ◽  
I. Demirkan ◽  
I. Turkmenoglu
Keyword(s):  
Brachial Plexus ◽  
Morphological Structure ◽  
Morphological Features ◽  
Plexus Brachialis ◽  
Nerve Branch ◽  
Long Thoracic Nerve ◽  
Spinal Nerves ◽  
Thoracic Limb ◽  
Stereo Microscope ◽  
Teres Minor

This study documents the detailed features of the morphological structure and the innervation areas of the plexus brachialis in the chinchilla (Chinchilla lanigera). The animals (5 female and 5 male) were euthanased with ketamine hydrocloride and xylazine hydrocloride combination, 60 mg/kg and 6 mg/kg, respectively. Skin, muscles and nerves were dissected under a stereo-microscope. The brachial plexus of the chinchilla is formed by rami ventrales of C5-C8, T1 and T2, and possesses a single truncus. The subscapular nerve is formed by the rami of the spinal nerves originating from C6 (one thin ramus) and C7 (one thick and 2 thin rami). These nerves innervate the subscapular and teres minor muscles. The long thoracic nerve, before joining with the brachial plexus, obtains branches from C6 and C7 in 5 cadavers (3 male, 2 female), from C7 in 4 cadavers (2 male, 2 female) and from C6-C8 in only 1 female cadaver. These nerves disperse in variable combinations to form the extrinsic and intrinstic named, nerves of the thoracic limb. An undefined nerve branch originates from the rami ventrales of C7, C8 and T1 spinal nerves enter the coracobrachial muscle.

scholarly journals Paralysis plexus brachialis - diagnostics and prognostics protocol

2004 ◽  
Vol 132 (suppl. 1) ◽  
pp. 58-61 ◽  
Author(s):  
Ivana Petronic ◽  
Milena Markovic ◽  
Dragana Cirovic ◽  
Dragana Dzamic ◽  
Ana Marsavelski ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Brachial Plexus ◽  
Treatment Session ◽  
Motor Recovery ◽  
Plexus Brachialis ◽  
Motion Coordination ◽  
Physical Treatment ◽  
Professional Orientation ◽  
Traumatic Injuries ◽  
Analysis Of Results

Traction injuries of the brachial plexus, if obstetrical, are diagnosed immediately upon birth based on clinical features, while the type and the degree of injury are confirmed by neurophysiological examination. In such cases, physical therapy is promptly applied and followed up until the age of three months, when, after consultation with neurosurgeon, either physical therapy is continued or surgery is performed. In traumatic injuries, based on clinical, neurological and neurophysiological findings, necessary surgical or pre- and postoperative physiatric interventions are performed. Timely diagnostics and therapy of brachial plexus injuries, followed by recovery of paralytic muscle motor function, enable motion coordination and prevention of contractures. From 2000-2004, 181 cases of brachial plexus birth trauma and 26 cases of brachial plexus traumatic lesions were diagnosed and treated in our institution. Among patients, there were 107 boys and 74 girls with birth injury of the brachial plexus, and 16 boys and 8 girls with traction injury of the brachial plexus sustained in traffic accident. Physical treatment involved combined thermo-, electro-, and kinesitherapy, with alignment of extremities. Upon completion of any treatment session and clinical and neurophysiological examinations, doctors? consultation determined whether to continue with physical therapy or to perform surgery followed by physical therapy with rehabilitation until achieving the maximal motor recovery. The analysis of results showed that functional and motor recovery was best if therapy was initiated immediately after the obstetrical injury or following the surgery. Therapeutic approach was individualized and depended on the level and degree of lesions. Thus, maximal motor and functional recovery of the injured extremity was achieved, with work therapy and professional orientation of such patients.

scholarly journals Nerves transfers for functional hand recovery in traumatic lower brachial plexopathy

2020 ◽  
Vol 11 ◽  
pp. 358
Author(s):  
Fernando Henrique Souza ◽  
Silvya Nery Bernardino ◽  
Auricelio Batista Cezar Junior ◽  
Hugo André de Lima Martins ◽  
Isabel Nery Bernardino Souza ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Hand Function ◽  
Case Series ◽  
Significant Loss ◽  
Plexus Brachialis ◽  
Brachial Plexopathy ◽  
Pronator Quadratus ◽  
Motor Branch ◽  
Nerve Transfers

Background: Distal nerve transfers are an innovative modality for the treatment of C8-T1 brachial plexus lesions. The purpose of this case series is to report the authors’ results with hand restoration function by nerve transfer in patients with lower brachial plexus injury. Methods: Three consecutive nerve transfers were performed in a series of 11 patients to restore hand function after injury to the lower brachial plexus: brachialis motor branch to anterior interosseous nerve (AIN) and supinator branch to the posterior interosseous nerve (PIN) in a first surgical procedure, and AIN to pronator quadratus branch of ulnar nerve between 4 and 6 months later. Results: In all, 11 male patients underwent 33 surgical procedures. Time between brachial plexus injury and surgery was a mean of 11 months (range 4–13 months). Postoperative follow-up ranged from 12 to 24 months. We observed recovery of M3 or better finger flexion strength (AIN) and wrist extension (PIN) in 8 of the 11 surgically treated upper limbs. These patients recovered full thumb and finger extension between 6 and 12 months of surgery, without significant loss of donor function. Conclusion: Nerve transfers represent a way of restoring volitional control of upper extremity function in patients with C8-T1 brachial plexus injury.

Peripheral Nerve and Brachial Plexus Impairment, AMA Guides, Sixth Edition

2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Complex Regional Pain Syndrome ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Type I ◽  
Sixth Edition ◽  
Nerve Entrapments

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.

Brachial Plexus Injuries

1984 ◽  
Vol 11 (1) ◽  
pp. 121-126
Author(s):  
Hanno Millesi
Keyword(s):  
Brachial Plexus

Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI

2019 ◽  
Vol 23 (04) ◽  
pp. 405-418 ◽  
Author(s):  
James F. Griffith ◽  
Radhesh Krishna Lalam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Muscle Denervation ◽  
Resonance Imaging ◽  
Neural Injury ◽  
Clinical Indications ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Extensive Involvement

AbstractWhen it comes to examining the brachial plexus, ultrasound (US) and magnetic resonance imaging (MRI) are complementary investigations. US is well placed for screening most extraforaminal pathologies, whereas MRI is more sensitive and accurate for specific clinical indications. For example, MRI is probably the preferred technique for assessment of trauma because it enables a thorough evaluation of both the intraspinal and extraspinal elements, although US can depict extraforaminal neural injury with a high level of accuracy. Conversely, US is probably the preferred technique for examination of neurologic amyotrophy because a more extensive involvement beyond the brachial plexus is the norm, although MRI is more sensitive than US for evaluating muscle denervation associated with this entity. With this synergy in mind, this review highlights the tips for examining the brachial plexus with US and MRI.

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