E1B Flashcards
Axilla
axilla
pyramidal shaped space between upper part of arm and side of thorax
axilla function
passage of nerves, blood/lymph vessels between root of neck and upper limb
axilla apex
cervico-axillary canal
directed toward root of neck
axilla apex boundaries
anterior: posterior border clavicle
posterior: superior border scapula
medial: lateral border 1st rib
axilla base boundaries
anterior: anterior axillary fold (pectoralis major)
posterior: posterior axillary fold (teres major, latissimus dorsi)
medial: thoracic wall
axilla anterior wall
pectoralis major/minor
sublclavius
clavipectoral fascia (encloses pec minor, subclavius)
axilla posterior wall
scapula
subscapularis
teres major
latissimus dorsi
axilla medial wall
upper 4 ribs (and intercostal spaces)
serratus anterior
axilla lateral wall (narrowest)
intertubercular (bicipital) groove of humerus
axilla contents
axillary artery and its branches
axillary vein and its tributaries
axillary lymph nodes and vessels
brachial plexus (cords and their branches)
axillary artery origin
lateral border of 1st rib as continuation of subclavian artery
axillary artery termination
inferior border of teres major
becomes brachial artery
axillary artery
surrounded by cords of brachial plexus and their branches
pectoralis minor crosses in front dividing it into 3 parts
1st part of axillary artery
lateral border of 1st rib to medial border pectoralis minor
2nd part of axillary artery
posterior to pectoralis minor
3rd part of axillary artery
lateral border pectoralis minor to inferior border of teres major
1st part of axillary artery branches
superior thoracic artery: supplies upper 2 intercostal spaces
2nd part of axillary artery branches
thoracoacromial artery
lateral thoracic artery
thoracoacromial artery
originates close to medial border of pectoralis minor
pierces clavipectoral fascia
gives off clavicular, acromial, pectoral, deltoid branches
lateral thoracic artery
originates close to lateral border of pectoral minor to thoracic wall
supplies pectoralis muscles, serratus anterior, lateral part of breast
3rd part of axillary artery branches
subscapular artery
anterior/posterior circumflex humeral artery
subscapular artery
usually largest branch of axillary
descents on subscapularis and divides into
circumflex scapular and thoracodorsal arteries
circumflex scapular artery
branch of subscapular
curves around lateral border of scapula (in triangular space) to supply posterior muscles of scapula
thoracodorsal artery (branch of subscapular)
inferior continuation of subscapular artery
supplies posterior wall muscles of axilla
terminates in latissimus dorsi
anterior circumflex humeral artery
anterior part of surgical neck of humerus
posterior circumflex humeral artery
larger than anterior
passes through quadrangle space with axillary nerve
posterior part of surgical neck of humerus
anastomoses with anterior circumflex humeral artery
arterial anastomoses around scapula
dorsal scapular (from subclavian)
suprascapular (from subclavian)
subscapular (from axillary)
arterial anastomoses around scapula
clinical significance
allow for collateral circulation
direction of blood flow is reversed d/t ligation or lesion
axillary vein origin
inferior border of teres major as continuation of basilica vein, ascends medial and anterior to axillary artery
axillary vein terminates
lateral border of 1st rib, becomes subclavian vein
axillary vein tributaries
correspond with branches of axillary artery plus cephalic vein
brachial veins may drain into basilic or axillary veins
axillary lymph nodes
anterior (pectoral) posterior (subscapular) lateral (humeral) central apical subclavian
anterior (pectoral) lymph nodes
lateral border of pectoralis minor close to lateral thoracic vessels
receive lymph from lateral quadrants of breast, anterior thoracic wall, anterior abdominal wall (above umbilicus)
posterior (subscapular) lymph nodes
lie along subscapular vessels
receive lymph from back (above iliac crests)
lateral (humeral) lymph nodes
lie along axillary vein
receive ALL lymph from upper limb EXCEPT that carried by lymph vessels accompanying cephalic vein (apical lymph nodes)
central lymph nodes
lie in center of axilla
receive lymph from anterior, posterior, lateral nodes
apical lymph nodes
lie at apex of axilla
receive lymph from all other axillary nodes plus cephalic vein
efferent vessels from apical group join to form subclavian lymph trunk
subclavian lymph trunk
drains into thoracic duct (left side) and right lymphatic duct (right side) OR
may drain separately at junction of internal jugular and subclavian veins
brachial plexus proximal to distal
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roots trunks divisions cords branches
brachial plexus roots
ventral rami of spinal nerves C5-T1
brachial plexus trunks
superior
middle
inferior
superior trunk brachial plexus
ventral rami of C5-6
middle trunk brachial plexus
ventral ramus of C7
inferior trunk brachial plexus
ventral rami of C8-T1
posterior cord brachial plexus
3 posterior divisions of all 3 trunks
lateral cord brachial plexus
anterior divisions of superior and middle trunks
medial cord brachial plexus
anterior division of inferior trunk
posterior cord terminal branches
axillary nerve C56
radial nerve C51
lateral cord terminal branches
musculocutaneous nerve (C57) lateral root of median nerve
medial cord terminal branches
ulnar nerve (C71) medial root of median nerve
median nerve
lateral and medial roots C61
branches from roots
dorsal scapular C5
long thoracic C57
branches from superior trunk
nerve to subclavius C56
suprascapular nerve C56
branches from posterior cord
upper and lower subscapular nerves C56
thoracodorsal nerve C68
branches from lateral cord
lateral pectoral nerve C57
branches from medial cord
medial pectoral nerve C81
medial brachial cutaneous T1
medial antebrachial cutaneous C81
