The Axilla OBJECTIVES Identify the walls of the
The Axilla
OBJECTIVES • • • Identify the walls of the axilla and how structures traverse them Study the course and branches of the axillary artery and recognize its important relations. Understand the arterial anastomosis around the scapula & shoulder joint Locate & study the groups of axillary lymph nodes Study the nerves of the upper limb and deduce their root value by understanding the arrangement of the brachial plexus
Surface anatomy
Walls
Apex (cervicoaxillary canal)= inlet
Axillary walls
Anterior wall
Medial wall
Posterior wall
Gaps in the Posterior wall of the axilla
Gaps in the Posterior wall of the axilla
Lateral wall
The Axillary artery 1 -1 Superior thoracic artery 2 -1 Thoracoacromial artery 2 -2 lateral thoracic artery 3 -1 Subscapular artery 3 -2 Ant. circumflex humeral artery 3 -3 Post. circumflex humeral artery 1 2 3
Humeral anastomosis
Anastomosis around the scapula
Important Relations Axillary vein Brachial plexus P major P minor Subscapularis L dorsi T major Biceps Corachobrachialis
The axillary lymph nodes
The axillary lymph nodes
1 -CENTRAL � 2 -LATERAL � 3 -PECTORAL � 4 -INFRACLAVICULAR � 5 -SUBSCAPULAR �
The Brachial Plexus
The Brachial Plexus
The Brachial Plexus
The Brachial Plexus
The Brachial Plexus
Branches from the roots Dorsal scapular (C 5) Ø Long thoracic (C 5, 6, 7) Ø
Branches from the upper trunk Suprascapular (C 5, 6) Ø Nerve to subclavius (C 5, 6) Ø
Branches from the lateral cord Lateral pectoral (C 5, 6, 7) Ø Musculocutaneous (C 5, 6, 7) Ø Lateral root of the median nerve (C 5, 6, 7) Ø
Branches from the medial cord Ø Ø Ø Medial pectoral (C 8, T 1) Medial cutaneous nerve of the arm (C 8, T 1, 2) Medial cutaneous nerve of the forearm (C 8, T 1) Ulnar nerve (C 7, 8, T 1) Medial root of median nerve (C 8, T 1)
Branches from the posterior cord Ø Ø Ø Upper subscapular (C 5, 6) Lower subscapular (C 5, 6) Thoracodorsal (C 6, 7, 8) Axillary (C 5, 6) Radial (C 5 -T 1)
Relation of the brachial plexus to the axillary artery
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