Anest. intenziv. Med. 2019;30(5):225-234 | DOI: 10.36290/aim.2019.060

Fascial planes for regional anaesthesia of the upper limbSpecial article

D. Nalos

Klinika anesteziologie, perioperační a intenzivní medicíny Univerzita J. E. Purkyně v Ústí nad Labem, Masarykova nemocnice v Ústí nad Labem

The article is another chapter in the series describing the importance of the fascias for regional anaesthesia. This chapter deals with the fascial planes of the nerves supplying the upper limb. The main vascular and nerve bundles for the cervical region run on the neck between deep and superficial fascias. There are several separate fascial planes under the deep cervical fascia, in which the individual nerves and the brachial plexus take place. The unique fascial function of the omohyoid muscle is newly described as a link between the deep and superficial fascial structures and the path for the suprascapular and infraclavicular nerves. The transition point between the fascias of the neck and upper limb is in the area of the first rib. This area is also important for the arrangement of the fascias and structures of the neural plexuses. The main peripheral nerves of the hand are formed here and the arrangement of innervation changes. The next part is devoted to the description of the axillary area, its shape, fascias and properties of the brachial plexus in the axilla. The last part is devoted to the peripheral nerves and their fascial planes on the upper limb which are suitable for ultrasonically assisted blockade.

Keywords: fascia; ultrasound; regional anaesthesia; upper limb

Received: September 17, 2019; Accepted: November 11, 2019; Published: December 1, 2019  Show citation