Brachial plexus puncture needle

The brachial plexus consists mainly of anterior branches of the spinal nerves C 5-8 and T 1 (C and T stand for neck and chest respectively) and innervates sensation and movement of the upper limbs. After passing through the foramen, these nerves pass through the intermuscular sulcus between the anterior and medial scalenes, where they merge with each other to form the brachial plexus. It then crosses over the surface of the first rib above the clavicle into the axilla and forms the main terminal nerves, the median, flex, ulnar, and musculocutaneous nerves. In the intermuscular sulcus, the brachial plexus is enclosed by a sheath formed by the prevertebral and scalenes fascia, which extends above the clavicle into the subclavian artery sheath and forms the axillary sheath in the axilla. Brachial plexus blocks can be performed in the intermuscular sulcus, supraclavicular, and axillary areas, and are called the intermuscular sulcus path, supraclavicular path, and axillary path, respectively  In order to be effective, local anesthetics must be injected into the sheath.