The brachial plexus is a complex network of nerves that originates from the spinal cord in the neck and supplies the shoulder, arm, and hand. It plays a vital role in both motor control (movement) and sensory perception (feeling) of the upper limb. Because of its intricate structure and importance, the brachial plexus is one of the most studied nerve networks in human anatomy.
Anatomy and Structure
The brachial plexus is formed by the ventral rami (anterior branches) of the fifth cervical (C5) to the first thoracic (T1) spinal nerves. In some people, contributions from C4 or T2 may also be present. The plexus is conventionally divided into five main parts:
- Roots – C5, C6, C7, C8, and T1.
- Trunks – The roots combine to form three trunks:
- Upper trunk (C5–C6)
- Middle trunk (C7)
- Lower trunk (C8–T1)
- Divisions – Each trunk splits into an anterior and posterior division.
- Cords – The divisions regroup to form three cords, named according to their position around the axillary artery:
- Lateral cord (from upper and middle trunk anterior divisions)
- Posterior cord (from all three posterior divisions)
- Medial cord (from the anterior division of the lower trunk)
- Branches – The cords give rise to major peripheral nerves of the upper limb.
Major Nerves of the Brachial Plexus
Several key nerves arise from the brachial plexus, each with specific motor and sensory functions:
- Musculocutaneous nerve – Controls flexion of the elbow (biceps and brachialis muscles).
- Axillary nerve – Supplies the deltoid and teres minor muscles; responsible for shoulder abduction.
- Radial nerve – Extends the elbow, wrist, and fingers; supplies sensation to the posterior arm and hand.
- Median nerve – Controls most forearm flexors and some hand muscles; provides sensation to the thumb, index, middle, and part of the ring finger.
- Ulnar nerve – Controls fine hand movements and provides sensation to the little finger and half of the ring finger.
Function
The brachial plexus ensures coordinated movement and sensation of the upper limb. It enables:
- Shoulder and arm movements such as lifting, rotating, and stabilizing.
- Elbow flexion and extension.
- Wrist and finger flexion, extension, and fine motor control.
- Sensory feedback that allows for touch, temperature, and pain perception.
Clinical Significance
Because the brachial plexus passes through the neck, shoulder, and axilla (armpit), it can be injured in several ways, including trauma, stretching, or compression. Common clinical conditions include:
- Erb’s palsy – Injury to the upper part of the plexus (C5–C6), often during childbirth or trauma. It causes weakness in shoulder abduction and elbow flexion.
- Klumpke’s palsy – Injury to the lower plexus (C8–T1), leading to weakness in hand muscles and a characteristic “claw hand.”
- Brachial plexus neuritis (Parsonage-Turner syndrome) – Sudden onset of shoulder pain followed by muscle weakness due to inflammation.
- Traumatic injuries – Common in motorcycle or sports accidents; may result in partial or complete paralysis of the arm.
Conclusion
The brachial plexus is essential for nearly all movements and sensations of the upper limb. Its intricate organization allows for precise control and coordination, but also makes it vulnerable to injury. Understanding its anatomy and function is crucial for diagnosing and treating nerve-related problems in the shoulder and arm.
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