The Anatomical Foundations of Regional Anesthesia and Acute Pain Medicine Macroanatomy Microanatomy Sonoanatomy Functional anatomy

Author(s): André P. Boezaart and Paul Bigeleisen

DOI: 10.2174/9781681081915116010004

Applied Macroanatomy of the Upper Extremity Nerves Above the Clavicle

Pp: 3-27 (25)

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Abstract

SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.

Abstract

In this chapter, the authors present the most common arrangement of the brachial plexus; its five roots of origin, three trunks, anterior and posterior divisions, three cords, and, finally, its terminal branches. The sensory dermatomal and osteotomal innervation of the spinal roots are discussed, as well as the neurotomal distribution of each peripheral terminal branch. Anatomical dissections of the lateral view of the neck and its posterior triangle are presented, as well as trans-sectional anatomical views at the level of the 6th cervical vertebra. Photographs of anatomical dissections of the five scalene muscles are discussed, especially the crossover of the fibers of the anterior and middle scalene muscles, which forms the paravertebral trough, and the seven most commonly found positional anomalies of the muscles with the roots of the cervical ventral rami. Finally, multiple anatomic sagittal sections of the neck, starting from the spine and ending at the mid-clavicular line, show the supraclavicular brachial plexus. These multiple sections are presented in the form of three figures of strategic positions, and also as a movie where these multiple sections have been added together to play sequentially. The authors discuss the innervation of the five joints around the shoulder girdle in some detail in this chapter.

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