Axilla Flashcards
What are the margins of the Axilla
Anterior wall – pec major and subclavius
Posterior wall – subscapularis, teres major, latissimus dorsi and long head triceps
Medial wall – upper thoracic wall and serratus anterior; Lateral wall – intertubecular groove.
Describe the sternoclavicular joint.
Sternoclavicular joint is synovial and allows movement in the vertical and horizontal plane and has 4 ligaments – the interclavicular ligament, anterior and posterior sternoclavicular ligaments and the costoclavicular ligament.
Describe the acromioclavicular joint.
Acromioclavicular joint is synovial and contains 3 main ligaments: the acromioclavicular ligament and the coracoclavicular ligaments made from the lateral trapezoid ligament and the medial conoid ligament.
Describe the Glenohumeral joint (not including ligaments)
Glenohumeral joint is synovial and unstable because of its range of movement. The cavity is deepened by the glenoid labrum which is continuous with the long head bicep tendon which is lined by the synovial membrane. There is a redundant capsule for when the arm is outstretched. There is a subscapular and subacromial/ subdeltoid bursa.
Describe how the glenohumeral joint is stabilised by ligaments andmuscles
There are 3 ligaments: the transverse humeral ligament connecting the greater and lesser trochanter, the (superior, middle and inferior) Glenohumeral ligaments and the coracohumeral ligament. An extra ligament not from the capsule is the coracoacromial ligament over the subdeltoid bursa creating the coracoacromial arch to prevent upper displacement. The joint is stabilised by the 4 rotator cuff muscles.
Describe fracture of the clavicle
Fracture of the clavicle tend to happen in the middle third, with mild trauma the joint capsule may tear, with greater trauma the coracoclavicular ligaments may damage resulting in dislocation at the acromioclavicular joint, if posterior problematic due to great vessels.
Medial fragment will move up due to the sternocleidomastoid muscle whilst the lateral fragment will move down due to the weight of the arm.
Discuss dislocation of the glenohumeral joint
Dislocation of Glenohumeral joint is common due to instability. Anterior>posterior. Anterior result in stretching of radial nerve and compression of axillary nerve/artery. Posterior due to violent muscle contraction – rip glenoid bursa making it more likely to occur again.
What is painful arc syndrome
Painful Arc syndrome – coracoacromial ligament susceptible to swelling from bursa and tendons. Causes pain when abducting the arm between 50-130 degrees. Supraspinatus tendon has poor blood supply – susceptible to degeneration and calcium deposits.
What is winged scapula
Winged scapula – damaged long thoracic nerve causing serratus anterior to not function. Also causes loss of normal elevation of the scapula.
What is risky about fracture of the first rib?
Risk of damage to great vessels.
How can you tell if someone has ruptures their long head bicep tendon
Rupture of the long head bicep tendon will cause a characteristic deformity – Popeye sign.
How can the radial nerve become damaged from fracture of the humerus.
Fracture of humerus at the radial groove – risk of laceration of the radial nerve and deep brachial artery – characteristic sign is wrist drop.
Describe the lymphatics of the upper node
Lymphatics include: humeral, pectoral, subscapular, central and apical nodes.
