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首页> 外文期刊>The Internet Journal of Neurology >Brachial Plexus: Our Anatomical Findings. (Part I)
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Brachial Plexus: Our Anatomical Findings. (Part I)

机译：臂丛：我们的解剖发现。 （第一部分）

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A retrospective review from our previous anatomical dissections looking for anatomical variations of the brachial plexus is made. All those dissections were made for teaching purposes at the Laboratory of Anatomy from Walter Sisulu University between January 2000 and January 2008 and the commonest findings are reported in this study. Its correlations with expected clinical manifestations in nerves injury are established. Introduction The brachial plexus is usually formed by the fusion of the anterior primary rami of the C5-8 and the T1 spinal nerves. It supplies the muscles of the back and the upper limb. The C5 and C6 fuse to form the upper trunk, the C7 continues as the middle trunk and the C8 and T1 join to form the lower trunk. Each trunk, soon after its formation, divides into anterior and posterior divisions. The anterior divisions of the upper and middle trunks form the lateral cord; the anterior division of the lower trunk continues as the medial cord and the posterior divisions of all three forms the posterior cord. The cords then give rise to various branches that form the peripheral nerves of the upper limb. The anterior divisions supply the flexor compartments of upper limb and the posterior divisions, the extensor compartments. Since the brachial plexus is a complex structure, variations in formation of roots, trunks, divisions and cords are common. The present study deals with some of the common variations and some hitherto unknown variations of the brachial plexus. [1]Axillary artery passes between the lateral and medial cords of the plexus. The medial root of median nerve crosses the axillary artery to unite with the lateral root to form the median nerve which is lateral and anterior to the axillary artery. [1]Lesions on brachial plexus is a challenger for general practitioner and in some cases even for experienced neurologist, orthopedist surgeons and neurosurgeons because anatomical variations of the brachial plexus can cause a broad spectrum of clinical manifestations, therefore to consider those anatomical variations for clinical reasoning is recommended. However, because is not possible to memorize each clinical picture for every anatomical change we decide to show the commonest anatomical presentation of brachial plexus and to propose its clinical manifestations in nerve injuries based on those findings. Material And Method The study was done in the Department of Anatomy, Faculty of Health Sciences, Walter Sisulu University, and Mthatha, South Africa. On routine dissection on embalmed African cadavers, variations in the formation of the brachial plexus were found. The clavicle and the scalenus anterior were cut to expose the roots and trunks of the plexus. The divisions and their branches were followed to the muscle they supplied for confirmation. Results And Comments Brachial Plexus innervates the upper limb. As it is the point of formation of many nerves, variations are common. Knowledge of these is important to anatomists, radiologists, anesthesiologists and surgeons. The presence of anatomical variations of the peripheral nervous system is often used to explain unexpected clinical signs and symptoms.In some cases the brachial plexus were formed from roots C5, C6, C7, C8 and T1 (Figure 1) and the upper trunk was formed by the union of C5 and C6. Before joining the C6, the C5 gave a direct branch to the Subclavius Muscle and the Dorsal Scapular Nerve. Similarly the C6 gave two small direct branches to Pectoralis Minor and a large branch to the Latissimus Dorsi Muscle (Thoracodorsal Nerve).As is well known, the brachial plexus is a somatic nerve plexus formed by intercommunications among the ventral rami of the lower four cervical nerves (C 5 - C 8) and most of the anterior ramus of the first thoracic nerve (T 1). The plexus is responsible for the motor innervations to all of the muscles of the upper limb with the exception of the trapezius and levator scapula. It supplies all of the cutaneous innervatio
机译：回顾性分析我们以前的解剖解剖结构，寻找臂丛神经的解剖变异。所有这些解剖工作都是在2000年1月至2008年1月期间由Walter Sisulu大学的解剖学实验室进行教学的，该研究报告了最常见的发现。建立了与预期的神经损伤临床表现的相关性。简介臂丛神经通常由C5-8的前原发拉米肌和T1脊神经融合而成。它提供背部和上肢的肌肉。 C5和C6熔合形成上部干线，C7继续作为中间干线，而C8和T1连接形成下部干线。形成后不久，每个主干都分为前部和后部。上部和中部主干的前部部分形成侧索。下躯干的前部分隔继续，而内侧索和后部分隔线全部形成后部索。然后，绳索会形成各种分支，这些分支形成了上肢的周围神经。前部为上肢的屈肌隔室提供动力，后部为伸肌室。由于臂丛神经是一个复杂的结构，因此根，躯干，分裂和绳索形成的变化很普遍。本研究处理了臂丛神经的一些常见变异和迄今为止未知的变异。 [1]腋动脉在丛的外侧和内侧之间通过。正中神经的内侧根穿过腋动脉与外侧根结合，形成位于腋动脉外侧和前方的正中神经。 [1]臂丛神经病变是全科医生的挑战者，在某些情况下甚至对于经验丰富的神经科医生，骨科医生和神经外科医师也是一个挑战，因为臂丛神经的解剖变异可引起广泛的临床表现，因此应考虑这些解剖变异用于临床建议进行推理。但是，由于不可能记住每项解剖变化的每张临床图片，因此我们决定显示臂丛神经的最常见解剖表现，并根据这些发现提出其在神经损伤中的临床表现。材料和方法这项研究是在沃尔特·西苏鲁大学（Walter Sisulu University）和南非Mthatha的卫生科学学院解剖学系完成的。在对经过防腐处理的非洲尸体进行例行解剖时，发现臂丛神经的形成存在差异。切开锁骨和前斜角肌，露出神经丛的根和主干。分割和分支跟随他们提供的肌肉以进行确认。结果与评论臂丛神经支配上肢。因为这是许多神经的形成点，所以变化很普遍。这些知识对解剖学家，放射线学家，麻醉学家和外科医生很重要。周围神经系统解剖学变异的存在常被用来解释意想不到的临床症状和体征。在某些情况下，臂丛神经由根C5，C6，C7，C8和T1形成（图1）并形成上躯干通过C5和C6的结合。在加入C6之前，C5直接向锁骨下肌和肩S骨背神经提​​供分支。同样，C6在小胸大肌上有两个小的直接分支，而在胸阔肌（Thoracodorsal Nerve）上有一个大分支，众所周知，臂丛是下四颈腹腹之间的相互交流形成的一种体神经丛。神经（C 5-C 8）和第一胸神经的大部分前支（T 1）。除斜方肌和提肌肩cap骨外，神经丛负责上肢所有肌肉的运动神经支配。它提供了所有的皮肤神经

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