THE BRACHIAL PLEXUS

Function of the Nerves in UE

sensory innervation to the skin and deep structures

motor innervation to the muscles

influence over the diameters of the blood vessels by the sympathetic vasomotor nerves

sympathetic secretomotor supply to the sweat glands

Brachial Plexus

Roots of C5 and 6 unite to form the upper trunk

Roots of C7 continues as the middle trunk

Roots of C8 and T1 unite to form the lower

Long Thoracic Nerve

C5,C6 & C7

enters the axukka by oassing down over the lateral border of the first rib behind the axillary vessels and
brachial plexus

Lateral Pectoral Nerve

arises from the lateral cord of the brachial plexus and supplies the pectoralis major muscle

Musculocutaneous Nerve

arises from the lateral cord of the brachial plexus

supplies the coracobrachialis muscle, and leaves the axilla by piercing it

Lateral cutaneous nerve - its branch at the forearm; supplies the skin of the front and lateral aspects of
the forearm down as far as the root of the thumb.

Median Nerve

C5, C6, C7, C8 & T1

Union of the lateral & medial roots front medial & lateral cords of the bracial plexus

Medial Pectoral Nerve

C8, T1

arises from the medial cord of the brachial plexus

supplies and pierces the pectoralis minor muscle, and supplies the pectoralis major muscle
Medial Cutaneous Nerve of the Arm

T1

Arises from the medial cord of the brachial plexus & is joined by the intercostobracial nerve (lateral
cutaneous branch of the second intercostal nerve)

It supplies the skin on the medial side of the arm

Medial Cutaneous Nerve of the Forearm

C8, T1

Supplies the skin at the medial side of the forearm

Ulnar Nerve

C8 & T1

Arises from the medial cord of the brachial plexus and descends in the interval between the axillary
artery and vein.

Upper & Lower Subscapular Nerve

C5, C6

Arises from the posterior cord of the brachial plexus and supply the upper and lower parts of the
subcapularis muscle

Thoracodorsal Nerve

C6, C7, & C8

Arises from the posterior cord of the brachial plexus and runs downward to supply the latissimus dorsi
muscle

Spinal Part of the Accessory Nerve (CN XI)

Runs downward in the posterior triangle of the neck on the levator scapulae muscle

Supplies the TRapezuis muscle and SCM

Axillary Nerve

C5, C6

one of the terminal branches of the posterior cord of the brachial plexus; branches;

An articular branch to the shoulder joint

An anterior terminal branch - supplies the deltoid and the skin that covers its lower parts.

A posterior terminal branch, which gives off a branch to the teres minor muscle and a few branches to
the deltoid, then emerges from the posterior border of the deltoid as the upper lateral cutaneous nerve
of the arm

Radial Nerve

C5,6,7,8; T1

Largest branch of the brachial plexus and lies behind the axillary artery

It gives off branches to the long and medial heads of the triceps muscle and the posterior cutaneous
nerve of the arm-distributed to the skin of the middle of the back of the arm

Suprascapular Nerve

Arises from the upper trunk of the brachial plexus (C5 and 6) in the posterior triangle in the neck

It runs downward and laterally and passes beneath the suprascapular ligament, which bridges the
suprascapular notch, to reach the supraspinous fossa

It supplies the supraspinatus and infraspinatus muscles and the shoulder joint.

Axillary Artery

Origin: Lateral border of the 1st rib

End: Lower border of the teres major muscle

[Divisions]

First Part

From the lateral border of the first rib to the upper border of the pectoralis minor

Second Part

Lies behind the pectoralis minor muscle

Third Part

From lower border of the pectoralis minor to the lower border of the teres major

Brachial Artery

Origin: From lower border of the teres major muscle

End: Opposite the neck of the radius by dividing into the radial and ulnar arteries
Ulnar Artery

Origin: cubital fossa at the level of the neck of the radius

End: By forming the superficial palmar arch, often anastomosing with the superficial palmar branch of
the radial artery

Radial Artery

Origin: From cubital fossa at the level of the neck of the radius.

End: Leaves the forearm by winding around the lateral aspect of the wrist to reach the posterior surface
of the hand.

The Axilla

pyramid-shaped space between the upper part of the arm and the side of the chest

important passage for the nerves, blood, and the lymph vessels.

Apex- directed into the root of the neck and is bounded in the front by the clavicle behind by the upper
border of the scapula, and medially by the outer border of the first rib

Base- bounded in front by the anterior axillary fold; behind by the posterior axillary fold; medially by the
chest wall

Walls of the Axilla

Anterior Wall

pectoralis major, subclavius, and pectoralis minor muscles

Posterior Wall

supscapularis, latissimus dorsi, and teres major muscles from above down

Medial Wall

upper four or five ribs and the intercostal spaces covered by the serratus anterior muscles

Lateral Wall

coracobrachialis and biceps muscles in the bicipital groove of the humerus

Contents of the Axilla

Axillary artery and its branches

Axillary vein and its tributaries

Lymph vessels and lymph nodes

The brachial plexus

These structures are embedded in the fat

The Cubital Fossa

Lateral: Brachioradialis muscles

Medial: Pronator teres muscles

Roof: Deep fascia strengthened by the aponeurosis of the biceps

Floor: Brachialis & supinator

[Contents]

Medial nerve

Bifurcation of the brachial artery

Tendon of the biceps

Radial nerve & its deep branch

Supratrochlear lymph node