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Gross & Applied Anatomy I > Axilla > Flashcards

Axilla Flashcards

1
Q

Axilla

A

“Axillary region”
Area that lies underneath the glenohumeral joint
At the junction of the upper limb and the thorax
Passageway by which neurovascular and muscular structures can enter and leave the upper limb.

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2
Q

Cutaneous innervation of Axilla

A 
Intercostobrachial nerve (T1)
Intercostal nerve (T2-T4)
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3
Q

Borders of Axilla

A

Anterior: anterior axillary fold
Posteror: posterior axillary fold
Medial: lateral thoracic wall with serrates ant.
Lateral: humerus, coracobrachialis, biceps
Apex: junction of walls at scapula & clavicle (superomedial)
Floor: axillary fascia

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4
Q

Clavipectoral Fascia

A

Covers proximal neuromuscular structures of the axillary region

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5
Q

Major components of axilla

A

1) Serratus anterior
2) Axillary lymph nodes
3) Axillary artery
4) Axillary vein
5) Axillary fascia
6) Cords of brachial plexus
7) Brachial Plexus

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6
Q

Axillary lymph nodes

A

Communicate with pectoral lymph nodes from the breast, neck, head, and upper limb, and with nodes from the other side of the body

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7
Q

Axillary Artery

A

Continuation of subclavian artery
From Rib I to lower border of Teres major
Determines nomenclature for brachial plexus cords
Has three parts: Part 1, Part 2, Part 3

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8
Q

Part 1 of Axillary Artery

A

Supreme Thoracic A.
Arises from anterior surface of the axillary a.
Supplies first intercostal space
Descends from behind the axillary v.

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9
Q

Part 2 of Axillary Artery

A

Thoracoacromial Trunk
Branches from anterior surface of axillary a.
Arises deep to pec major
Usually arises medial to pec minor
Divides into:
DELTOID, PECTORAL, ACROMIAL, & CLAVICULAR ARTERIES (to SC joint)

Lateral Thoracic A.
Descends along the lateral border of pec minor
Supplies serratus anterior and mammary gland

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10
Q

Part 3 of Axillary Artery

A

Posterior Humeral Circumflex A.

Anterior Humeral Circumflex A.

Supscapular A.
Thoracodorsal A.
Scapular Circumflex A.

Shoulder Anastomosis
(among thoracic-acromial branch)

Scapular Anastomosis

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11
Q

How do veins compare to arteries?

A

Arteries: carry oxygenated blood away from the heart to the body
Veins: carry oxygen-poor blood back from the body to the heart.

Not an exact match
Partially due to development
Veins are usually BIGGER (carry 70% of blood at a time)
Branches look so varied in the body!

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12
Q

Posterior Humeral Circumflex A.

A 
Component of Part 3 of Axillary A.
Travels medial to surgical neck of humerus
Runs posteriorly 
Travels with anterior humeral circumflex
Supplies deltoid, teres minor, GH joint
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13
Q

Anterior Humeral Circumflex A.

A

Component of Part 3 of Axillary A.
Passes deep to coracobrachialis & Biceps brachii
Runs anterior to surgical neck of humerus
Supplies shoulder joint

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14
Q

Subscapular A.

A

Component of Part 3 of Axillary A.
Largest branch of Axillary A.
Arises at level of the subscapularis muscle along the posterior border of axillary A.
Has two sub-portions:
Thoracodorsal A.
Scapular Circumflex A. (larger, supplies shoulder joint and muscles)

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15
Q

Major veins of arm

A

Cephalic vein - on lateral side of arm
Basophilic vein - on medial (base) side of arm
Both are very long veins

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16
Q

Axillary Vein

A

Formed by union of:
basilic vein & various brachial veins
Empties into subclavian vein

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17
Q

Axillary Fascia

A

Continuous with deep back fascia, pectoral fascia, and brachial fascia
Forms floor of axilla

18
Q

Cords of Brachial Plexus

A

Named for proximity to axillary artery

3 cords: Medial, Lateral, & Posterior

19
Q

Brachial Plexus Schematic**

A

Netter Plate 430/418

20
Q

Brachial Plexus

A

Ventral Rami of C5-T1 (5 Levels)
Ventral Rami of these spinal n. emerge through the intervertebral foramina

Many components:
Roots
Trunks
Divisions
Cords
21
Q

Brachial Plexus:

Roots

A

FIVE!
Travel deep to scalene anterior muscle
Travel superficial to scalene medius muscle

Deep to scalene anterior, the roots form trunks.
Between scalene ant. and medius are found: brachial plexus trunks
subclavian a. and vein.
axillary a. and vein
Nerves that come off of the roots:
Dorsal scapular N.
Long thoracic N.

22
Q

Brachial Plexus:

Trunks

A

THREE
Upper - Combination of C5 & C6 (2 roots)
N. to Subclavius muscle
Suprascapular N.

