臂神经丛
臂神经丛（英文：brachial plexus）為一神經叢。起源于第五節頸椎神經（C5）到第一節胸椎神經（T1）的前支。在頭、颈、上肢内连接鎖骨、上臂、前臂、手的神经丛的名称。
| 臂神经丛 | |
|---|---|
 右侧颈部的表面解剖图，在前斜角肌后部便是臂神经丛。 | |
 The roots, trunks and cords of the plexus shown in a dissected cadavaric specimen. | |
| 细节 | |
| 拉丁语 | plexus brachialis |
| 來源 | C5、C6、C7C8、T1 |
| 支配 | 上肢感覺與運動 |
| 识别标示 | |
| 格雷氏 | p.930 |
| TA | A14.2.03.001 |
| FMA | FMA:5906 |
臂神经丛會由cervicoaxillary canal進入腋窩，支配上肢。
脊髓神经在头部、后背、肩部的分支与上肢中后头、颈部、锁骨的颈神经丛相互连接被称作颈臂神经丛。
臂神经丛的构成
臂神经丛是第5颈神经～第1胸神经的前枝構成，分为根、神经干和神经束。
第5、第6颈神经的前支相交上神经干，第7颈神经的前支相交中神经干，第8颈神经和第1胸神经前支相交下神经干。上・中神经干的分支（前部）与外側神经束（C5～C7），上、中、下的神经干的分支（後部）与后神经束（C5～Th1），下神经幹的分支（前部）与内側神经束（C8、Th1）共同形成。
- 外側神经束外側：肌皮神经（C5~C7）
- 外側神经束内側和内側神经束外側的相交部：正中神经（C5~Th1)
- 内側神经束内側：尺骨神经（C8~Th1）
- 後神经束：桡骨神经（C6~C8）、腋窝神经（C5~C6）
臂神经丛的分支
臂神经丛的分支大体上可以分为锁骨上支和锁骨下支。
鎖骨上枝
- 肩胛背神经（C4~C6）
- 肩胛上神经（C5）
- 胸长神经（C5~C7）
- 锁骨下肌神经（C5）
鎖骨下枝
- 胸背神经（C5~C8）
- 外侧胸肌神经（C5~C7）
- 内侧胸肌神经（C7~Th1）
- 肩胛下神经（C5~C7）
- 外側上臂丛皮肤神经
- 内側上臂丛皮肤神经
- 外側前臂丛皮肤神经
- 内側前臂丛皮肤神经
分支
粗體表示的是主要脊神經根。斜體則表示經常匯入該神經的神經根，但不一定會匯入該神經。
| 來源 | 神經 | 神經根[1] | 支配肌肉 | 皮神經支配 |
| 脊神經根 | 背肩胛神經 | C4, C5 | 大菱肌、小菱肌，和提肩胛肌 | - |
| 脊神經根 | long thoracic nerve | C5, C6, C7 | serratus anterior | - |
| 脊神經根 | branch to phrenic nerve | C5 | Diaphragm | - |
| 上神經幹 | nerve to the subclavius | C5, C6 | subclavius muscle | - |
| 上神經幹 | suprascapular nerve | C5, C6 | supraspinatus and infraspinatus | - |
| 外神經幹 | lateral pectoral nerve | C5, C6, C7 | pectoralis major and pectoralis minor (by communicating with the medial pectoral nerve) | - |
| 外神經幹 | musculocutaneous nerve | C5, C6, C7 | coracobrachialis, brachialis and biceps brachii | becomes the lateral cutaneous nerve of the forearm |
| 外神經幹 | lateral root of the median nerve | C5, C6, C7 | fibres to the median nerve | - |
| 後神經幹 | upper subscapular nerve | C5, C6 | subscapularis (upper part) | - |
| 後神經幹 | thoracodorsal nerve (middle subscapular nerve) | C6, C7, C8 | latissimus dorsi | - |
| 後神經幹 | lower subscapular nerve | C5, C6 | subscapularis (lower part ) and teres major | - |
| 後神經幹 | axillary nerve | C5, C6 | anterior branch: deltoid and a small area of overlying skin posterior branch: teres minor and deltoid muscles | posterior branch becomes upper lateral cutaneous nerve of the arm |
| 後神經幹 | radial nerve | C5, C6, C7, C8, T1 | triceps brachii, supinator, anconeus, the extensor muscles of the forearm, and brachioradialis | skin of the posterior arm as the posterior cutaneous nerve of the arm. Also superficial branch of radial nerve supplies back of the hand, including the web of skin between the thumb and index finger. |
| medial cord | medial pectoral nerve | C8, T1 | pectoralis major and pectoralis minor | - |
| medial cord | medial root of the median nerve | C8, T1 | fibres to the median nerve | portions of hand not served by ulnar or radial |
| medial cord | medial cutaneous nerve of the arm | C8, T1 | - | front and medial skin of the arm |
| medial cord | medial cutaneous nerve of the forearm | C8, T1 | - | medial skin of the forearm |
| medial cord | ulnar nerve | C8, T1 | flexor carpi ulnaris, the medial two bellies of flexor digitorum profundus, the intrinsic hand muscles except the thenar muscles and the two most lateral lumbricals | the skin of the medial side of the hand and medial one and a half fingers on the palmar side and medial two and a half fingers on the dorsal side |
臂神经丛麻痹
原因分为外傷、分娩麻痺、背包麻痹、睡眠中的压迫、肿瘤、肩膀关节脱臼、注射、手术等等。
參考文獻
- Moore, K.L.; Agur, A.M. 3rd. Baltimore: Lippincott Williams & Wilkins. 2007: 430–1. ISBN 978-0-7817-6274-8.
参见
- 颈椎后三角
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