Investigation On Detection Of The Brachial Plexus And Its Branches By Ultrasonography For Clinical Application

Objective For gaining a convenient and effective method of checking upper limbnerves by ultrasonography, we studied where the probe was put on upper limb and whichscanning mode was used for offering helps to clinical application of ultrasound technique.Methods First observing five nerves on upper extremity and brachial plexus andchoosing three cross sections of sample' s in supraclavicular region as the scanningsection when checking brachial plexus with ultrasound. And then ten spots on upper limbwere chosen as scanning position for axillary nerve,radial nerve,ulnar nerve,musculocutaneous nerve,median nerve respectively. Then twenty two volunteers werechecked by ultrasonography with 5-12MHz broad frequency liner array detector andaccompanying color Doppler to show bloodstream, the results were was stored into thegraph workstation. At last, we analyzed how we can check upper limb nerves convenientlyand effectively.Results 1. Above the middle part of clavicle the trunks of brachial plexus could bechecked with ultrasound quickly and exactly through scanning the cross section which isparallel with trunks or is rectangular to subclavian artery when combining these twomethods.2. The sonogram of nerve root of neck 6 could be affirmed due to the character ofits anterior tubercle of transverse process is bigger and vertebral artery is ascending fromits transverse foramen, and the sonogram of consecutive neck 5 and 7 could be speculated,but it was difficult to ascertain nerve root of neck 8 and chest 1.3. The medial and lateral cords of brachial plexus could be checked in subclavianregion excepting post bundle and postclavicular portion of the brachial plexus.4. As checking several major nerves of upper limb, scanning these positions could get the ultrasonogram easily respectively, the median nerve: superior and inferiorsegment of anterior region of the forearm,anterior region of elbow and superior segmentof anterior region of the arm; the ulnar nerve: superior segment of anterior region of theforearm and the posterior region of elbow; the radial nerve: lateral of elbow region orscanning along humeromuscular tnnel; musculocutaneous nerve: superior segment ofanterior region of the arm. But about axillary nerve, though its oblique section could beseen winding the surgical neck as the probe was put on posterior shoulder, but how tocheck it with ultrasound is needed for further studying.Conclusion It is feasible to check brachial plexus,radial nerve,ulnar nerve,musculocutaneous nerv and median nerve by ultrasonography, and this technique maybecome a new imageological check method for finding pathogeny of cervical syndrome,upper limb nerve injure and other disease.