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PT 603 Anatomy > Axilla > Flashcards

Axilla Flashcards

1
Q

Define: Axilla

A

pyramidal space inferior to the glenohumeral joint and superior to the axillary fascia at the jxn of the arm and thorax

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2
Q

Main Fxn of Axilla

A

provides passageway for vessels and nerves to reach the arm

Consists of an apex, 4 walls, and a floor

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3
Q

Axilla Borders: Apex

A

inlet of axilla

entrance from the neck to the axilla and is called cervicoaxillary canal

Cervicoaxillary canal lies b/w 1st rib, clavicle, and superior edge of subscapularis

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4
Q

Axilla Borders: Anterior wall

A

formed by the pectoral muscles

completed by the clavicopectoral fascia and inferolateral extension of pectoral fascia

Inferiorly demarcated by the anterior axillary fold which consists primarily of pec. major mm

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5
Q

Axilla Borders: Posterior wall

A

scapulae and subscapularis mm form anterior surface

teres major and latissimus dorsi form inferior border and form the posterior axillary fold

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6
Q

Axilla Border: Medial Wall

A

formed by the thoracic wall, the 1st through 4th ribs and the overlying serratus anterior mm

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7
Q

Axilla Border: Lateral Wall

A

narrow boney wall formed by the intertubercular (bicipital) groove

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8
Q

Axilla Border: Base floor

A

Concave skin, subcutaneous tissue, and deep fascia

the deep fascia extends from the arm laterally to the thorax medially

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9
Q

Contents of the Axilla

A

Major vessels, nerves, and lymphatics of the upper limb

Proximal part of biceps brachii and coracobrachialis

Axillary process of the breast

Collections of lymph nodes which drain the upper limb and chest wall

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10
Q

Axillary Artery

A

Distal continuation of the subclavian artery

Supplies the wall of the axilla and related regions and continues as the major blood supply of the upper limb

Begins at the lateral border of the 1st rib, passes inferior to pectoralis minor, and ends at inferior border of the teres major to become renamed the brachial artery

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11
Q

Part 1 of the axillary artery

A

Located b/w the lateral border of the 1st rib and the medial border of the pectoralis minor

Portion of the axillary has ONE branch called the superior (supreme) thoracic artery

This artery remains posterior to the axillary vein which is NOT enclosed in the axillary sheath

Superior Thoracic Artery supplies: musculature of the 1st and 2nd intercostal spaces and the Subclavius mm

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12
Q

Second part of the axillary artery

A

Portion of the axillary artery lies deeper to the pec minor

Second part has TWO main branches

Thoracoacromial Trunk

Lateral Thoracic Artery

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13
Q

Thoracoacromial Trunk

A

Short arterial trunk that originates from anterior surface of the axillary artery; posterior to the medial margin of the pec major

Curves around the medial border of the pec minor

Penetrates the clavicopectoral fascia and divides into four branches:

Acromial Branch: supplies the deltoid at the level of the acromion process

Clavicular branch: supplies the sternoclavicular joint and the subclavius muscle

Deltoid branch: supplies the deltoid and part of the pectoralis major as it courses with the cephalic vein in the deltopectoral groove

Pectoral Branch: supplies the pectorals by four smaller branches deep to the clavicular head of the pectoralis major and participate in the BS to the breast

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14
Q

Lateral Thoracic Artery

A

Arises from the anterior surface of the second part of the axillary artery posterior to lateral border of pec minor mm

Passes lateral to and follows lateral margin of the pectoralis minor

Supplies: the pectoral muscles and serratus anterior

Branches of this artery also participate in the vasculature of the breast

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15
Q

Third part of the axillary artery

A

Extends from lateral border of the pectoralis minor mm to the inferior border of the teres major

THIRD part of the axillary has THREE main branches

Subscapular artery

Anterior circumflex humeral artery

Posterior circumflex humeral artery

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16
Q

Subscapular artery

A

1) Thoracodorsal Artery:

follows the lateral border of the scapula to the inferior angle

Supplies: latissimus dorsi

2) Circumflex Scapular Artery

Passes through the triangular space

Pierces the teres minor to enter the infraspinous fossa

Anastomoses: w/ dorsal scapular artery to contribute to collateral circulation of the scapula

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17
Q

Anterior Circumflex Humeral Artery

A

Originates from the lateral aspect of the 3rd part of the axillary a.

