scholarly journals A cadaveric microanatomical study of the fascicular topography of the brachial plexus

2016 ◽  
Vol 125 (2) ◽  
pp. 355-362 ◽  
Author(s):  
Sumit Sinha ◽  
G. Lakshmi Prasad ◽  
Sanjeev Lalwani
Keyword(s):  
Brachial Plexus ◽  
Suprascapular Nerve ◽  
Spinal Nerve ◽  
Cross Sectional ◽  
Spinal Nerves ◽  
Lateral Cord ◽  
Total Cross Sectional Area ◽  
Anatomical Localization ◽  
Intervertebral Foramina ◽  
Brachial Plexus Surgery

OBJECT Mapping of the fascicular anatomy of the brachial plexus could provide the nerve surgeon with knowledge of fascicular orientation in spinal nerves of the brachial plexus. This knowledge might improve the surgical outcome of nerve grafting in brachial plexus injuries by anastomosing related fascicles and avoiding possible axonal misrouting. The objective of this study was to map the fascicular topography in the spinal nerves of the brachial plexus. METHODS The entire right-sided brachial plexus of 25 adult male cadavers was dissected, including all 5 spinal nerves (C5–T1), from approximately 5 mm distal to their exit from the intervertebral foramina, to proximal 1 cm of distal branches. All spinal nerves were tagged on the cranial aspect of their circumference using 10-0 nylon suture for orientation. The fascicular dissection of the C5–T1 spinal nerves was performed under microscopic magnification. The area occupied by different nerve fascicles was then expressed as a percentage of the total cross-sectional area of a spinal nerve. RESULTS The localization of fascicular groups was fairly consistent in all spinal nerves. Overall, 4% of the plexus supplies the suprascapular nerve, 31% supplies the medial cord (comprising the ulnar nerve and medial root of the median nerve [MN]), 27.2% supplies the lateral cord (comprising the musculocutaneous nerve and lateral root of the MN), and 37.8% supplies the posterior cord (comprising the axillary and radial nerves). CONCLUSIONS The fascicular dissection and definitive anatomical localization of fascicular groups is feasible in plexal spinal nerves. The knowledge of exact fascicular location might be translatable to the operating room and can be used to anastomose related fascicles in brachial plexus surgery, thereby avoiding the possibility of axonal misrouting and improving the results of plexal reconstruction.

Gait analysis after neurorrhaphy in the brachial plexus

2015 ◽  
Vol 18 (2) ◽  
pp. 367-370 ◽  
Author(s):  
P. Reichert ◽  
Z. Kiełbowicz ◽  
J. Kuryszko ◽  
A. Bocheńska
Keyword(s):  
Statistical Analysis ◽  
Brachial Plexus ◽  
Gait Analysis ◽  
Group Versus ◽  
Spinal Nerve ◽  
Control Group ◽  
Nerve Function ◽  
Animal Locomotion ◽  
Spinal Nerves ◽  
Potential Use

Abstract The gait is a form of human and animal locomotion on land by using limbs. The study assessed functional recovery after end to side and side to side neurorrhaphy the ventral branches of the C5 and C6 spinal nerves to the C7 spinal nerve on the rabbit brachial plexus. Gait statistical analysis showed significant differences between the control group versus the end-to-side and side to side neurorrhaphy groups, in opposite to the comparison between the two experimentals groups. Gait analysis results corresponded with the histomorphometric results. The results indicate the potential use of gait analysis for the assessment of the recovery of nerve function.

scholarly journals Quantitative Ultrasonographic Analysis of Changes of the Suprascapular Nerve in the Aging Population With Shoulder Pain

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei-Ting Wu ◽  
Lan-Rong Chen ◽  
Hsiang-Chi Chang ◽  
Ke-Vin Chang ◽  
Levent Özçakar
Keyword(s):  
Rotator Cuff ◽  
Older People ◽  
Brachial Plexus ◽  
Shoulder Pain ◽  
Supraspinatus Tendon ◽  
Suprascapular Nerve ◽  
Control Group ◽  
Full Thickness ◽  
Cross Sectional ◽  
Rotator Cuff Lesions

BackgroundOlder people are vulnerable to painful shoulder syndromes, the majority of which are derived from degenerative rotator cuff pathologies. The suprascapular nerve (SSN) is closely related to the rotator cuff complex, and its role in shoulder pain has recently been highlighted. This study aimed to explore the differences in SSN among older people with and without shoulder pain, and to investigate the potential factors influencing the nerve size using ultrasound (US) imaging.MethodsParticipants aged ≥60 years were enrolled in the study. A systematic and bilateral US examination of the rotator cuff tendons was performed. The SSN was examined from its origin in the brachial plexus to the spinoglenoid notch of the infraspinatus fossa. The association between the nerve’s cross-sectional area (CSA) and rotator cuff lesions was analyzed using the generalized estimation equation.ResultsAmong the 94 participants, 45 (with bilaterally asymptomatic shoulders) were classified into the control group, whereas 49 (with at least one-sided shoulder pain) were classified into the group with shoulder pain. The average CSAs of the SSN at the level of the brachial plexus, supraspinatus fossa, and infraspinatus fossa were comparable between the patients in the control group and those with shoulder pain. There was a higher prevalence of rotator cuff lesions and enlarged distal SSNs in the painful shoulders than in the asymptomatic shoulders of patients with unilateral involvement. A full-thickness tear of the supraspinatus tendon was associated with swelling of the SSN in the supraspinatus fossa (β coefficient = 4.068 mm2, p < 0.001).ConclusionIn the older population, full-thickness tears of the supraspinatus tendon are independently associated with enlargement of the distal SSN. In cases with large rotator cuff tendon tears with poor response to conservative treatments, possible SSN entrapment should be considered and managed accordingly.

