brachial plexus

Question 1

extraplexus nerve transfers

Answer 1

1. contralateral C7 to median nerve
2. Phrenic
   - suprascap, axillary for shoulder
   - musculocutaneous for elbow
3. CN XI (spinal accessory)
   - supra scapular for shoulder
   - musculocutaneous for elbow
4. intercostal 3-6
   - musculocutaneous for elbow
   - neurotize free flap muscle transfer

Question 2

overall plexus function

Answer 2

C5 - shoulder
C6 - elbow
C7 - wrist
C8, T1 - hand

Question 3

nerve transfers within the limb

Answer 3

ulnar nerve fascicle to musculocutaneous
median nerve fascicle to musculocutaneous
triceps branch to axillary nerve

Question 4

shoulder abduction tendon transfers

Answer 4

upper trapezius
latissimus
pectoralis

Question 5

elbow flexion

Answer 5

triceps to biceps
latissimus to biceps
pectoralis to biceps
move flexor tendon mass more proximally on humorous (steinle flexorplasty)

Question 6

free flap muscle transfer

Answer 6

gracilis for elbow flexion and finger extension then a second flap for finger flexion