Surgical and Radiologic Anatomy

, Volume 40, Issue 7, pp 815–822 | Cite as

The zonal pattern of arterial supply to the brachial plexus and its clinical significance

  • An-bo Gao
  • Yun-cheng Lv
  • Ai-ping Wang
  • Li-yuan Zhong
  • Mao-lin Tang
  • Binu-prathap Thomas
  • Tian-hong Peng
Original Article



To provide the anatomical basis of blood supply of brachial plexus for the clinical microsurgical treatment of brachial plexus injury.


Thirteen adult anticorrosive cadaveric specimens (8 males, 5 females) were dissected in this study. 3 fresh cases (2 males, 1 female) were used to observe the zonal pattern of arteries supplying brachial plexus, and 10 cases (6 males, 4 females) were used to observe the source and distribution of the brachial plexus arteries under microscope.


The brachial plexus is supplied by branches of the subclavian–axillary axis (SAA), and these branches anastomose each other. According to distribution feature, blood supply of the brachial plexus could be divided into three zones. The first zone was from the nerve roots of intervertebral foramina to its proximal trunks, which was supplied by the vertebral artery and the deep cervical artery. The second zone was from the distal nerve trunks of the brachial plexus, encompassing the divisions to its proximal cords, which was supplied by direct branches of the subclavian artery or by branches originating from the dorsal scapular artery. The third zone was from the distal portion of the cords to terminal branches of the brachial plexus, which was supplied by direct branches of the axillary artery.


The zonal pattern of arterial supply to the brachial plexus is a systematic and comprehensive modality to improve anatomical basis for the clinical microsurgical treatment for brachial plexus injury.


Brachial plexus Subclavian artery Axillary artery Microsurgical techniques 



This project was financed by the National Natural Science Foundation of China (Grant No. 81770460 to Yun-cheng Lv, Grant No. 81600040 to Ai-ping Wang), the startup funds for Ph.D.s in the University of South China (Grant No. 2014XQD37), Zhengxiang scholar program (Prof. Xiangyang Tang) of the University of South China, the construct program of the key discipline in Hunan Province, Key Lab for Clinical Anatomy & Reproductive Medicine of Hengyang city (Grant No. 2017KJ182).

Author contributions

ABG: data collection; data analysis; manuscript writing and editing. YCL: protocol development; data analysis; manuscript editing. APW: data analysis. LYZ: data analysis; manuscript editing. MLT: protocol development; data collection; data analysis; manuscript editing. BPT: data analysis; manuscript editing. THP: protocol development; data analysis; data collection; manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

Written consent approval of the School of Medicine in the University of South China was obtained for all procedures performed in this study involving human participants. This study was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Anatomy & Reproductive Medicine Application Institute, School of MedicineUniversity of South ChinaHengyangChina
  2. 2.Dr. Paul Brand Centre for Hand Surgery and Peripheral Nerve SurgeryChristian Medical College HospitalVelloreIndia
  3. 3.Department of AnatomyWenzhou Medical UniversityWenzhouChina

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