Passes anterior to the surgical neck of the humerus

Anastomoses: w/ posterior circumflex humeral artery

Supplies: GH joint and head of the humerus

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18
Q

Posterior circumflex humeral artery

A

Originates from the lateral surface of the 3rd part of the axillary artery

Passes through the quadrangular space with the axillary nerve

Curves around the surgical neck of the humerus

Supplies: GH joint and surrounding tissues

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19
Q

Axillary Vein

A

Begins at the lower margin of the teres major mm

Continuation of the basilic vein

passes medial to the axillary artery and become the subclavian vein at the lateral border of the 1st rib

receives tributaries that generally correspon to branches of the axillary artery

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20
Q

Define: Brachial Plexus

A

A network of ventral primary rami that combine to form peripheral nerves of the UE

Formed by the union of the ventral rami of C5 through C8 and the greater part of the ventral rami of T1

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21
Q

Brachial Plexus: Roots

A

Formed by the ventral rami of C8-T1

Roots usually pass through the gap b/w anterior and middle scalenes interval

Roots are accompanied by subclavian artery

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22
Q

Brachial Plexus: Trunks

A

Formed by the union of roots

3 trunks:

Superior: Formed from the union of the C5 and C6 roots

Middle: continuation of C7 root

Inferior: Formed from the union of C8-T1 root

23
Q

Brachial Plexus: Divisions

A

Each trunk divides into an anterior and posterior division

Anterior: supplies anterior compartment of the UE (flexors)

Posterior: supplies posterior compartments of the UE (extensors)

24
Q

Brachial Plexus: Cords

A

Formed by union of divisions

3 cords: named with respect to their relationship to the second part of the axillary artery

Lateral: formed by the anterior divisions of superior and middle trunks

Medial: continuation of the anterior division of the inferior trunk

Posterior: formed by the union of the posterior divisions of all three trunks

25
Q

Branches of the ROOTS: Dorsal Scapular Nerve

A

(C4,5)

Arises from posterior aspect of the ventral ramus of C5

Frequent contribution of C4

Pierces the scalene

Innervates the levator scapulae and the rhomboids

26
Q

Branches of the ROOTS: Long thoracic nerve

A

(C5,6,7)

Arises from the posterior aspect of the ventral rami of C5,6,7

Passes through teh apex of the axilla

Supplies serratus anterior

27
Q

Branches off the TRUNKS: Nerve to subclavius

A

((C4),C5,C6)

Arises from anterior aspect of teh superior trunk

Receives fibers primarily from C5 with occasional additions from C4 and C6

Supplies the subclavius

28
Q

Branches off the TRUNKS: suprascapular nerve

A

((C4), C5, C6)

Arises from the posterior surface of the superior trunk

Receives fibers from primarily C5, 6 and often C4

Supplies innervation to the infraspinatus and supraspinatus and the GH joint

29
Q

Branches of the LATERAL CORD: Lateral Pectoral Nerve

A

(C5,C6,C7)

Primarily supplies the pectoralis major

Sends a branch to the medial pectoral nerve

30
Q

Branches of the LATERAL CORD: Musculocutaneous nerve

A

(C5-7)

Exits axilla by piercing the coracobrachialis

Passes b/w the biceps brachii and the brachialis

Supplies all of the muscles in the anterior arm

Becomes cutaneous in the forearm as the lateral antebrachial cutaneous nerve

31
Q

Branches of the LATERAL CORD: Lateral Root

A

lateral communicating branch of median nerve

Will join medial root of the median nerve to form the median nerve

32
Q

Branches of the LATERAL CORD*: Median Nerve

A

(C5-C8, T1)

Arises by medial and lateral roots from the medial and lateral cords

Supplies primarily anterior compartment muscles in the forearm, 5 muscles in the hand and skin

33
Q

Branches of the MEDIAL CORD: Medial root

A

medial communicating branch of the median nerve

will join the lateral root of the median nerve to form the median nerve

34
Q

Branches of the MEDIAL CORD: Medial pectoral nerve

A

(C5-C8,T1)

Pierces the pectoralis minor

Supplies the pectoralis minor and major

actually lateral to the lateral pectoral nerve

35
Q

Branches of the MEDIAL CORD: Medial brachial cutaneous

A

(C8,T1)

Supplies the skin on the medial side of the arm

36
Q

Branches of the MEDIAL CORD: Medial antebrachial cutaneous

A

(C8,T1)

Supplies the skin on the medial side of the forearm

37
Q

Branches of the MEDIAL CORD: Ulnar nerve

A

(C8,T1 sometimes C7)

Does not branch in the forearm

Supplies one and 1/2 muscles in the anterior forearm

Continues into the hand

38
Q

Branches of Posterior Cord: Upper scapular Nerve

A

(C5,C6)

