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31

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Anatomy

Upper Limb

Question 154 of 180

A 24 year old man presents following a seizure. He has severe epilepsy and regularly dislocates his left shoulder. He has dislocated his shoulder as a result of today's seizure and appears to have axillary nerve damage. The axillary nerve arises from which of the following cords of the brachial plexus:

Answer:

The axillary nerve arises from the posterior cord containing fibres from nerve roots C5 and C6.

Table: Anatomical Overview of the Axillary Nerve

Nerve Axillary
Nerve roots C5 and C6
Plexus cords Posterior cord
Motor Supply Deltoid, teres minor
Sensory supply Regimental badge area on lateral arm via superior lateral cutaneous nerve of the arm

The axillary nerve arises from the posterior cord containing fibres from nerve roots C5 and C6.

The axillary nerve and associated blood vessels (the posterior circumflex humeral artery and vein) enter the deltoid by passing posteriorly around the surgical neck of the humerus (where it is vulnerable to damage).

The axillary nerve innervates the teres minor and deltoid muscles and the skin over the inferior portion of the deltoid, the 'regimental badge area' (via the superior lateral cutaneous nerve of the arm).

Axillary Nerve. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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