Axilla and Brachial Plexus Flashcards
Axilla
Pyramidal shaped region between arm & chest
Pec. major & minor mm. = Anterior wall
Lat. dorsi, teres major & subscapularis mm. = Posterior wall
Serratus anterior m. = Medial wall
Intertubercular sulcus of humerus = Lateral wall
Skin & Fascia of armpit = base
Axilla boundaries
Pectoralis major & minor mm. = Anterior wall
Lat. dorsi, teres major & subscapularis mm. = Posterior wall
Serratus anterior m. = Medial wall
Intertubercular sulcus of humerus = Lateral wall
Skin & Fascia of armpit = base
Axilla
Muscles in the lateral wall
include the Coracobrachialis (larger and posterior); & anteromedially = short head of Biceps m.; anterolaterally = Long head of Biceps m.
Axilla: Contents
Fat & connective tissue
Axillary v. & lymphatics (outside sheath)
Cutaneous nerves
Axillary sheath – axillary a. & brachial plexus
Axillary nodes
in fat; 5 principle groups:
pectoral nodes (anterior): 3-5 nodes near the lateral thoracic v. & inferior border of the pectoralis minor m. – receiving lymph from ant. thoracic wall and most of breast.
subscapular nodes (posterior): 6-7 nodes along subscapular vessels – receiving lymph from the post. thoracic wall and scapular region
humeral nodes (lateral): 4-6 nodes along lateral axilla and around axillary v. – receiving lymph from UL except for the portion along the cephalic v. which drain into the apical axillary and infraclavicular nodes.
central nodes: 3-4 large nodes deep to pectoralis minor
apical nodes: receive lymph from all the other groups of axillary nodes as well as the proximal cephalic v. nodes; forms the subclavian lymphatic trunk and may be joined by the jugular and bronchomediastinal trunks on the Rt side to form the Rt lymphatic jugular duct OR on the left the subclavian trunk most commonly joins the thoracic duct.
pectoral nodes (anterior)
(anterior): 3-5 nodes near the lateral thoracic v. & inferior border of the pectoralis minor m. – receiving lymph from ant. thoracic wall and most of breast.
subscapular nodes
(posterior): 6-7 nodes along subscapular vessels – receiving lymph from the post. thoracic wall and scapular region
humeral nodes
(lateral): 4-6 nodes along lateral axilla and around axillary v. – receiving lymph from UL except for the portion along the cephalic v. which drain into the apical axillary and infraclavicular nodes.
central nodes
3-4 large nodes deep to pectoralis minor
apical nodes
receive lymph from all the other groups of axillary nodes as well as the proximal cephalic v. nodes; forms the subclavian lymphatic trunk and may be joined by the jugular and bronchomediastinal trunks on the Rt side to for the Rt lymphatic jugular duct OR on the left the subclavian trunk most commonly joins the thoracic duct.
Sensory Innervation of UL
Sensory = cutaneous
Axillary sheath
contains the axillary a., nerves, veins and lymphatics
Location of the sheath is down the medial aspect of the arm
Axillary artery
Arises from the subclavian a. at the lateral border of the 1st rib
gives rise to the brachial a. at the inferior border of the teres major m.
superiorly located branches of the subclavian a.: Suprascapular a. & Dorsal Scapular a. will
anastomose with the more inferiorly found Circumflex scapular arterial branch of the subscapular a from the 3rd part of the Axillary a.
deep transverse cervical branch will
anastomose with the dorsal scapular a.
Axillary Artery: 3 Parts
1st: between 1st rib & pec. minor m.
Gives off Superior thoracic a.
2nd: deep to pec. minor m.
Gives off Thoracoacromial & Lateral Thoracic aa.
3rd: between pec. minor & teres major mm.
Gives off Subscapular, Anterior, & Posterior Circumflex Humeral aa.
The Brachial Plexus
Composed of ventral rami C5-T1
Provides nerves for all UL mm. except trapezius m. (innervated by CN XI)
8 cervical nn., but only 7 cervical vertebrae
C1-C7 nn. emerge above C1-C7 vertebrae
C8 n. emerges below C7 vertebra
All other spinal nerves emerge below vertebrae of same number
Structure of Brachial plexus
Rami (5): emerge in upper neck Trunks (3): form in lower neck Divisions (6): split off behind clavicle Cords (3): form in axillary region Branches (5): split off in upper arm