Brachial Plexus, Pre and Postganglionic Injury - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the anatomy of the brachial plexus.
The brachial plexus has 5 roots,
C5, C6 join together and form the upper trunk,C7 makes the middle trunk, C8, T1 join together and form the lower trunk.
Each trunk splits into 2 divisions: anterior and posterior division.
The 3 posterior divisions unit to form the Posterior cord.
The upper 2 anterior division join together and form the Lateral cord.
The anterior division of the lower trunk forms the Medial cord.
They are named for their position in relation to the Axillary artery.
The branches:
From the roots:
- From C5: the dorsal scapular nerve that supply the: Levator scapula muscle, Rhomboids major muscle, Rhomboids minor muscle.
- From C5 C6 C7 comes the long thorasic nerve which supply the Serratus anterior muscle, injury to this nerve will affect the serratus anterior and cause medial winging of the scapula, if you see medial winging scapula in a case of brachial plexus injury you need to determine if injury to the nerve is preganglionic or postganglionic. Look for additional conditions such as: Horner’s syndrome ( ptosis, miosis, anhidrosis, enophthalmosis), these symptoms signal a preganglionic lesion.
- Only the upper trunk gives branches to: the suprascapular nerve, which supply the supraspinatus muscle and the infraspinatus muscle.
And the also give us the nerve to subclavius: which supply th subclavius muscle.
- The divisions don’t give branches.
- The Lateral cord gives:
1- The Lateral pectoral.
2- The Musculocutaneous.
3- The Lateral branch of median nerve.
- The Posterior cord gives:
1- The Upper subscapular.
2- The Thoracodorsal.
3- The Lower subscapular.
4- The Axillary nerve.
5- The Radial nerve.
- The Medial cord gives:
1- The Medial pectoral.
2- The Medial cutaneous nerve of the arm
3- THE Medial antibrachial nerve.
4- The Ulnar nerve.
5- The Media branch of the median nerve.
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[@drmiro2010]

Marvelous as usual Dr. Ebrahim! I have only one comment: Preganglionic injury produces a complete distal sensory loss but preserves distal sensory conduction. This occurs because the dorsal root ganglion in the case of dorsal root avulsion is still in continuity with peripheral sensory nerve fibers. In other words, in preganglionic injuries there is complete sensory loss but with preserved sensory nerve action potentials

[@kevi152]

Hence normal histamine test. Shouldn’t the H wave Hoffmann test be negative in the EMG ?

[@Anuanu-uc5bq]

11:27,12:38,14:13,13:26 pre-clavicular nerve root involvement - pre ganglionic... proximal to dorsal root ganglion; post-clavicular nerve root involvement - post gang... Distal to dorsal root gang.

[@vijayboopathi8027]

Anyone can please explain the pre clavicular and post clavicular nerve involvement means?

[@gamaltaher9714]

Good, thanks

[@يوسفحميد-ل5ض]

Thank you very much ❤️ You are a wonderful doctor

[@physiotherapy1602]

Great work 👍

[@doctoransari9137]

Thank you so much great explanation

[@kevi152]

Could one use the H wave ( Hoffmann ) reflex to determine only sensory avulsion rather partial posterior avulsion ?

[@RamandeepKaur-sr6vw]

Thanks a lot sir

[@haneenalkouz3367]

الله يحفظك جزاك الله ألف خير

[@grigoryfionik2110]

“C7 like a middle child, that wants to be independent until a first lesson 😂”. It’s brilliant comparison.

[@lol-si4gh]

Hai doctor..im from malaysia.. Can i have ur email? Im a brachial plexus injury patient.. Can we do some surgery For get the normal back for my left hand?

[@hedwegg]

Brachial!

[@san_1012]

Why do we need brachial plexus? I mean why can't each nerve be independent? Why does only primary ventral rami form plexus?

[@RichRich1955]

Read Why Evolution is True

[@55freeagain]

The structure of the plexus is needed to reduce mechanical traction on the nerves during normal (and abnormal ) movements of the arm and leg, therefore it takes a great deal of force to injure nerves constructed this way. Evolution indeed!

[@Rrrrcc4666]

@@RichRich1955 Evolution hmmm!!! 🙄🙄🤦‍♀️🤦‍♀️

[@yelyab1]

Wait a minute. How did he figure this all out? It basically electrical circuitry. I’m a ME but this circuitry is a mess. It took a lot of mind numbing work to figure this out. The question is why did the guy that designed this use such a confusing arrangement. I got a book full of these questions if the creator ever comes to me and asks why I haven’t committed yet. My answer will be that we have to go through a few technical questions first. Not sure how well that will be received. Too bad, it’s a big decision. Right?

[@nabilebraheim]

It is perfectly designed to work appropriately.

[@TheOriginalMarimoChan]

I love all of Dr. E's helpful videos, I've been a fan for years!

[@nazakhtar9227]

You r genius

[@drneelz]

Excellent teacher 👌👌👌👍

[@HappyLife-iq2bb]

tnx for such a usefull inform.

[@eslammahmoud3720]

first :D

[@ryantaylor6353]

Like this very much. Thank you

[@marwasaber8760]

Thanks 💗💗

[@kareemabbey8804]

🙏🙏🙏

[@yongkwan-zt8tx]

감사합니다.

[@balbo5starhighly597]

Hello 👋 i got into a serious moto bike accident which damage my brachial nerve my left hand dont move. After 10 months i did an emg an was told the 3 main nerves are cut badly. Is the problem fixable

[@ninosh]

👌👌👌

[@ЮліяБуян]

Чи можна десь почути переклад???

[@sohaibtorab4348]

Seem as he is egyptian doctor

[@KM-sy5qb]

That’s lovely - thank you so much

[@adambit1470]

Thank you so much sir

[@엉냔안녕]

It was fun and practical! 😊

[@ehsanazeem988]

Answer please soon

[@chrisplayfair9976]

Excellent.

[@ssalasambajoel9526]

God bless ya

[@a.mmathematicscoach3206]

Hello sir I'm from UTTARAKHAND roorkee I'm also suffering brachial plexus injury since the by birth I did consult many dr. But i didn't get right treatment 😔 Everyday i followed exercise at Least 2 an hour but i don't know it will be fine or not and i got feel motivate from this video.... My left hand muscle is very weak as compared to right hand, sir Please guide me which dr i should have to follow?🙏

[@Rrrrcc4666]

Have you checked with a physiotherapist? They can train your muscles and strengthen then with muscle stimulation.

[@ahmedsobhy9730]

عالمي 👏

[@MrBangla11]

Is it easy to repair any damage to the brachial plexus ? If so what kind of doctor could diagnose/ repair it ? Thanks

[@Donateforx440]

You can diagnosed it by MRI

[@sewqiibrahim3121]

Thank you very much dr nabeel ❤️❤️