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Gross Anatomy of the Brachial Plexus Sheath in Human Cadavers
  1. Carlo D. Franco, M.D.a,b,
  2. Abed Rahman, M.D.a,
  3. Gennadiy Voronov, M.D.a,
  4. James M. Kerns, Ph.D.b,
  5. Robert J. Beck, Ph.D.b and
  6. Chester C. Buckenmaier, M.D.c
  1. aDepartment of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois
  2. bDepartment of Anatomy and Cell Biology, Rush University Medical Center, Chicago, Illinois
  3. cDepartment of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.


Background and Objectives: Major nerves and vessels run alongside each other in a “neurovascular bundle” kept together by connective tissue that is often referred to by anatomists, surgeons, and anesthesiologists as the “sheath.” Our goal was to macroscopically demonstrate the brachial plexus sheath in embalmed and fresh cadaver dissections.

Methods: Systematic dissections were performed on 11 embalmed cadavers (6 females and 5 males), plus one fresh, unembalmed male cadaver. Dissections were started in the arm, and progressed proximally to the axilla and the supraclavicular area. Notes and photographic documentation were obtained.

Results: A sheath around the neurovascular bundle of the brachial plexus was visible to the naked eye in every dissection. The sheath had a fibrous external appearance, and was filled with loose connective tissue. No evidence of septa was found.

Conclusions: We observed a macroscopic fibrous structure surrounding the plexus, which was filled with loose connective tissue lacking any apparent organization.

  • Brachial plexus
  • Sheath
  • Anatomy

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  • Reprint requests: Carlo D. Franco, M.D., Department of Anesthesiology, John H. Stroger Jr. Hospital of Cook County, 1901 West Harrison St., Suite 5670, Chicago, IL 60612. E-mail: carlofra{at}

  • C.D.F. dedicates this work to Alon P. Winnie, MD, for his love and knowledge of anatomy, and for having introduced the author to regional anesthesia.