Human Anatomy Vol 1

UPPER LIMB

Bronches

The roots value of each branch is given in brackets.

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L Nerve to serratus anterior (long thoracic nerve) (C5,

C6, C7)

2 Nerve to rhomboids (dorsal scapular nerve) (C5).

3 Branches to longus colli and scaleni muscles (both

C5-C8) and branch to phrenic nerve (C4).

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These arise only from the upper trunk which gives two

branches.

1. Suprascapular nerve (C5, C6)
   2 Nerve to subclavius (C5, C6)

Branches of lateral cord

1 Lateral pectoral (C5{7)

2 Musculocutaneous (C5-C7)

3 Lateral root of median (CS-CZ)

Branches of rnedial cord

L Medial pectoral (C8, T1)

2 Medial cutaneous nerve of arm (C8, T1)

3 Medial cutaneous nerve of forearm (C8, T1)

4 Ulnar (C7, CB, Tl). C7 fibres reach by a com-

municating branch from lateral root of median nerve.

5 Medial root of median (C8, T1)

Branches of posterior cord

1 Upper subscapular (C5, C6)

2 Nerve to latissimus dorsi (thoracodorsal) (C6, C7,C8)

3 Lower subscapular (C5, C6)

4 Axillary (circumflex) (C5, C6)

5 Radial (C5-C8, T1)

In addition to the branches of the brachial plexus,

the upper limb is also supplied, near the trunk, by the

supraclavicular branches of the cervical plexus, and by

the intercostobrachial branch of the second intercostal

nerve. Sympathetic nerves are distributed through the

brachial plexus. The arrangement of the various nerves

in the axilla was studied with the relations of the axillary

artery.

i. Birth injury

ii. Fall on the shoulder

iii. During anaesthesia.

Nerue roots inaoloed; Mainly C5 and partly C5.

Muscles paralysed: Mainly biceps brachii, deltoid,

brachialis and brachioradialis. Partly supraspinatus,

infraspinatus and supinator.

Deformity and position of the limb

Arm: Hangs by the side; it is adducted and medially

rotated.

Forearm: Extended and pronated.

The deformity is known as'policeman's tip hand'

or waiter's tip hand or'porter's tip hand' (Fig. a.16).

Disability: The following movements are lost.

r Abduction and lateral rotation of the arm at

shoulder joint.

o Flexion and supination of the forearm,

. Biceps and supinator jerks are lost.
o Sensations are lost over a small area over the
lower part of the deltoid.

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Erb's Porolysis

Site of injury. One region of the upper trunk of the

brachial plexus is called Erb's poirrt (Fig.4.15). Six

nerves meet here. Injury to the upper trunk causes

Erb's paralysis.

Cnuses of injury: Undue separation of the head

from the shoulder, which is commonly encountered

in the following.

Anterior

division

F Posterior

drvision

Erb's point

Nerve to subclavius

Fig.4.15: Erb's point

Fig. 4.16: Erb's paralysis of right arm