Brachial plexus

The brachial plexus is an arrangement of nerve fibres, running from the spine,
specifically from above the fifth cervical vertebra to underneath the first thoracic vertebra
(C5-T1). It proceeds through the neck, the axilla (armpit region) and into the arm.
Function

The brachial plexus is responsible for cutaneous and muscular innervation of the entire
upper limb, with two exceptions: the trapezius muscle innervated by the spinal accessory
nerve and an area of skin near the axilla innervated by the intercostobrachialis nerve.

This function may be impaired by tumor growth of the Apical region of either Lung.

Therefore, brachial plexus lesions can lead to severe functional impairment.

Anatomy
One can remember the order of brachial plexus elements by way of the mnemonic, "Read
The Damn Cadaver Book" - Roots, Trunks, Divisions, Cords, Branches[1] or - Roots,
Trunks, Divisions, Cords, Collateral/Pre-terminal Branches, and (Terminal) Branches.

• The five roots are the five anterior rami of the spinal nerves, after they have given
off their segmental supply to the muscles of the neck.

• These roots merge to form three trunks:

o "superior"[2] or "upper" (C5-C6)
o "middle"[3] (C7)
o "inferior"[4] or "lower" (C8-T1)

• Each trunk then splits in two, to form six divisions:

o anterior division[5] of the superior, middle, and inferior trunks
o posterior division[6] of the superior, middle, and inferior trunks

• These six divisions will regroup to become the three cords. The cords are named
by their position in respect to the axillary artery.
o The posterior cord is formed from the three posterior divisions of the
trunks (C5-T1)
o The lateral cord is the anterior divisions from the upper and middle trunks
(C5-C7)
o The medial cord is simply a continuation of the lower trunk (C8-T1)

• The branches are listed below. Most branch off of the cords, but a few branch
(indicated in italics) directly off of earlier structures. The five in bold are
considered "terminal branches".
Diagram

[edit] Specific branches

From Nerve Roots Muscles Cutaneous

dorsal scapular rhomboid muscles and
roots C5 -
nerve levator scapulae
C5, C6,
roots long thoracic nerve serratus anterior -
C7
superior nerve to the
C5, C6 subclavius muscle -
trunk subclavius
superior supraspinatus and
suprascapular nerve C5, C6 -
trunk infraspinatus
pectoralis major (by
lateral C5, C6,
lateral pectoral nerve communicating with the -
cord C7
medial pectoral nerve)
coracobrachialis, becomes the lateral
lateral musculocutaneous C5, C6,
brachialis and biceps cutaneous nerve of the
cord nerve C7
brachii forearm
lateral lateral root of the C5, C6, fibres to the median
-
cord median nerve C7 nerve
posterior upper subscapular C5, C6 subscapularis (upper -
cord nerve part)
posterior C6, C7,
thoracodorsal nerve latissimus dorsi -
cord C8
posterior lower subscapular subscapularis (lower
C5, C6 -
cord nerve part) and teres major
anterior branch: deltoid
and a small area of posterior branch
posterior overlying skin becomes upper lateral
axillary nerve C5, C6
cord posterior branch: teres cutaneous nerve of the
minor and deltoid arm
muscles
triceps brachii, anconeus, skin of the posterior
C5, C6,
posterior the extensor muscles of arm as the posterior
radial nerve C7, C8,
cord the forearm, and cutaneous nerve of the
T1
brachioradialis arm
medial pectoralis major and
medial pectoral nerve C8, T1 -
cord pectoralis minor
portions of hand not
medial medial root of the fibres to the median
C8, T1 served by ulnar or
cord median nerve nerve
radial
medial medial cutaneous front and medial skin
C8, T1 -
cord nerve of the arm of the arm
medial medial cutaneous medial skin of the
C8, T1 -
cord nerve of the forearm forearm
the skin of the medial
flexor carpi ulnaris, the side of the hand and
medial 2 bellies of flexor medial one and a half
medial
ulnar nerve C8, T1 digitorum profundus, fingers on the palmar
cord
most of the small side and medial two
muscles of the hand and a half fingers on
the dorsal side

Additional images