Topographic pattern of the brachial plexus at the axillary fossa through real-time ultrasonography in Koreans.
10.4097/kjae.2014.67.5.310
- Author:
Jin Hye HAN
1
;
Youn Jin KIM
;
Jong Hak KIM
;
Dong Yeon KIM
;
Guie Yong LEE
;
Chi Hyo KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea. ankyj@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Anatomy;
Axilla;
Brachial plexus;
Ultrasonography
- MeSH:
Anatomy, Cross-Sectional;
Anesthesia, Conduction;
Arm;
Arteries;
Axilla;
Axillary Artery;
Axillary Vein;
Brachial Plexus*;
Elbow;
Forearm;
Humans;
Musculocutaneous Nerve;
Shoulder;
Supine Position;
Ultrasonography*;
Veins
- From:Korean Journal of Anesthesiology
2014;67(5):310-316
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The ability to explore the anatomy has improved our appreciation of the brachial anatomy and the quality of regional anesthesia. Using real-time ultrasonography, we investigated the cross-sectional anatomy of the brachial plexus and of vessels at the axillary fossa in Koreans. METHODS: One hundred and thirty-one patients scheduled to undergo surgery in the region below the elbow were enrolled after giving their informed written consent. Using the 5-12 MHz linear probe of an ultrasound system, we examined cross-sectional images of the brachial plexus in the supine position with the arm abducted by 90degrees, the shoulder externally rotated, and the forearm flexed by 90degrees at the axillary fossa. The results of the nerve positions were expressed on a 12-section pie chart and the numbers of arteries and veins were reported. RESULTS: Applying gentle pressure to prevent vein collapse, the positions of the nerves changed easily and showed a clockwise order around the axillary artery (AA). The most frequent positions were observed in the 10-11 section (79.2%) for the median, 1-2 section (79.3%) for the ulnar, 3-5 section (78.4%) for the radial, and 8-9 section (86.9%) for the musculocutaneous nerve. We also noted anatomical variations consisting of double arteries (9.2%) and multiple axillary veins (87%). CONCLUSIONS: Using real-time ultrasonography, we found that the anatomical pattern of the major nerves in Koreans was about 80% of the frequent position of individual nerves, 90.8% of the single AA, and 87% of multiple veins around the AA.
