Median nerve and medial cords of the brachial plexus, courses through the anterior part of arm, forearm, and hand, and terminates by supplying the muscles of the hand. After receiving inputs from both the lateral and medial cords of the brachial plexus, the median nerve enters the arm from the axilla at the inferior margin of the teres major muscle. It then passes vertically down and courses lateral to the brachial artery between biceps brachii (above) and brachialis (below). At first, it is lateral to the artery and lies anterior to the elbow joint; it then crosses anteriorly to run medial to
Brachial plexus block represent the limit below which the needle must not be directed (the pleural cavity and uppermost part of the lung are located at this level). Palpation or ultrasound visualization of the subclavian artery just above the clavicle provides a useful anatomic landmark for locating the brachial plexus, which is lateral to the artery at this level. Proximity to the brachial plexus can be determined using by elicitation of a paresthesia, use of a peripheral nerve stimulator, or ultrasound guidance. Compared to the interscalene block, the supraclavicular block — despite eliciting a more complete block of the median, radial ulnar and