Axilla, Anterior Chest and Breast

Question 1

Pyramidal/pyramid-shaped space

Answer 1

Axilla

Question 2

Location of Axilla:

Inferior to _______
Superior to _______

Answer 2

Location of Axilla:

Inferior to Glenohumeral joint
Superior to Axillary fascia at junction of arm and thorax

Question 3

Function of axilla

Answer 3

Passageway “Distribution Center” for neuromuscular structures protected by ADDUCTED upper limb

Question 4

Neuromuscular structures pass through via:

Superiorly:
Anteriorly:
Inferiorly and laterally:
Posteriorly:
Inferiorly and medially:

Answer 4

Neuromuscular structures pass through via:

Superiorly: cervico-axillary canal to and from root of neck
Anteriorly: clavipectoral triangle to the pectoral region
Inferiorly and laterally: into limb itself
Posteriorly: quadrangular space to scapular region
Inferiorly and medially: along thoracic wall to inferiorly-placed axis - appendicular muscles (serratus anterior and latissimus dorsi)

Question 5

T/F: Axilla is an important passage for nerves, blood, and lymph vessels from root of neck to upper limb.

Answer 5

True

Question 6

Boundaries of axila

Answer 6

Apex
Base
4 Walls

Question 7

Causes axilla to rapidly resume the protected position when invasion threatens

Answer 7

Tickle reflex

Question 8

APEX of axilla

Answer 8

Cervico-axillary canal bounded by:

1st rib
clavicle
superior edge of scapula

Arteries, veins, lymphatics, and nerves transverse in this opening to pass to or from the arm

Question 9

BASE of axilla

Answer 9

1. Concave skin
2. Subcutaneous tissue
3. Deep axillary fascia

Deep axillary fascia: from arm to thoracic wall (4th rib level)
Base of axilla forms the axillary fossa

Question 10

Axillary fossa: _______

Answer 10

Armpit

Question 11

2 layers of ANTERIOR WALL of axilla

Answer 11

2 layers of ANTERIOR WALL of axilla

Anterior:
Pecs (Major and minor)
Pectoral and clavipectoral fascia

Inferior:
Anterior axillary fold (may be grasped between fingers)

Question 12

POSTERIOR WALL of axilla

Answer 12

POSTERIOR WALL of axilla

Anterior:
Scapula
Subscapularis

Inferior:
Teres Major
Latissimus Dorsi

Question 13

Inferiormost of posterior wall

Answer 13

Posterior axillary fold

(May be grasped, extends father inferiorly than the anterior wall)

Axillary fold is made up of: Latissimus Dorsi, Teres Major, Overlying Integument

Question 14

MEDIAL WALL of axilla

Answer 14

Thoracic wall (1st - 4th ribs and intercostal muscles), and overlying Serratus Anterior

Question 15

LATERAL WALL of axilla

Answer 15

Narrow bony wall formed by Intertubercular sulcus in the humerus

Question 16

Describe:

Axillary Artery

Answer 16

Begins at lateral border of 1st rib as continuation of subsclavian artery;

Ends at inferior border of teres major

Passes posterior to pectoralis minor in arm&raquo_space; Brachial Artery when it passes inferior border of teres major, and has reached humerus

Question 17

What divides Axillary Artery into 3 parts?

Answer 17

Pectoralis Minor

Question 18

Describe:

1st part of axillary artery

Answer 18

Location: Between lateral border of 1st rib and medial border of pectoralis minor

Enclosed in: Axillary sheath

Has ONE branch = Superior thoracic artery

Question 19

Describe:

2nd part of axillary artery

Answer 19

Location: posterior to pectoralis minor

Has TWO branches:
1. Thoraco-acromial - passes medially to muscle
2. Lateral thoracic arteries - passes laterally to muscle

Question 20

Describe:

3rd part of axillary artery

Answer 20

Location: Extends from lateral border of pectoralis minor to inferior border of teres major

Has THREE branches:
1. Subscapular artery - Largest branch of axillary artery
2. anterior circumflex humeral artery
3. posterior circumflex humeral arteries

Question 21

Which is the largest branch of axillary artery?

Answer 21

Subscapular artery

Question 22

Identify:

Small, highly variable vessel that arises just inferior to subclavius

Answer 22

Superior Thoracic Artery

STA anastomoses with intercostal and/or internal thoracic arteries

Question 23

True or False:

Superior Thoracic Artery commonly runs inferomedially anterior to axillary vein.

Answer 23

FALSE

STA runs inferomedially posterior to axillary vein.

Question 24

Which muscles are supplied to by STA?

Answer 24

Subclavius muscles in 1st and 2nd intercostal spaces
Superior slips of Serratus Anterior
Overlying Pectoral Muscles

Question 25

Short wide trunk, which **pierces costocoracoid membrane**

Answer 25

**Thoraco-Acromial Artery** | Divides into 4 branches: **Acromial, Deltoid, Pectoral, and Clavicular** ## Footnote Divides deep to clavicular head of pectoralis major

Question 26

Arises as the **2nd branch of 2nd part of axillary artery** and descends along lateral border of pectoralis minor ## Footnote From **thoracic wall**, may arise from *thoraco-acromial, suprascapular, or subscapular arteries

Answer 26

**Lateral Thoracic Artery**

Question 27

Lateral thoracic artery supplies the _____________ (5)

Answer 27

**1. Pectoral muscles 2. Serratus anterior 3. Intercostal muscles 4. Axillary lymph nodes 5. Lateral aspect of breast***

Question 28

Axillary artery branch **with the greatest diameter** but *shortest length descends along lateral border of subscapularies on posterior axillary wall*

Answer 28

**Subscapular Artery** ## Footnote Terminates by dividing into: **circumflex scapular artery** and **thoracodorsal artery**

Question 29

**Larger** terminal branch of *subscapular artery*

Answer 29

**Circumflex Scapular Artery** ## Footnote Curves **posteriorly** around **lateral border** of scapula Pass **posteriorly** between **subscapularis and teres major** to *supply muscles on the dorsum of scapula* Participates in **anastomoses** around scapula

Question 30

*Continues the course of subscapular artery to the inferior angle of the scapula* and **supplies** adjacent muscles, principally **latissimus dorsi**

Answer 30

**Thoracodorsal Artery** ## Footnote Participates in **anastomoses** around scapula

Question 31

Encircle surgical neck of humerus, anastomosing with each other

Answer 31

**Circumflex Humeral Arteries**

Question 32

**Smaller** circumflex humeral artery which **passess laterally**, deep to coracobrachialis and biceps brachii

Answer 32

**Anterior Circumflex Humeral Artery** ## Footnote Gives off an **ascending branch** that supplies the shoulder

Question 33

**Larger** circumflex humeral artery which **passes medially** through *posterior wall of axilla via **quadrangular space** with axillary nerve to **supply glenohumeral joint and surrounding muscles**

Answer 33

**Posterior Circumflex Humeral Artery**

Question 34

Formed by union of **brachial vein** and **basilic vein** at the inferior border of teres major ## Footnote Lies **initially (distally)** on **anteromedial** side of axillary artery with its *terminal part antero-inferior to artery*

Answer 34

**Axillary Vein**

Question 35

Three parts that correspond to 3 parts of axillary artery

Answer 35

1. **Initial, distal end** is the *3rd part* 2. **Terminal, proximal end** is the *1st part*

Question 36

*Ends at lateral border of 1st rib*, where it becomes **subclavian vein**

Answer 36

**Axillary Vein** ## Footnote Veins of axilla are: **more abundant than arteries** **highly variable** **frequently anastomose**

Question 37

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