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

Author(s): Donald S. Bohannon, André P. Boezaart and Paul E. Bigeleisen

DOI: 10.2174/9781681081915116010007

Applied Macro- and Microanatomy of the Nerves Below the Clavicle

Pp: 79-92 (14)

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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 discuss the macro- and microanatomy of the brachial plexus cords below the clavicle. The area below the clavicle is defined, for the purposes of this discussion, as the area from just below the clavicle - the proximal infraclavicular area, to the lateral border of the major pectoral muscle and the deltopectoral groove – the distal infraclavicular area. In the proximal infraclavicular area, the three cords are situated lateral to the axillary artery and vein and all three cords are in a communal circumneural (paraneural) sheath. As the cords track more distally, they spread out around the artery so that the three cords are apart and each is in its own circumneural sheath. The lateral cord is now anterolateral, the medial cord is anteromedial, and the posterior cord is posterior to the axillary artery.

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