Chapter 2

The Microanatomy of the Brachial Plexus and Peripheral Nerves

André P. Boezaart

Abstract

The aims of this chapter are to explain and present the older and new concepts and understanding around the microanatomy of nerve roots, trunks, and peripheral nerves. More recent work over the past 3 or 4 years looked at nerves with high-definition ultrasound and electron microscopy and illustrated that the paraneural or circumneural sheath is what neurosurgeons for years have been calling the “gliding apparatus” of the nerve. The space just deep to this layer is the subcircumneural (subparaneural) space, which should most probably be the target space for successful and safe single-injection block and catheter placement for continuous nerve block. The different microanatomical features of spinal roots, plexus trunks, and peripheral nerves are discussed and compared, as well as the microanatomical explanation of the different sonographical appearance of these three types of nerves.

Total Pages: 29-53 (25)

Purchase Chapter  Book Details