scholarly journals Good sensory recovery of the hand in brachial plexus surgery using the intercostobrachial nerve as the donor

2017 ◽  
Vol 75 (11) ◽  
pp. 796-800 ◽  
Author(s):  
Luciano Foroni ◽  
Mário Gilberto Siqueira ◽  
Roberto Sérgio Martins ◽  
Carlos Otto Heise ◽  
Hugo Sterman Neto ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Sensory Stimuli ◽  
Lateral Cord ◽  
Sensory Recovery ◽  
Intercostobrachial Nerve ◽  
Brachial Plexus Surgery ◽  
Sensory Reconstruction

ABSTRACT Objective: Restoration of the sensitivity to sensory stimuli in complete brachial plexus injury is very important. The objective of our study was to evaluate sensory recovery in brachial plexus surgery using the intercostobrachial nerve (ICBN) as the donor. Methods: Eleven patients underwent sensory reconstruction using the ICBN as a donor to the lateral cord contribution to the median nerve, with a mean follow-up period of 41 months. A protocol evaluation was performed. Results: Four patients perceived the 1-green filament. The 2-blue, 3-purple and 4-red filaments were perceptible in one, two and three patients, respectively. According to Highet's scale, sensation recovered to S3 in two patients, to S2+ in two patients, to S2 in six patients, and S0 in one patient. Conclusion: The procedure using the ICBN as a sensory donor restores good intensity of sensation and shows good results in location of perception in patients with complete brachial plexus avulsion.

scholarly journals The minute anatomy of the brachial plexus

1887 ◽  
Vol 41 (246-250) ◽  
pp. 423-441 ◽  
Keyword(s):  
Connective Tissue ◽  
Brachial Plexus ◽  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Spinal Nerves ◽  
Final Destination ◽  
Naked Eye

It has for some time appeared probable that the spinal nerves which form the brachial plexus do not become confounded one with another, but retain each its separate course and its separate functions. To the naked eye a nerve is a bundle of parallel threads bound together, and at the same time divided by a sheath of connective tissue. It seemed to me possible that the course of the spinal nerve roots could be traced by a dissection which should follow each through the plexus to the nerves which branch therefrom, and in these to its final destination.

scholarly journals Macro anatomical investigation of brachial plexus of the White New Zealand rabbit (Orycotolagus cuniculus)

1970 ◽  
Vol 1 (3) ◽  
pp. 74-76 ◽  
Author(s):  
M Mohiuddin ◽  
ML Rahman ◽  
MA Alim ◽  
MBH Kabir ◽  
MA Kashem
Keyword(s):  
New Zealand ◽  
Brachial Plexus ◽  
Spinal Nerve ◽  
Natural Sciences ◽  
Spinal Nerves ◽  
Zealand Rabbit ◽  
Thoracic Spinal ◽  
Cervical Spinal Nerve

In present study, the brachial plexus of the White New Zealand rabbit (Orycotolagus cuniculus) was investigated. Five adult rabbits were used and organizations of the brachial plexus of them were investigated. It was found that the brachial plexus of the rabbit was formed by rami ventralis of fifth cervical spinal nerve (C5), sixth cervical spinal nerve (C6), seventh cervical spinal nerve (C7), eighth cervical spinal nerve (C8), first thoracic spinal nerve (T1) and second thoracic spinal nerve (T2). The rami ventralis of C5 spinal nerve and T2 spinal nerve were divided into two branches. The caudal branch of C5 spinal nerve and cranial branch of T2 spinal nerve contributed to the brachial plexus. The caudal branch of C5 spinal nerve and C6 spinal nerve constituted the cranial trunk and the caudal trunk was formed by a branch which came from cranial trunk, rami ventralis of C7, C8, T1 spinal nerves and the cranial branch of ventral ramus of T2 spinal nerve. Contribution of caudal branch of ventral ramus of C5 spinal nerve and cranial branch of ventral ramus of T2 spinal nerve to the formation of the brachial plexus of rabbit and division of the brachial plexus to the caudal and cranial trunks resemble to porcupine and differ the brachial plexus of this species from those of rat, mouse and mammals.Key words: Spinal nerves; Orycotolagus cuniculus; Brachial plexus; Rabbits.DOI: http://dx.doi.org/10.3329/ijns.v1i3.8825International Journal of Natural Sciences (2011), 1(3):74-76

