A meta-analysis on the anatomical variability of the brachial plexus: Part II — Branching of the supraclavicular part

Beneš, Michal; Kachlík, David; Belbl, Miroslav; Whitley, Adam; Havlikova, Sarlota; Kaiser, Radek; Kunc, Vladimír; Kunc, Vojtěch

doi:10.1016/j.aanat.2021.151788

Cited by 5 publications

(18 citation statements)

References 26 publications

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“…The phrenic nerve mostly sends a very thin branch to the upper trunk at a point passing through the superficial aspect of the upper trunk; therefore, the fine C4 branch actually participates in the brachial plexus more frequently (Figure 1B). On the other hand, cases of C3 contribution to the human brachial plexus are quite rare and rarely reported [6,7,19], and we have never observed it in our 322 previously studied sides [26], nor in the present 354 sides.…”

Section: Phenotypic Changes Of the Brachial Plexus Roots In Variant Thoracolumbar Countscontrasting

confidence: 51%

“…Recently, a meta-analysis study of the human brachial plexus anatomy has revealed many morphological characteristics [6,7]. In this analysis, ultimately rare variations in the partial contribution from the third spinal nerve (C3) or almost all contribution from the fourth (C4) or tenth (T2) spinal nerve to the human brachial plexus reported in past studies remain lost information on their vertebral formula.…”

Section: Introductionmentioning

confidence: 99%

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Does the phenotypic morphology of the human brachial plexus reflect the theoretical development of concomitant regulation in thoracolumbar spines and nerves?

2022

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Background: Experimental evidences identified that thoracolumbar mutants caused by Hox genes 7-10 mutants also involve a craniocaudal shift and/or the addition or reduction of segments of the limb plexus roots. This study investigated whether the theoretical concomitant shift of the brachial plexus roots in human different thoracolumbar counts is shared as confirmed in those of the human lumbosacral plexus. Material and methods:The phenotypic morphology of the brachial plexus and its arterial interaction on 20 sides of 10 atypical human thoracolumbar counts out of the 354 sides of the 177 cadavers, were compared with those of 52 sides of 26 cases in a typical human vertebral formula (7C_12T_5L_5S).Results: Regardless of the course and branching patterns of the axillary artery, our results showed that the main brachial plexus roots were composed of only five segments of the 5 th -9 th spinal nerves, with small contributions from the 4 th and/or 10 th nerves. This root composition is identical to a typical human thoracolumbar formula, and therefore, neither a craniocaudal shift nor additional/reduced main roots occurred in our thoracolumbar variants. Conclusions:Unlike the concomitant shift of the lumbosacral plexus roots, our present cases suggest that the phenotypic morphology of the human brachial plexus may be less likely to 1 show theoretical craniocaudal shifts, further data on the root changes in different vertebral formulae are needed for its accurate validation.

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Section: Phenotypic Changes Of the Brachial Plexus Roots In Variant Thoracolumbar Countscontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Does the phenotypic morphology of the human brachial plexus reflect the theoretical development of concomitant regulation in thoracolumbar spines and nerves?

2022

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“… 6 Certain anatomical landmarks help define the BP segments 4 . For example, the first rib is a useful landmark: the T1 nerve courses inferior to the rib, and the C8 nerve root lies superior 7 . Conventional arrangement of the BP includes the upper trunk formed by the union of the C5–C6 roots, the C7 root continuing as the middle trunk, and the C8–T1 roots forming the lower trunk (Fig.…”

Section: Bp Anatomymentioning

confidence: 99%

“…The relationship of injured nerve segments to the clavicle helps determine the surgical approach 8 . The supraclavicular plexus comprises the extraforaminal roots and trunks, whereas the infraclavicular plexus comprises the divisions and cords 7 . The divisions frequently form behind the clavicle and are often referred to separately as the retroclavicular segment (Fig.…”

Section: Bp Anatomymentioning

confidence: 99%

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Brachial Plexus Magnetic Resonance Neurography

et al. 2022

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Magnetic resonance neurography of the brachial plexus (BP) is challenging owing to its complex anatomy and technical obstacles around this anatomic region. Magnetic resonance techniques to improve image quality center around increasing nerve-to-background contrast ratio and mitigating imaging artifacts. General considerations include unilateral imaging of the BP at 3.0 T, appropriate selection and placement of surface coils, and optimization of pulse sequences. Technical considerations to improve nerve conspicuity include fat, vascular, and respiratory artifact suppression techniques; metal artifact reduction techniques; and 3-dimensional sequences. Specific optimization of these techniques for BP magnetic resonance neurography greatly improves image quality and diagnostic confidence to help guide nonoperative and operative management.

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Anatomical variations of the brachial plexus in adult cadavers: A descriptive study and clinical significance

Han,

An,

Zilundu

et al. 2024

Microsurgery

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BackgroundBrachial plexus injury is recognized as one of the most severe clinical challenges due to the complex anatomical configuration of the brachial plexus and its propensity for variation, which complicates safe clinical interventions. This study aimed to ascertain the prevalence and characterize the types of brachial plexus variations, and to elucidate their clinical implications.Materials and MethodsWe conducted meticulous dissections of 60 formalin‐fixed cadavers' upper arm, axilla and lower neck to reveal and assess the roots, trunks, divisions, cords, and branches of the brachial plexus. The pattern of branching was noted by groups of dissecting medical students and confirmed by the senior anatomists. The variations discovered were record and photographed using a digital camera for further analysis.ResultsVariations in the brachial plexus were identified in 40 of the 60 cadavers, yielding a prevalence rate of 66.7%. These variations were classified into root anomalies (2.1%), trunk anomalies (8.5%), division anomalies (2.1%), and cord anomalies (4.3%). Notably, anomalies in communicating branches were observed in 39 cadavers (83.0%): 14 with bilateral anomalies, 14 with anomalies on the left side, and 11 on the right side. These communicating branches formed connections between the roots and other segments, including trunks, cords, and terminal nerves, and involved the median, musculocutaneous, and ulnar nerves.ConclusionThe frequency and diversity of brachial plexus variations, particularly in communicating branches, are significant in cadavers. It is imperative that these variations are carefully considered during the diagnostic process, treatment planning, and prior to procedures such as supraclavicular brachial plexus blocks and nerve transfers, to mitigate the risk of iatrogenic complications.

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A meta-analysis on the anatomical variability of the brachial plexus: Part II — Branching of the supraclavicular part

Cited by 5 publications

References 26 publications

Does the phenotypic morphology of the human brachial plexus reflect the theoretical development of concomitant regulation in thoracolumbar spines and nerves?

Does the phenotypic morphology of the human brachial plexus reflect the theoretical development of concomitant regulation in thoracolumbar spines and nerves?

Brachial Plexus Magnetic Resonance Neurography

Anatomical variations of the brachial plexus in adult cadavers: A descriptive study and clinical significance

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