Gross anatomy of the brachial plexus sheath in human cadavers

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.