The 2-Dimensional and 3-Dimensional Anatomy of the Adult Brachial Plexus Divisions and Cords

Hand ◽  
2020 ◽  
pp. 155894472090651
Author(s):  
Junot H. S. Neto ◽  
Bernardo C. Neto ◽  
Andre B. D. Eiras ◽  
Renato H. S. Botelho ◽  
Jose M. de M. Carmo ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Critical Review ◽  
Suprascapular Nerve ◽  
3 Dimensional ◽  
Lateral Cord ◽  
Posterior Division ◽  
Anterior Division

Background: The objective of this work was to perform a critical review of the 2-dimensional and 3-dimensional anatomy of the adult brachial plexus divisions and cords. Methods: Twelve adult brachial plexuses from fresh cadavers were dissected. All were male and aged between 30 and 50 years. Only corpses without brachial plexus injuries were selected. The purpose of the dissections was to identify the origin of the anterior and posterior divisions of the adult brachial plexus in their respective trunks, as well as the positioning of the posterior, lateral, and medial cords. Results: The posterior division of all trunks had a cranial and dorsal origin, while the anterior division of all trunks had a caudal and ventral origin. The posterior cord was the most cranial of all, the lateral cord was central, and the medial cord was the most caudal of all cords. The posterior division of the superior trunk was always between the suprascapular nerve and the anterior division. Conclusions: Brachial plexus diagrams in most textbooks and papers are different from what was found in our dissections. Contrary to the known diagram, the posterior divisions always had a cranial origin in the superior, middle, and inferior trunks.

Multiple nerve transfers for the reanimation of shoulder and elbow functions in irreparable C5, C6 and upper truncal lesions of the brachial plexus

2008 ◽  
Vol 05 (02) ◽  
pp. 95-104 ◽  
Author(s):  
PS Bhandari ◽  
LP Sadhotra ◽  
P Bhargava ◽  
AS Bath ◽  
MK Mukherjee ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Suprascapular Nerve ◽  
Shoulder Function ◽  
Spinal Nerve ◽  
Shoulder Abduction ◽  
Nerve Branch ◽  
Nerve Transfers

AbstractIn irreparable C5, C6 spinal nerve and upper truncal injuries the proximal root stumps are not available for grafting, hence repair is based on nerve transfer or neurotization. Between Feb 2004 and May 2006, 23 patients with irreparable C5, C6 or upper truncal injuries of the Brachial Plexus underwent multiple nerve transfers to restore the shoulder and elbow functions. Most of them (16 patients) sustained injury following motor cycle accidents. The average denervation period was 5.3 months. Shoulder function was restored by transfer of distal part of spinal accessory nerve to suprascapular nerve, and transfer of radial nerve branch to long head of triceps to the anterior branch of axillary nerve. Elbow function was restored by transfers of ulnar and median nerve fascicles to the biceps and brachialis motor branches of musculocutaneous nerve. All patients recovered shoulder abduction and external rotation; 7 scored M4 and 16 scored M3. Range of abduction averaged 1230(range, 800-1700). Full elbow flexion was restored in all 23 patients; 15 scored M4 and 8 scored M3. Patients with excellent results could lift 5 kgs of weight. Selective nerve transfers close to the target muscle provide an early and good return of functions. There is negligible morbidity in donor nerves. These intraplexal transfers are suitable in all cases of upper brachial plexus injuries.

Posterior subscapular approach to the brachial plexus

1993 ◽  
Vol 79 (3) ◽  
pp. 319-330 ◽  
Author(s):  
Annie S. Dubuisson ◽  
David G. Kline ◽  
Steven S. Weinshel
Keyword(s):  
Brachial Plexus ◽  
Thoracic Outlet Syndrome ◽  
Anterior Chest Wall ◽  
Spinal Nerve ◽  
Brachial Plexopathy ◽  
Brachial Plexus Palsy ◽  
Content Type ◽  
Spinal Nerves ◽  
Operative Experience ◽  
Prior Operation

✓ A 15-year operative experience with 105 posterior subscapular approaches to the brachial plexus in 102 patients is presented. The procedure is indicated in carefully selected cases, especially where the proximal portions of lower spinal nerves are involved. Its main advantage is proximal exposure of the plexus spinal nerves, particularly at an intraforaminal level. The indications in this series were thoracic outlet syndrome (TOS) in 51 carefully selected procedures, brachial plexus tumor involving proximal roots in 22 patients, post-irradiation brachial plexopathy in 14 cases, and proximal traumatic brachial plexus palsy in 18 patients. Thoracic outlet syndrome associated with neurological loss, recurrent TOS after a prior operation, or proximal brachial plexus surgical lesions involving the spinal nerve(s), especially at an intraforaminal level, can be approached advantageously by such a posterior subscapular approach. The technique should also be considered when prior operation, trauma, or irradiation to the neck or anterior chest wall make a posterior exploration of the plexus easier than an anterior one. Anterior exposure of the plexus is the preferable approach for the majority of lesions needing an operation, but the posterior subscapular procedure can be useful in well-selected cases.

Sign in / Sign up

Export Citation Format

Share Document