Brachial Plexus Injury-Adult-Brachial Plexus Overview

Brachial Plexus Overview

Pdf Summary

The adult brachial plexus is a complex network of nerves that arises from the C5-T1 nerve roots. The brachial plexus is divided into segments, including roots, trunks, divisions, cords, and nerves. The notable nerve branches include the long thoracic nerve, suprascapular nerve, lateral pectoral nerve, medial brachial cutaneous nerve, medial antebrachial cutaneous nerve, thoracodorsal nerve, and upper and lower subscapular nerves.<br /><br />Evaluation of the adult brachial plexus includes motor and sensory examinations. Motor examination involves assessing shoulder abduction, elbow flexion, wrist extension, forearm supination and pronation, wrist flexion, finger extension, finger flexion, and finger abduction. Sensory examination assesses sensory function in various areas of the upper limb.<br /><br />Physical examination should also include a thorough neurologic examination and evaluation for sympathetic dysfunction, which can manifest as changes in skin color, temperature, and sweat pattern. Vascular injuries should also be assessed by documenting peripheral pulses and blood pressure.<br /><br />Imaging modalities such as radiographs, CT, CT myelography, and MRI can be used to assess brachial plexus injuries, associated fractures, and spinal root avulsion.<br /><br />The treatment of adult brachial plexus injuries depends on the extent and severity of the injury. Immediate repair or reconstruction is usually reserved for cases of penetrating trauma or tumor resection. Delayed treatment allows for a better evaluation of the injury but may result in less recovery of motor function. Surgical options for reconstruction include neurolysis, primary nerve repair or grafting, nerve reconstruction with nerve grafts, nerve transfers, tendon transfers, free muscle transfers, osteotomies, and arthrodesis.<br /><br />In summary, the adult brachial plexus is a complex network of nerves that can be injured through various mechanisms. Evaluation involves motor and sensory examinations, as well as imaging studies. Treatment options depend on the extent and severity of the injury and can include both surgical and non-surgical approaches.

Keywords

adult brachial plexus

nerves

C5-T1 nerve roots

segments

long thoracic nerve

suprascapular nerve

lateral pectoral nerve

medial brachial cutaneous nerve

motor examination

sensory examination