Master The Brachial Plexus:

In 5 Easy Steps

Written by:
Trevor Lohman DPT
Illustrated by:
Dennis Breese
Olivia Martinucci
Brachial Plexus

© Copyright 2014 by Trevor A. lohman

All rights reserved. This book or any portion thereof

may not be reproduced or used in any manner whatsoever

without the express written permission of the publisher

except for the use of brief quotations in a book review.

www.AandPonline.com
i
 “Lorem ipsum dolor sit
Brachial Plexus amet, donec ornare vitae.”
– Leo Venenatis
What is the Brachial Plexus?

While intimidating at first glance, you will ous system. The brachial plexus is the link
find the Brachial Plexus to be one of the between the spinal cord and the muscula-
more interesting peripheral nervous sys- ture and sensory receptors of the upper
tem structures found in the body. By ana- quarter.
lyzing the structure of the anatomical term
“Brachial Plexus” we see that brachial This neural network originates from the spi-

means pertaining to the arm, and plexus nal nerves exiting the intervertebral foram-

means network. Put simply, this is exactly ina of the cervical region of the vertebral

what the brachial plexus is. A network of column. Specifically from the C5, C6, C7,

nerves innervating the musculature of the C8, and T1 nerve roots. After exiting these

upper extremity while simultaneously relay- intervertebral foramina and traveling dis-

ing sensory information to the central nerv- tally towards the clavicle, these neural

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structures branch and merge repeatedly We have broken the drawing of the bra-
as they travel down the upper extremity chial plexus down into five simple steps.
forming the “network” of nervous struc- One step dedicated to each of the basic
tures that we will be drawing on the pages regions of the brachial plexus. First we will
to follow. It will be your goal to learn the draw the roots, then the trunks, then the
names and locations of each component divisions, then the cords, and lastly we will
of this neural network. It will seem difficult add the branches. Remembering the order
at the outset, but by breaking the brachial of this progression can be simplified with
plexus down into its aggregate compo- the follow mnemonic device:
nents: roots, trunks, divisions, and
branches, it will be much simpler to mas- “Randy Travis Drinks Cold Beverages”

ter.
As we continue, pay careful attention to

The picture on the following page is only a how the components of the brachial

diagram of this complex structure. While it plexus relate to one another. In lab, you

may not look identical to the brachial may not be able to find a particular struc-

plexus you will be studying on cadavers, ture, but with a knowledge of how these

you will find it to be an incredibly useful neural structures relate to one another, you

study aide. Once you master the ability to may be able to use the more easily found

draw the brachial plexus, you will have structures, to work backwards and identify

mastered the ability to name all of its com- certain components that you are struggling

ponents and their locations. Then you sim- to locate.

ply need to apply this mental map to the

Your journey towards Brachial Plexus mas-
cadavers in lab.
tery is about to begin. The next page

There are of course differences between serves simply as a structure bank. Soon

each cadaver, but the basic structure of you will know the location of each of these

the brachial plexus will be remarkably simi- structures. For now, simply admire the vol-

lar to the “map” you see on the previous ume of material you will soon master and

page. This is why we will dedicate the next continue on to Chapter 2: How to Draw the

several pages to mastering the ability to Brachial Plexus. Good Luck!

draw and label this diagram.

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Brachial Plexus Structure List:

Nerve Roots: Branches:

C5, C6, C7, C8, T1 Dorsal scapular n.

Suprascapular n.

Trunks: N. to subclavius.

Superior Trunk Long thoracic n.

Middle Trunk Lateral pectoral n.

Inferior Trunk Medial pectoral n.

Medial cutaneous n. to the arm

Divisions: Medial cutaneous n. to the forearm

3 Anterior Upper subscapular n.

3 Posterior Thoracodorsal n.

Lower subscapular n.

Axillary n.
Cords:
Musculocutaneous n.
Lateral Cord
Radial n.
Posterior Cord
Ulnar n.
Medial Cord
Lateral head of median n.

Medial head of median n.

Median n.
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How To Draw The Brachial Plexus (5 steps)
Step 1: Roots C5-T1

Start by drawing roots C5-T1. These nerve form the superior trunk. C8 and T1 n. roots
roots give rise to the entire brachial plexus. merge to form the inferior trunk, while the
C7 n. root does not merge and becomes
It is through these roots that all motor and the middle trunk as we move distally away
sensory information to and from the upper from the spinal cord.
extremity travel. These roots, also known
as ventral primary rami or spinal nerves,
serve as the link between the spinal cord
and the plexus of nerves that innervate the
upper extremity.

After exiting the intervertebral foramen,

nerve roots C5 and C6 quickly merge to

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How To Draw The Brachial Plexus
Step 2: Superior, Middle, and Inferior Trunks

Now add the three trunks of the brachial culature of the neck immediately lateral to
plexus. These trunks, from superior to infe- the spinal column.
rior, are the Superior Trunk, Middle Trunk,
and Inferior Trunk. When trying to find these structures on a
cadaver, you should begin your search lat-
The superior and inferior trunks begin as eral to the cervical region, and superior to
soon as the C5/C6 and C8/T1 nerve roots the clavicle.
merge, while the middle trunk is simply a
continuation of the C7 n. root.

