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brachial_plexus [2025/06/25 20:21] – scottbrachial_plexus [2025/06/25 21:18] (current) – scott
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 =====Anatomy===== =====Anatomy=====
  
-The brachial plexus exam can be more difficult exam than a standard brain or spine exam, as there is more complex anatomy to know and different positioning requirements.+The brachial plexus exam can be more difficult than a standard brain or spine exam, as there is more complex anatomy, different positioning requirements, and different scanning challenges.  A good sense of the anatomy is crucial to proper coverage and slice orientation. 
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 +The brachial plexuses are bundles of nerves that originate from about C4/5 to T2/3 and extends into the forelimbs on both sides. When there is an injury or lesion in the brachial plexus, a patient may present with muscle atrophy or forelimb lameness without an orthopedic cause. Below are MIPs of the brachial plexus nerves in 3 planes. Keep in mind that the nerves extend deeper into the forelimb than visualized on these sequences, so the required coverage will be larger. 
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 +{{::nervestir_sag_mip.gif?}}  {{::nerve_stir_ax_mip.gif?}}  {{::nerve_stir_dor_mip.gif?}}
  
 =====Scan Coverage and Planning===== =====Scan Coverage and Planning=====
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 ====Axial Plane==== ====Axial Plane====
-There are two common variations for planning axial slices in the cervical spine, parallel to the intervertebral disc or perpendicular to the spinal cord. Both variations will yield diagnostic images, so be sure to **check clinician preference**.  + 
-In the image below, axial slices prescribed parallel to the disc are in __orange__, and slices prescribed perpendicular to the cord are in __yellow__. Center the FOV in the middle of the intervertebral disc and check dorsal images to ensure that the slices are not tilted tot he left or right. If patient positioning is suboptimal, it may be necessary to rotate the slices to match any side-to-side curve of the neck. If axial slices are being prescribed caudally toward C5/C6/C7, check axial and dorsal images to ensure wrap won't occur.+Axial coverage for the brachial plexus should cover from typically C4/5 to T3/4 to ensure that the entire plexus is covered. Angling parallel to the intervertebral disc will generally display the nerves exiting the foramen more clearly. The FOV should be centered at the inferior aspect at the vertebrae and large enough to include the mid shaft of the humerus on both sides.
  
 {{:cspineaxplan.png?500|}} {{:cspineaxplan.png?500|}}