Topografía Infraclavicular De Los Fascículos Del Plexo Braquial En Diferentes Posiciones Del Miembro Superior

Brachial plexus neuropathies are common complaints among patients seen at orthopedic clinics. The causes range from traumatic to occupational factors and symptoms include paresthesia, paresis, and functional disability of the upper limb. Treatment can be surgical or conservative, but detailed knowledge of the brachial plexus is required in both cases to avoid iatrogenic injuries and to facilitate anesthetic block, preventing possible vascular punctures. Therefore, the objective of this study was to evaluate the topography of the infraclavicular brachial plexus fascicles in different upper limb positions adopted during some clinical procedures. A formalin-preserved, adult, male cadaver was used. The infraclavicular and axillary regions were dissected and the distance of the brachial plexus fascicles from adjacent bone structures was measured. No anatomical variation in the formation of the brachial plexus was observed. The metric relationships between the brachial plexus and adjacent bone prominences differed depending on the degree of shoulder abduction. Detailed knowledge of the infraclavicular topography of neurovascular structures helps with the diagnosis and especially with the choice of conservative or surgical treatment of brachial plexus neuropathies. © 2016, Universidad de la Frontera. All rights reserved.3431063106

Median Nerve Behavior in Different Upper Limb Positions

The neural compression syndromes peripheral upper limb are common in clinical medicine and the causes range from trauma and occupational factors. Technical evaluation manuals as neural tension at different positions of the upper limb as well as knowledge of the topography of the affected nerve are essential for accurate diagnosis. The objective of this study was to analyze the behavior of the median nerve in different positions of the upper limb. Fifteen formalin-fixed cadavers were used for morphometric and topographic evaluation of the median nerve in different positions of the right upper limb. In all cases analyzed, the median nerve originated from the lateral and medial fascicles of the brachial plexus and attended by the arm and forearm in accordance with the classical descriptions in the literature. Measurement of the length of the nerve in different positions of the upper limb showed greater stretching during the position that combined extension and external rotation of the shoulder and extension of the elbow/wrist/fingers. In conclusion, the metric landmarks and positions studied are important for the precise diagnosis of median nerve neurobiomechanics in nerve compression syndromes.3041280128