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Nerves in the Axilla
Brachial Plexus
With one exception, all of the muscles of the upper
limb are supplied by branches of the brachial plexus. The exception is the
trapezius m. which is supplied by the cranial nerve (XI), spinal accessory.
Although only part of the brachial plexus is found in
the axilla, we will present a general layout of the plexus before covering the
parts that are found in the axilla. Whoever first described the brachial plexus
must have been a nature lover, or at least a tree lover, because the various
parts of the plexus are named according to various parts of a tree, starting
from the roots.
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The brachial plexus starts in the
neck from the ventral rami of spinal nerves C5 - T1 (5th cervical to 1st
thoracic spinal cord segments). These rami are called roots. The roots will
continue through the neck and, some of them merge, to form trunks. C5 and C6
form the upper trunk, C7 continues as the middle trunk and C8 and T1 for the
lower trunk. While still in the neck, the trunks divide into anterior and
posterior divisions. The divisions then reunite in different patterns. The
anterior divisions of the upper and middle trunks merge to form the lateral
cord. The anterior division of the lower trunk continues as the medial cord.
The posterior divisions of all trunks merge to form the posterior cord. At
this point, the cords are in the axilla. The cords are named according to
their relationship with the axillary artery. Medial to it, lateral to it or
posterior to it. Finally, the cords give rise to various branches that
supply the upper limb structures. I want to point out that although most of
the branches to the upper limb muscles arise from the plexus in the axilla,
some arise from the cervical (neck) part of the plexus. These nerves are the
dorsal scapular, nerve to subclavius, long thoracic, and suprascapular.
Needless to say, the brachial plexus is a very important structure in the
axilla and can be injured here through various types of trauma (athletic
injuries, humeral dislocations, crutch injuries, surgical injuries),
carcinomas and other pathological problems
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Branches of Brachial Plexus
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| Roots |
Trunks |
Cords |
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Lateral |
Medial |
Posterior |
dorsal scapular (2)
long thoracic (1)
nerve to subclavius (3) |
suprascapular (4) |
lateral pectoral (5)
lateral head of median n. (6)
musculocutaneous |
medial pectoral (8)
medial cutaneous of arm (9)
medial cutaneous of forearm(10)
medial head of median n.(11)
ulnar(12) |
upper subscapular(14)
thoracodorsal(15)
lower subscapular
axillary(17)
radial(18) |
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