A 40-year-old patient undergoing upper limb surgery receives an axillary brachial plexus block. The nerve most likely to be missed with this approach, requiring supplemental blockade, is:

• A Median nerve
• B Ulnar nerve
• C Radial nerve
• D Musculocutaneous nerve ✓

Explanation

The musculocutaneous nerve leaves the brachial plexus sheath proximal to the axilla and travels within the coracobrachialis muscle, often exiting the neurovascular sheath before the needle reaches it during an axillary approach. It provides motor supply to the biceps and brachialis and sensory supply to the lateral forearm (lateral cutaneous nerve of forearm). Surgeries on the lateral forearm may be inadequately blocked unless the musculocutaneous nerve is separately infiltrated into the coracobrachialis muscle at the time of axillary block.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.