Brachial plexus

This plexus extends from the spinal cord, through the cervicoaxillary canal in the neck, over the first rib, and into the armpit, it supplies afferent and efferent nerve fibers to the chest, shoulder, arm, forearm, and hand.

The dorsal scapular nerve comes from the superior trunk[2] and innervates the rhomboid muscles which retract and downwardly rotate the scapula.

This nerve innervates the serratus anterior, which draws the scapula laterally and is the prime mover in all forward-reaching and pushing actions.

The terminal branches of the brachial plexus (musculocutaneous n., axillary n., radial n., median n., and ulnar n.) all have specific sensory, motor and proprioceptive functions.

[9] Injuries can be caused by stretching, diseases, and wounds to the lateral cervical region (posterior triangle) of the neck or the axilla.

Testing the patient's ability to perform movements and comparing it to their normal side is a method to assess the degree of paralysis.

A common brachial plexus injury is from a hard landing where the shoulder widely separates from the neck (such as in the case of motorcycle accidents or falling from a tree).

[10] For the upper brachial plexus injuries, paralysis occurs in those muscles supplied by C5 and C6 like the deltoid, biceps, brachialis, and brachioradialis.

An inferior brachial plexus injury is far less common but can occur when a person grasps something to break a fall or a baby's upper limb is pulled excessively during delivery.

Preganglionic injuries cause loss of sensation above the level of the clavicle, pain in an otherwise insensate hand, ipsilateral Horner's syndrome, and loss of function of muscles supplied by branches arising directly from roots—i.e., long thoracic nerve palsy leading to winging of scapula and elevation of ipsilateral diaphragm due to phrenic nerve palsy.

Additionally, the compression of cords can cause pain radiating down the arm, numbness, paresthesia, erythema, and weakness of the hands.

"[12] An athlete can incur this injury in a collision that can cause cervical axial compression, flexion, or extension of nerve roots or terminal branches of the brachial plexus.

[13] In a study conducted on football players at United States Military Academy, researchers found that the most common mechanism of injury is, "the compression of the fixed brachial plexus between the shoulder pad and the superior medial scapula when the pad is pushed into the area of Erb's point, where the brachial plexus is most superficial.".

Although very hard to prevent during live birth, doctors must be able to deliver a newborn with precise and gentle movements to decrease chances of injuring the child.

Dorsal scapular nerve (rhomboids, levator scapulae) Suprascapular nerve (supraspinatus, infraspinatus) Nerve to subclavius (subclavius) Lateral pectoral nerve (pectoralis major) Musculocutaneous nerve (coracobrachialis, brachialis, biceps brachii) Axillary nerve (deltoid, teres minor) Median nerve (forearm flexors except FCU and radial part of FDP, thenar muscles) Ulnar nerve (FCU and ulnar part of FDP, most intrinsic hand muscles Medial cutaneous nerve of forearm Medial cutaneous nerve of arm Radial nerve (triceps brachii, supinator, anconeus, forearm extensors, brachioradialis) Lower subscapular nerve (lower part of subscapularis, teres major) Thoracodorsal nerve (latissimus dorsi) Medial pectoral nerve (pectoralis major, pectoralis minor) Upper subscapular nerve (upper part of subscapularis) Long thoracic nerve of Bell (serratus anterior) Cervical spinal nerve 5 Cervical spinal nerve 6 Cervical spinal nerve 7 Cervical spinal nerve 8 Thoracic spinal nerve 1
Anatomical illustration of the brachial plexus with areas of roots, trunks, divisions and cords marked. Clicking on names of branches will link to their Wikipedia entry.
This shows a simulated example of motorcyclist colliding with the floor at an angle, which may damage the brachial plexus nerves. The photo shows how head and shoulder are extremely separated, which may stretch or even tear the nerves in the between area. Protective gear can help prevent nerve damage by providing extra support on the opposite side of the head to prevent over-stretching the neck.
Brachial Plexus relation with the clavicle and the subclavian artery.