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 subjected himself to the supraclavicular block. Later that year, Georg Hirschel (18751963) described a percutaneous approach to the brachial plexus from the axilla. In 1928, Kulenkampff and Persky published their experiences with a thousand blocks without apparent major complications. They described their technique with the patient in the sitting position or in the supine position with a pillow between the shoulders. The needle was inserted above the midpoint of the clavicle where the pulse of the subclavian artery could be felt and it was directed medially toward the second or third thoracic spinous process. By the late 1940s, clinical experience