Cadaveric Study of Supraclavicular Part of Brachial Plexus

Abstract

Introduction: Brachial plexus is network of nerves present in the neck and axilla supplying the upper limb. It is formed by the ventral rami of lower four cervical and first thoracic nerves. Surgical intervention in axilla, root of neck, brachial plexus block, orthopaedic surgeries in shoulder region requires detailed knowledge of anatomy of the brachial plexus and its variations. Aim: To note for any variations in the supraclavicular part of brachial plexus. Materials and Methods: The study was carried on 30 adult cadavers (60 upper limbs) in the Department of Anatomy, Kasturba Medical College, Manipal. Posterior triangle were dissected and any variations in roots, trunks and divisions of brachial plexus were noted and photographed. Results: Out of 60 upper limbs, in 57 there was normal formation of brachial plexus. In one cadaver there was bilateral absence of middle trunk and lower trunk was formed by C7, C8 and T1. Upper and lower trunks formed a single cord instead of forming divisions and gave all the branches of brachial plexus. In one another cadaver on the right side formation of trunks were normal but lower trunk did not divide into anterior and posterior divisions instead continued down as medial cord and gave all the branches of medial cord. In the same cadaver posterior cord was formed by posterior division of upper and middle trunk only. Conclusion: Knowledge of these variations of the brachial plexus has clinical significance especially in prevention of injuries to these nerves in surgical interventions of the axilla, neck and arm. Therefore, the present study will be of importance to surgeons, anaesthetists and radiologists.

Keywords

• axilla
• brachial plexus block
• cervical nerves
• thoracic nerves