Following an axillary brachial plexus block performed for hand surgery, the block is dense over the palmar surface but the patient feels the skin incision over the lateral forearm. Which nerve accounts for this failure?

• A Radial nerve
• B Medial cutaneous nerve of forearm
• C Musculocutaneous nerve ✓
• D Median nerve

Explanation

The musculocutaneous nerve leaves the brachial plexus sheath proximally, piercing coracobrachialis, so it lies outside the axillary perivascular compartment and is frequently missed by an axillary approach. It supplies sensation to the lateral forearm. Supplementation as a separate injection into the body of coracobrachialis is standard practice. The radial nerve stays inside the sheath and the medial cutaneous nerve of forearm travels with it, so both are usually blocked.

Reference: Hadzic's Textbook of Regional Anesthesia and Acute Pain Management, 2nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.