Middle - Root of C7 (1 root)

Lower - Combination of C8 & T1 (2 roots)

23
Q

Brachial Plexus:

Divisions

A

THREE ANTERIOR & THREE POSTERIOR
Every trunk has an anterior and posterior division
Divisions combine to form cords

24
Q

Brachial Plexus:

Cords

A

THREE
Found in axilla itself, deep to the pec minor muscle
Named for their relation to axillary artery:
Medial
Lateral
Posterior

25
Q

Brachial Plexus:

Terminal Branches

A

EVERY CORD HAS TWO

All cords end where branches depart.

26
Q

Medial Cord

A

C8 & T1
Formed by anterior division of lower trunk ONLY
Medial pectoral n. (C8 and T1)
Ulnar n. (C8 and T1)
Medial brachial cutaneous (C8 and T1)
Medial antebrachial cutaneous (C8 and T1)
Medial cord contribution to median nerve

27
Q

Lateral Cord

A 
C5, C6, C7
Formed by anterior divisions of upper and middle trunks.
Lateral pectoral nerve (C5-C7)
Musculocutneous nerve (C5-C7)
Median Nerve (C5-T1) or (C6-T1)
28
Q

Posterior Cord

A 
C5-T1
Formed by posterior divisions of all trunks
Upper Subscapular N. (C5-C6)
Lower Subscapular N. (C5-C6)
Thoracodorsal N. (C6-C8)
Axillary N. (C5-C6)
Radial N. (C5-T1)
29
Q

Ulnar Nerve

of Brachial Plexus

A

Part of medial cord in brachial plexus.
C8 & T1
Most medial nerve in arm
Main role: Intrinsic hand movement
Also supplies some of wrist and digital flexors
Cutaneous to medial part of the hand (palmar and dorsal sides)

30
Q

Medial Brachial Cutaneous N.

of Brachial Plexus

A

Part of medial cord in brachial plexus.
C8 & T1
Cutaneous from the medial aspect of the arm (anterior & posterior sides)

31
Q

Medial Antebrachial Cutaneous N.

of Brachial Plexus

A

Part of medial cord in brachial plexus.
C8 & T1
Cutaneous from the medial aspect of forearm (anterior & posterior sides)

32
Q

Radial N.

A

Part of lateral cord in brachial plexus.
C5-T1
Main role: elbow, wrist, and digital extensors
Cutaneous skin over extensor compartment of the arm, forearm, and part of hand

33
Q

Levels in the Brachial Plexus per branch

A

Roots: one
Trunks: two
Cords: two-five
Branches: may have any # of levels

34
Q

Common Injuries of Brachial Plexus:

Stretching of the Neck

A

Result in Upper Brach. Plex. Injuries
(C5 and C6 roots or upper trunk)

Ex: Falls on shoulder, stretch of head from shoulder, breached births

Deficits: Affect deltoid, biceps, brachial, brachioradialis = extended elbow, medially rotated arm

Erb Palsy, Erb Duschennes Palsy, Upper Radicular Syndrome

35
Q

Common Injuries of Brachial Plexus:

Stretching of the Upper Limb Superiorly

A

Result in Lower Brach. Plex. Injuries
(C8 and T1 roots or lower trunk)

Ex: Breaking a fall, difficult births

Mainly felt in areas supplied by the Ulnar N.

Chronic semi-extension of Chris, paralysis of hand, claw hand

36
Q

“Cervical Nerve”

A

Rarely occurs
Found at C7
Mainly affects the Ulnar N.

37
Q

Radial Nerve Injuries

A

Occur at radial groove or near elbow
Result in wrist drop
Diaphysial fractures, humeral fractures
Weakens extensors

38
Q

Median Nerve Injuries

A 
Occur in the carpal tunnel
Thumb opposition lost
Thumb stuck to palm in a "simian hand"
Large disruption of sensory supply to hand
(repetitive use syndrome)
39
Q

Ulnar Nerve Injuries

A

Occurs at eblow or at wrist

“Results in claw hand or palpal blessing hand”

40
Q

Long Thoracic Nerve Injuries

A

Right on serratus
Crutch injuries
Winged scapula

41
Q

Axillary Nerve Injuries

A

Crutch injuries
Also Surgical neck fractures
Deltoid is compromised, so paraesthesia of shoulder
Proximal arm weakness

42
Q

Thoracic Outlet/Thoracic Inlet Syndrome

A

“Catch all”
Neurovascular compression syndrome
Uncategorable abnormality of the axillary a. or inferior trunk
May result from cervical ribs, enlarged lymph nodes, vascular compression, particular weakness, etc.
*Usually involves the artery if inferior trunk involved
Signs: cold, weak, cyanosis in hands

Gross & Applied Anatomy I (6 decks)

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