Both the roots and trunks are relatively

short nerve structures. All of these struc-
tures are nestled amongst the scalene mus-

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How To Draw The Brachial Plexus
Step 3a: Posterior Divisions

Prior to this point, the brachial plexus has This results in the division of the brachial
lain in a single plane. Now it will divide into plexus into two “levels” of nerve struc-
an anterior and posterior component, inner- tures, one lying on top of the other. Al-
vating the anterior and posterior compo- though these structures are often referred
nents of the upper extremity, respectively. to collectively as posterior divisions. They
can be further specified based on location
Start by drawing the three posterior divi- in the following manner:
sions. One division arises from each of
three trunks. All three posterior divisions 1. superior posterior division
converge to form a single posterior cord
which we will add in a following step. 2. middle posterior division

Although it is difficult to see in a simple 3. inferior posterior division

drawing, these posterior divisions travel

slightly posteriorly as they move laterally. 8
How To Draw The Brachial Plexus
Step 3b: Anterior Divisions

Next, add the three anterior divisions of and forearm while carrying sensory infor-
the brachial plexus. mation towards the CNS from the anterior
aspect of the arm and forearm. The poste-
The most superior of the three anterior divi- rior nerve structures do the same for the
sions is simply a continuation of the supe- posterior aspect of the arm and forearm.
rior trunk. Moving inferiorly, the next ante-
rior division originates from the middle Like the posterior divisions the anterior divi-
trunk and merges with the first. The last an- sions can be further specified in the follow-
terior division is simply a continuation of ing manner:
the inferior trunk.
1. superior anterior division
Now the brachial plexus has divided into
the two “levels” identified on the previous 2. middle anterior division

page. The anterior nerve structures will in-

3. inferior anterior division
nervate anterior musculature of the arm 9
 How To Draw The Brachial Plexus
Step 4: Lateral, Posterior, and Medial Cords

Next, add the following cords: You may have noticed a change in terms. Ear-
lier, we labeled the trunks as superior, mid-
-Lateral Cord dle, and inferior based on their location.
Now, we have labeled the cords as lateral,
-Medial Cord
posterior, and medial based on their location.
-Posterior Cord Although in the diagram, the trunks and
cords may appear to be arranged in a similar
The Lateral and Medial cords stem from the fashion, in reality they are not, hence the
anterior divisions you drew in the last step, change in directional terminology. In reality,
while the Posterior cord is a continuation of the brachial plexus has begun to turn inferi-
all three posterior divisions.These cords con- orly, in order to travel distally down the arm.
tinue to lie in two different planes due to the For this reason we change from the terms su-
orientation of the posterior and anterior divi- perior, middle and inferior used to describe
sions. the trunks to the terms lateral, posterior, and
medial used to describe the cords. 10
 How To Draw The Brachial Plexus
Step 5a: Branches, “The M”

Next we will start adding the branches. There When you are studying the brachial plexus on
are many branches of the brachial plexus and cadavers, you will find that the M is a very
for this reason we will break this step into two helpful landmark to identify. It is easily recog-
parts. nizable and typically exposed on most cadav-
ers because it is usually located distal to the
First add “the M”. The M is a combination of clavicle. it is also easy to follow the M proxi-
the following structures that resembles, you mally to locate the lateral and medial cords. If
guessed it, an M. you continue proximally you will find all three
anterior divisions, then the trunks, and lastly
- Musculocutaneous n.
you will locate the roots.
- Medial and Lateral heads of median n.
Keep in mind that “the M” is not an actual ana-
- Median n. tomical term. It is important to master the
names of its components however.
- Ulnar n.
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How To Draw The Brachial Plexus
Step 5b: Branches cont’d

Next, add the remaining branches. There are quite a few of them! Like “the M” these are
the terminal branches of the brachial plexus and supply motor signals to the muscles of
the arm and forearm and also carry sensory information to the spinal cord from the arm
and forearm.

Branches by Site of Origin

Roots: Cords: Cords cont’d
-dorsal scapular n. (1) -lateral pectoral n. (5) -medial pectoral n. (10)
-long thoracic n. (2) -”UTLA’ -medial cutaneous n. to
a. upper subscapular n. arm (11)*
Trunks: (6) -medial cutaneous n. to
-suprascapular n. (3) b. thoracodorsal n. (7) forearm (12)*
- n. to subclavius (4) c. lower subscapular n. *alternate names exist for these structures

(8)
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d. axillary n. (9)
 All Done!

Great! You’ve drawn the brachial plexus. You will find that the brachial plexus isn’t
That is a great first step. Once you’ve mas- quite so nicely arranged in the body as it is
tered drawing and labeling the brachial in this image. You will often only be able to
plexus from memory you need to make sure locate a handful of structures immediately.
you can apply your knowledge to the cadav- However, if you have a knowledge of how
ers and models in the lab. the structures relate to one another, finding
a handful of structures easily is all you need.
Although you may or may not be tested on Then you can use your knowledge of how
your ability to draw or label the brachial these structures relate to one another to
plexus on an exam, a knowledge of how the trace backwards and find the other compo-
structures relate to one another is vital. The nents of the brachial plexus.
best way to gain this knowledge outside of
lab is by drawing and labeling this picture. You can do it!

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 Student Labeling Section

Now that you understand the basic struc-

ture of the brachial plexus, it is time to ap-
ply your knowledge to more realistic look-
ing illustrations. Do your best to label as
many structures on the image above and
on the image to the right as you can. Feel
free to consult the structure list found at
this beginning of this book for help.

Good Luck!!

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