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Related Concept Videos

Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
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Spinal Nerves: Plexus II01:21

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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Arteries of the Upper Limbs01:12

Arteries of the Upper Limbs

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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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Related Experiment Video

Updated: Apr 16, 2026

Development of a Neonatal Rat Model for Brachial Plexus Birth Injury
09:42

Development of a Neonatal Rat Model for Brachial Plexus Birth Injury

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Permanent upper trunk plexopathy after interscalene brachial plexus block.

Merce Avellanet1, Xavier Sala-Blanch2, Lidia Rodrigo3

  • 1Physical Medicine and Rehabilitation Department, Hospital Nostra Sra. Meritxell, Fiter i Rossell 1-13, Escaldes, AD 700, Andorra. merceavellanet@gmail.com.

Journal of Clinical Monitoring and Computing
|March 7, 2015
PubMed
Summary
This summary is machine-generated.

A rare but severe neurologic deficit occurred after an interscalene brachial plexus block (IBPB). Ultrasound guidance may offer a safer alternative for regional anesthesia to prevent brachial plexus injury.

Keywords:
Brachial plexus blockInterscalene blockIntraneural injectionNerve injuryNeurostimulationUltrasound

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Area of Science:

  • Anesthesiology
  • Neurology
  • Regional Anesthesia

Background:

  • Interscalene brachial plexus block (IBPB) is a common regional anesthesia technique for shoulder surgery.
  • Postoperative neural injury is a known complication, with an estimated incidence as high as 3%.

Observation:

  • A case report details a 55-year-old male experiencing severe long-term neurologic deficit after a nerve stimulator-guided IBPB.
  • The patient reported immediate sharp arm pain upon needle insertion, followed by severe pain, muscle atrophy, and diaphragmatic palsy.

Findings:

  • Electromyography confirmed an upper trunk brachial plexus injury with severe denervation of shoulder muscles and moderate biceps brachii involvement.
  • Persistent phrenic nerve paralysis and brachial plexus dysfunction were noted 18 months post-block.

Implications:

  • Direct intraneural injection of local anesthetic is the suspected cause of severe brachial plexopathy.
  • Ultrasound guidance is proposed as a potentially safer method for performing nerve blocks, reducing the risk of catastrophic complications.