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The brachial plexus is formed by the ventral rami of C5-C6-C7-C8-T1, occasionally with small contributions by C4 and T2.There are multiple approaches to blockade of the brachial plexus, beginning proximally with the interscalene block and continuing distally with the supraclavicular, infraclavicular, and axillary blocks.
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.
ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. [1]
CPN is generally performed complementary to nerve blocks, due to the severe pain associated with the injection itself. Neurolysis is commonly performed only after a successful celiac plexus block. [4] CPN and celiac plexus block (CPB) are different in that CPN is permanent ablation whereas CPB is temporal pain inhibition. [4]
The cervical plexus has two types of branches: cutaneous and muscular. [3] Cutaneous (4 branches): Lesser occipital nerve - innervates the skin and the scalp posterosuperior to the auricle (C2) Great auricular nerve - innervates skin near concha auricle and external acoustic meatus (C2-C3)
The dorsal scapular nerve is a branch of the brachial plexus, usually derived from the ventral ramus of cervical nerve C5. It provides motor innervation to the rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. Dorsal scapular nerve syndrome can cause a winged scapula, with pain and limited motion.
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 always a noticeable difference in the compound muscle action potential's dispersion, and conduction block is commonly experienced. [ 26 ] An MRI can show proximal nerve or root enlargement and gadolinium enhancement, which indicate active inflammation as well as demyelination in the brachial plexus [ 27 ] or cauda equina .
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