THE COURSE AND DISTRIBUTION

OF THE BRACHIAL PLEXUS

ORIGIN
Roots

Upper Trunk

Lateral Cord

BRANCHES
Dorsal Scapular Nerve
(C5)
Long Thoracic nerve
(C5, 6, and 7)

Nerve to Subclavius
(C5 and 6)
Suprascapular nerve
(C5, 6, and 7)
Lateral Pectoral Nerve
Musculocutaneous nerve

Lateral Root of the median

nerve

Medial Cord

DISTRIBUTION

Enters the axilla;

Passes down over the lateral aspect of
the first rib behind the axillary vessels
behind the brachial plexus

Serratus anterior muscle

Descended in front of the trunks of the

brachial plexus and subclavian artery of
the neck

Subclavius muscle
May give a contribution to the
phrenic nerve (C5) as the
accessory phrenic nerve

Pierces the clavicopectoral fascia

Supplies corachobrachialis muscle then
Leaves the axilla by piercing the
coracobrachialis muscle

Pectoralis major
Chorachobrachialis

Passes downward on the lateral side of

the axillary artery

NO BRANCHES TO THE AXILLA

Medial Pectoral nerve

Medial cutaneous nerve
of arm (T1)
Medial cutaneous nerve
of forearm
Ulnar nerve
Medial root of the median
nerve

Posterior
cord

COURSE

Joined by intercostobrachial nerve of

the 2nd intercostal nerve
Descends in front of the axillary artery
Descends in the interval between the
axillary artery and vein
Crosses in front of the 3rd part of the
axillary artery to join the lateral root of
the median nerve

Upper and lower

subscapular nerve
Thoracodorsal nerve
Axillary nerve
Radial nerve

Runs downward on the subscapularis

to the latissimus dorsi; Accompanies
the subscapular vessels
Runs backward at the lower border of
the subscapularis muscle and passes
through the quadrilateral space
Direct continuation of the posterior cord
Lies behind the axillary artery

Supplies pectoralis major

Supplies and pierces the pectoralis
minor
Skin on the medial side of the arm

NO BRANCHES TO THE AXILLA

Both supply the upper and lower

parts of the subscapularis muscle
Lower subscapular nerve supplies
the teres muscle
Latissimus dorsi

Gives off branches to the long and

medial heads of the triceps muscle
and the posterior cutaneous nerve of
the arm

From
Roots
Superior Trunk

Nerve
dorsal scapular nerve

C5

long thoracic nerve

nerve to the subclavius
suprascapular nerve

C5, C6, C7
C5, C6
C5, C6
C5,
C6,
C7
C5,
C6,
C7
C5,
C6,
C7

lateral pectoral nerve

Lateral Cord

Musculo-cutaneous
nerve
lateral root of the median
nerve
upper subscapular nerve
thoracodorsal nerve
lower subscapular nerve

Posterior Cord

Medial Cord

Roots

C5, C6
C6, C7, C8
C5, C6

Muscles
rhomboid muscles levator
scapulae
serratus anterior
subclavius muscle
Supraspinatus infraspinatus
pectoralis major
(by communicating with the
medial pectoral nerve)

None
None
None
None
becomes the lateral
cutaneous nerve of
the forearm

fibres to the median nerve

None

subscapularis
(upper part)
latissimus dorsi
subscapularis
teres major
anterior branch:
deltoid and a small area of
overlying skin

C5, C6

radial nerve

C5, C6, C7,

C8, T1

medial pectoral nerve

C8, T1

medial root of the

median nerve

C8, T1

fibres to the median nerve

C8, T1

C8, T1

C8, T1

flexor carpi ulnaris,

the medial 2 bellies of flexor
digitorum profundus,
most of the small muscles of
the hand

ulnar nerve

None

coracobrachialis brachialis
biceps brachii

axillary nerve

medial cutaneous nerve

of the arm
medial cutaneous nerve
of the forearm

Cutaneous

posterior branch:
teres minor
deltoid muscles
triceps brachii, supinator,
anconeus, the extensor
muscles of the forearm,
and brachioradialis
pectoralis major and pectoralis
minor

