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The brachial plexus is formed by the ventral rami of C5-C6-C7-C8-T1, occasionally with small contributions by C4 and T2.There are multiple approaches to blockade of the brachial plexus, beginning proximally with the interscalene block and continuing distally with the supraclavicular, infraclavicular, and axillary blocks.
A supraclavicular nerve block is useful when performing surgery on the shoulder, anaesthetising a large area of skin. [5] The supraclavicular nerves are vulnerable during surgery on the clavicle, and must be identified early on in surgeries to reduce the risk of nerve injury and neuroma. [6]
The left supraclavicular nodes are the classical Virchow's node because they receive lymphatic drainage of most of the body (from the thoracic duct) and enters the venous circulation via the left subclavian vein. The metastasis may block the thoracic duct leading to regurgitation into the surrounding Virchow's nodes.
Injury to Erb's point is commonly sustained at birth or from a fall onto the shoulder.The nerve roots normally involved are C5 and partly C6. Symptoms include paralysis of the biceps, brachialis, and coracobrachialis (through the musculocutaneous nerve); the brachioradialis (through the radial nerve); and the deltoid (through the axillary nerve).
The supraclavicular fossa is an indentation (fossa) immediately above the clavicle. In terminologia anatomica , it is divided into fossa supraclavicularis major and fossa supraclavicularis minor Fullness in the supraclavicular fossa can be a sign of upper extremity deep venous thrombosis .
The subclavian triangle (or supraclavicular triangle, omoclavicular triangle, Ho's triangle), the smaller division of the posterior triangle, is bounded, above, by the inferior belly of the omohyoideus; below, by the clavicle; its base is formed by the posterior border of the sternocleidomastoideus.
The accessory nerve is directed obliquely across the space from the Sternocleidomastoideus, which it pierces, to the under surface of the Trapezius; below, the supraclavicular nerves and the transverse cervical vessels and the upper part of the brachial plexus cross the space.
The first sign of a malignancy, especially an intra-abdominal one, may be an enlarged Virchow's node, a lymph node in the left supraclavicular area, in the vicinity where the thoracic duct empties into the left brachiocephalic vein, right between where the left subclavian vein and left internal jugular join (i.e., the left Pirogoff angle).