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Injury to Erb's point is commonly sustained at birth or from a fall onto the shoulder.The nerve roots normally involved are C5 and partly C6. Symptoms include paralysis of the biceps, brachialis, and coracobrachialis (through the musculocutaneous nerve); the brachioradialis (through the radial nerve); and the deltoid (through the axillary nerve).
There is anastomosis with accessory nerve, hypoglossal nerve and sympathetic trunk. It is located in the neck, deep to the sternocleidomastoid muscle. [5] The branches of the cervical plexus emerge from the posterior triangle at the nerve point, a point which lies midway on the posterior border of the sternocleidomastoid.
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve.
However, a recent study using ultrasound to follow the spread of local anesthetic demonstrated an improved success rate of the block (relative to blocks done with nerve stimulator alone) even at the inferior roots of the plexus. [2] For supraclavicular block, nerve stimulation with a minimal threshold of 0.9 mA can offer a dependable block. [11]
The supraclavicular nerve is a cutaneous (sensory) nerve of the cervical plexus that arises from the third and fourth cervical (spinal) nerves. It emerges from beneath the posterior border of the sternocleidomastoid muscle, then split into multiple branches. Together, these innervate the skin over the shoulder.
The brachial plexus is a network of nerves (nerve plexus) formed by the anterior rami of the lower four cervical nerves and first thoracic nerve (C5, C6, C7, C8, and T1).This plexus extends from the spinal cord, through the cervicoaxillary canal in the neck, over the first rib, and into the armpit, it supplies afferent and efferent nerve fibers to the chest, shoulder, arm, forearm, and hand.
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Illustration of imaging from a CT-guided nerve block. The needle tip has been placed at the top of the pudendal canal to block the pudendal nerve. Diagnostic nerve blocks are very effective for identifying sensory entrapment points. Their strength is that they can directly measure whether a given nerve is contributing pain, or not.
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