Brachial plexus

What is Brachial plexus?

The alternative names of the Brachial plexus are traumatic brachial plexus injury, lesions of the brachial plexus, supraclavicular injuries, upper plexus injuries, lower plexus injuries, shoulder injuries.The Brachial plexus is an arrangement of nerve fiber that comes from the spinal cord and get streched.The nerves are electrical wiring which transfer the massage from brain to the rest of the body.There are two types of nerves that is Motor and Sensory nerve.Sensory nerve transfer the massage to the brain from the all part of the body while the Motor nerves transfer the massage from the brain to the all part of the body.Injury to the nerve causes to stop the signal from brain to all part of the body.

It begins from the spinal cord and controls to the hands,shoulder,arms.Generally it occurs in the sports specially in football players.Sometime it occurs in baby at the time of birth.It is widely occurred syndrome known as Parsonage-Turner Syndrome.The main function of the Brachial plexus is to cutaneous and muscular innervation of the entire upper limb which has two exception,trapezius muscle inverted by the spinal accessory nerve and the area of skin near the axilla innervated by the intercosto brachial nerve.The young ones are mostly affected by this Brachial plexus.

Anatomy of the Brachial plexus

It consist of Roots, Trunks,Division,branches,cords.

Roots - Roots are five at the anterior rami of the spinal nerves.The roots are arises from the transverse processes of the cervical vertebrae and immediately posterior to the vertebral artery, which travels in a cephalocaudad direction through the transverse foramina.

Trunks - he trunks are travels through the anterior and medial scale muscle.The trunks are splits into two and divided into six divisions.The first one is anterior division of superior,medial,inferior trunks and second is posterior division of superior,medial,inferior trunks.

Cords - The six division are grouped to form acords.The name is given due to it's position in respect to axillary artery.There are three types of cords that is posterior,lateral medial cords. The posterior cord is formed from the posterior division of the trunks.The lateral cord is formed from the lateral division of the trunks.The medial cord is formed from the medial division of the trunks.There are number of branches are arises from the spinal cord.

Causes of Brachial plexus

• Large weight of the birth baby.
• Maternal diabetes.
• The Brachial plexus causes in infant at the time if birth if the shoulder is stretched during the passage in the birth canal.
• The Brachial plexus occurs due to assisted delivery.
• Breech presentation.
• Brachial plexus causes due to damage of nerves due to stretching,pressure or cutting..
• Shoulder dystocia.
• Traumatic injury occurred in road traffic and the persons which falls from the height.
• Due to intrauterine torticollis.

Symptoms of Brachial plexus

• Weakness and numbness in arm.
• Swelling around the shoulder.
• Neck,arm and shoulder pain.
• Broken clavical.
• Paresthesias and dysesthesias
• Complete injury in lower plexus in Horner's syndrome.

Treatment of Brachial plexus

Brachial plexus are minor and recovered completely within a several weeks or months.Some Brachial plexus are permanent which are not cured.These Brachial plexus are recovered by the time and therapy.Treatment of narcotics is done for several weeks.The reflective use of the weekness required the use of a toss.

• Different types of surgical techniques are used to recover the Brachial plexus.
• Physical therapy for an about 2-8 weeks is required to maintain strength and mobility that improve the condition of patients.
• Transfer of the functioning muscle take place over the area of functioning.
• MRI scan means the Magnetic Resonance Imaging technology will improve the high signal intensity of affected muscle.
• Physical Examination - Cautious examination and palpation of the axial skeleton may disclose concomitant injuries.The Sensory and Motor nerve examination test are required to recover Brachial plexus.
• Other Test -

1. Electromyography - It is not use in first week of the injury.The EMG are not used to keep out the complete disturbance upto the voluntary motor unit action potential are found.
2. Somatosensory evoked potentials - It is widely used.SNAPs are more reliable than SSEPs

• Medical Therapy - The nonoperative treatment of the Brachial plexus is complex in structure.It consist of multidisciplinary team which has skilled orthotist, occupational therapists, physical therapists, and physicians.
• Surgical Therapy - Some injuries are cured by surgically.The surgery is done if the function is not done after 3-4 months.In surgical therapy transfer of nerves,nerve grafting, muscle transfers, free muscle transfers, and neurolysis of scar around the brachial plexus.
• Follo-up care - Invigorating is used to prevent contractures after s surgery.

Prevention of Brachial plexus

• Check the strength of muscles and sensation.
• Regular take up of medicine will reduces the pain.
• check the sensory and motor nerve.