Where is the brachial plexus?
Forms in the side of the neck, passes under the clavicle into the axilla and ends as the nerves of the arm: musculocutaneous, axillary, radial, median and ulnar.
What does the brachial plexus do?
Carries every motor command and all sensation for the upper limb.
Clinical relevance of the brachial plexus
- A difficult delivery (shoulder dystocia) can stretch the upper plexus (C5–C6) and cause Erb's palsy: the arm hangs with the elbow straight and the forearm turned in.
- Crutches pressing into the axilla can injure the radial nerve and cause wrist drop.
- Holding the arm out at more than 90° for a long time, for example during surgery, can stretch the plexus.
Nursing focus: the brachial plexus
- Teach crutch users to carry their weight on the hands, with the crutch pads 2 to 3 finger widths below the axilla.
- Keep arm boards below 90° of abduction when positioning a client for surgery.