None
None
None
posterior branch
becomes upper
lateral cutaneous
nerve of the arm
skin of the posterior
arm as the posterior
cutaneous nerve of
the arm
portions of hand not
served by ulnar or
radial
front and medial skin
of the arm
medial skin of the
forearm
the skin of the
medial side of the
hand and medial
one and a half
fingers on the
palmar side and
medial two and a
half fingers on the
dorsal side

AXILLARY NODES
Group

Location

Structures Drained

Anterior

Lower border of the pectoralis minor

behind the pectoralis major

Lateral quadrate of the breast

Superficial aspect of the anterolateral abdominal wall above
the umbilicus

Posterior

In front of the subscapularis

From the back down to the level to the iliac crest

Lateral

Medial side of the axillary vein

Upper limbs (except the superficial vessels that drain the

lateral side)

Central

Center of the axilla

Drains the anterior, posterior or lateral group of nodes

Apical

Lateral border of the 1st rib

All other axillary nodes

Infraclavicular
(OUTSIDE AXILLA)

Outside the axilla between the deltoid and

the pectoralis major

Lateral side of the arm, forearm and the hand

OIAI (ARM and BACK)

Muscle
BICEPS BRACHII
Long Head

Origin

Insertion

Nerve Supply

Anterior Compartment of the Arm

Tuberosity of the radius
Musculo-cutaneous
and bicipital aponeurosis nerve
Supraglenoid into the deep fascia of
Tubercle of
forearm
the scapula

Short Head

CORACOBRACHIALIS
BRACHIALIS

Coracoid
process of
the scapula
Coracoid
process of
the scapula
Front of
lower half of
the humerus

Action
Supinator of the
forearm and
flexor of the
elbow joint;
weak flexor of
the shoulder
joint

Medial aspect of the shaft

of the humerus

Musculo-cutaneous
nerve

Flexes arm and

weak adductor

Coronoid Process of the

Ulna

Musculo- cutaneous
nerve
*Radial nerve
A small part is in the
posterior
compartment.

Flexor of elbow
joint

Posterior Compartment of the Arm

TRICEPS

Infraglenoid

Long Head

Tubercle of
the scapula

Lateral Head

Upper half of
the posterior
surface of
the shaft of
the humerus

Medial Head

Serratus Posterior
Superior

Olecranon process of the

ulna

Radial Nerve

Lower half of
the posterior
surface of
the shaft of
the humerus
The Serratus Posterior Muscles (Superior and Inferior)
Upper ribs
Intercostal nerves
Lower
cervical and
thoracic
spines

Serratus Posterior
Inferior

Upper
Lumbar and
Lower
Thoracic
Spines

Lower ribs

Intercostal nerves

Extensor of the
elbow joint

Raises the ribs

and therefore
inspiratory
muscles
Depresses ribs
and therefore
expiratory
muscles

Erector Spinae (Sacrospinalis)

Erector spinae
iliocostalis
longissimus
spinalis

the iliac
crest,
sacrum,
sacroiliac
ligaments,
inferior
lumbar
spinous
processes

Iliocostalis: angles of the

ribs
Longissimus: transverse
process of the thoracic
and cervical vertebrae,
mastoid process of the
temporal bone
Spinalis: spinous process
of the thoracic vertebrae

Extends the head

and the vertebral
column
Rotates the head to
same side
(longissimus)
Releases to allow
flexion to be slow
and controlled

Dorsal ramus of
the spinal
nerves

Extends the cervical

and the thoracic
regions of the
vertebral region

Dorsal rami of
the cervical
spinal nerves

The Segmental Muscles

Semispinalis

Rotates these
regions towards the
opposite side
Extends the head
Unilaterally- flexes
the trunk laterally
and rotates it to the
opposite side
Bilaterally extends
the trunk and
stabilizes the
vertebral column
Rotate the superior
vertebrae to the
opposite side
Helps extend the
vertebral column

Multifidus

Rotatores

Interspinalis
Intertransversarius

Lateral flexion of the

superior vertebra

Levatores
costarum

Raises the ribs during

inspiration

Ventral rami of
the cervical
nerves
Some dorsal
rami of the
cervical nerves
Dorsal rami of
the cervical
region (lateral
division)