Supplies superior part of subscapularis

39
Q

Branches of the Posterior Cord: Thoracodorsal Nerve

A

(C6,C7,C8)

Supplies inferior part of the subscapularis

Supplies Teres major mm

40
Q

Branches of Posterior Cord: Axillary Nerve

A

(C5,C6)

A terminal branch of the posterior cord

Passes through the quadrangular space

Winds around the surgical neck of the humerus

Supplies Teres minor and Deltoid

Distally continues as the superior lateral cutaneous nerve of the arm to supply the skin over the inferior half of the deltoid

41
Q

Radial Nerve

A

Other terminal branch of the posterior cord

(C5-C8,T1)

Largest branch of the brachial plexus

Supplies musculature in the posterior compartment of the arm

Supplies the skin of the posterior aspect of the arm and forearm

Runs in the triangular interval

42
Q

Quadrangular Space

A

Borders:

Inferior margin of Teres minor mm

Surgical neck of humerus

Superior margin of Teres Major

Lateral margin of LH of triceps

Contains:

Axillary Nerve

Posterior circumflex humeral artery

43
Q

Triangular Space

A

Borders:

Medial margin of LH of triceps

Superior margin of Teres Major

Inferior margin of Teres Minor

Contains: Circumflex scapular artery/vein

44
Q

Axillary nerve Trauma: clinical implications

A

MOI:

Can result from fx of the surgical neck of the humerus

Can result from dislocation of the GH joint (traction)

Results in:

Atrophy and wasting of deltoids

May have loss of sensation over the inferior half of the deltoid (cutaneous innervation from the superior lateral cutaneous nerve)

45
Q

Erb’s palsy

A

Injury to the superior part of the brachial plexus

Traction of C5-C6

MOI: Thrown/Childbirth

Results in: Brachial plexus compression

46
Q

Brachial Plexus Cord Compression

A

Results from prolonged overhead activities

Compression b/w the coracoid process and the pectoralis minor

47
Q

Pec Major

A

PA: medial 1/2 clavicle anterior portion;

1/2 anterior surface sternum;

1-7 ribs costal cartilage

sternal end of 6th rib & aponeurosis of EAO

DA: Lateral lip of bicipital groove

N: med/lat pectoral; clavicular fibers: C5-6, Sternal: C6-T1

BS: Pectoral Artery

OC: Humeral addiction & medial rotation

clavicular fibers: flex and extended arm

Sternal fibers: extend a flexed arm

CC: draws trunk upward & forward

48
Q

Pec Minor

A

PA: ribs 3-5 along upper margins & outer surfaces near costal cartilage

DA: coracoid process along medial border and upper surface

N: Medial and lateral pecotral (C5-T1)

BS: Pectoral Artery

AX: Scapular depression (downward rotation & inferior slide); assists with protraction (IR and Lateral slide of scapula)

49
Q

Subclavius

A

PA: 1st jxn of rib and its costal cartilage

DA: groove on middle 1/3 of clavicles inferior surface

N: nerve to subclavius (C5,6)

BS: Clavicular artery

Ax: OC: shunting the clavicle towards manubrium in violent UE motions; clavicular depression & protraction

CC: secondary mm of respiration

50
Q

Serratus Anterior

A

PA: upper 8 ribs

DA: scapula medial border of anterior surface

N: Long thoracic nerve (C5,6,7)

BS: Lateral thoracic artery

AX: scapular upward rotation, lateral slide, prevents scapular winging

51
Q

Subscapularis

A

PA: Med 2/3 subscapular fossa & adjoining fascia

DA: lesser tubercle of humerus blends with GH fibrous capsule

N: Upper and lower subscapular n (C5,6)

BS: subscapular artery

Ax: IR of humerus, stabilizes GH jt

52
Q

Teres Major

A

PA: scapula along inf 1/3 of lateral border & post surface, adjoining fascia

DA: humerus along medial border of bicipital groove

N: Lower subscapular nerve (C5-7)

BS: Thoracodorsal A.

AX: extension and medial rotation of humerus

53
Q

Latissimus Dorsi

A

PA: T7-12 SP,lumbar SP,median sacral crest, supraspinous ligs,and post iliac crest via the post layer thoracolumbar fascia, outer lip of post iliac crest lat to erector spinae, muscular slips to ribs 9-12

DA: floor of bicipital groove

N: thoracodorsal nerve (C6-8)

Thoracodorsal Artery

Ax: adduction, extension, IR of humerus

assists with scapular depression

CC-trunk elevation

PT 603 Anatomy (4 decks)

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