Correlative ultrasound anatomy of the feline brachial plexus and major nerves of the thoracic limb

Abstract

Brachial plexus avulsions commonly occur in cats due to traumatic injuries involving the shoulder. Ultrasound may be an effective method for detecting injured nerves. Additional applications may include characterization of brachial plexus neoplasms and guidance of anesthetic nerve blocks. Aims of this study were to describe ultrasonographic approaches and the normal appearance of this plexus and other major nerves of the thoracic limb in cats. Eight feline cadavers were used to determine anatomic landmarks, obtain cross-sectional anatomic images of the target nerves, and compare these with ultrasound images. An ultrasonographic study was performed in five fresh feline cadavers to assess the brachial plexus and its major components at the levels of the axilla and proximal, middle and distal (lateral and medial approaches) humeral regions. Five healthy adult cats were recruited for an in vivo ultrasonographic study using the same protocol described for the cadaver ultrasonographic study. The roots of the brachial plexus appeared as a cluster of small, round hypoechoic structures surrounded by a hyperechoic rim in the axillary approach. The radialis, medianus, and ulnaris nerves were individually visualized on proximal and middle humeral approaches. The medianus and ulnaris nerves were easily identified on the medial aspect of the humerus in the distal approach. The superficial branch of radialis nerve was seen on the lateral aspect of the distal humerus approach. The nerves appeared as oval-to-round hypoechogenic structures with a hyperechogenic rim. Future studies are needed to compare findings from this study with those in cats with confirmed brachial plexus injuries or other lesions.