lecture 10: axilla and upper limb vasculature Flashcards
what is the function of the axilla
funnels vessels and nerves from the neck to the upper limb
where is the only entering of vessels into the UE
the axilla
what is the superior border of the axilla
clavicle, scapula and 1st rib
what is the inferior border/base of the axilla
axillary skin, fascia at the lower borders of the pectorals major, heres major/lat doors
what makes up the posterior wall of the axilla
subscapularis m, teres makor and lat dorsi
what makes up the medial wall of the axilal
serrates anterior
what makes us the anterior wall of the axilla
pectorals major and minor muscles
what makes the lateral wall of the axilla
humerus (inter tub groove)
be able to know the borders of the axilla .
what does the axillary sheath contain
axillary artery, vein and brachial plexus
what tendons pass through the axilla
tendons of biceps brachii and coracobrachialis
true or false: axilla does not have adipose tissue
false, it does
true or false: serrates anterior makes up the medial wall of the axilla
true
does the subscapularis make ip the posterior or anterior wall of the axilla
posterior
what lymph nodes are found i the axilla
axillary lymph nodes
pec major and minor make up what wall of the axilla
anterior
what are the contents of the axilla
1) axillary sheath (axillary a, v and brachial plexus)
2) axillary lymph nodes
3) tendons of the biceps brachii and coracobrach)
4) adipose tissue
what are the 3 vasculature of the axilla and upper limb (UL)
subclavian
axillary artery
brachial artery
where does the subclass exit through
the thoracic inlet
where is the subclavian artery locatied
under the clavicle
what is the first major early branch of the aorta
subclavian
when does the subclav become the axillary artery
after passing under the calvicle
true or false: axilary is divided into 3 parts
true
where is the 1st section of the axillary artery
before the pec minor
where is the 2nd section of the axillary artery
under the pec minor
where is the 3nd section of the axillary artery
after the pec minor
after the axillary arttery passes the pectoralis minor, what does it necome
brachial artery
when does axillary artery become the brachial artery
after passing beyond inferior border of teres major
whta are the bracnes of the subclavian artery
VIT
C and D
(vertebral, internal thoracic, thyrocervical trunk, costocervical trunk. and sometimes dorsal scapularO
where does the vert arterby pass
through the transvere foramina (head and brain)
where does the internal thoracic run and what does it branch into
goes anterior and runs on either side of the sternum and branhces into
-anterior intercostals
-musculophrenic
-sup epigastric
where does the thyrocervical trunk supply (general)
thyroid and neck region
where does the costocervical trunk supply (general)
supply neck and rubs/costal region
why is the dorsal scapular artery only sometimes considered a branch off the subclav artery
cause sometimes i can branch directly from the subclavian or sometimes it can ocome off the thyrocervical trunk
true or false: the dorsal scapular a can branch off the thyrocervical trunk
true
wht are the arterties that branch off the thyrocervical trunk
inferior thyroid
cervical
transverse cervical
suprascapualr
most posterior intercostal arteries arrise from where
thoracic aorta
true or false: most posterior intercostal arteries arrise from thoracic aorta (except for the first two) which some from superior intercostal
true
true or false: most posterior intercostal arteries arrise from thoracic aorta (except for which ones
the first 2
where do the 1st and 2nd posterior intercostals branch off from
superior intercostal
what are the 2 branches off the costocervical trunk
superior intercostal
deep cervical
locate the first part of the axillary artery
b/w clavicle and medial border of the pectoralis minor
what is the branch off of the 1st part of the axillary arterior
superior thoracic
what are the branch off of the 2nd part of the axillary arterior
thoracoacromial trunk
lateral thoracic
locate the second part of the axilalry artery
deep to the pectolaris minor
what are the 4 branches off of the thoracoacromial trunk
clavicular (c)
acromial (a)
deltoid (d)
pectoral (p)
what does the superior thoracic supply
pecs, subclavius and serratus anterior
what does the lateral thoracic supply
secarus anterior
locate the 3rd part of the axillary artery
between the lateraial border of the pec minor and inferior border of the teres major
what are the branches (3-4) of the third part of the axillary artery
subscapular a (circumflex scapular and thoracodorsal)
anterior and posteiror humeral circumflex
true or false: the ant and post humeral circular aa normally arrise fom a common trunk
true
where do the anterior posterior humeral circumflexs surround and why is that dangerous
around the surgical neck of the humerus
(if there is a fracture, compromises vascaularure)
what atery is parallel to the lateral throacic
thoracodorsal
where does the circumflex scapular tranvel, anterior or posterior
posterior
what does the dorsal scapular a supply
lev scap and rhomboids
what does the suprascapular a suppkly
supra and infra spinatus
why are the anastomoses important in the back
because muscles of upper back and shoulder have multiple sources of arterial blood
what are the 3 scapular arterial anastomoses
suprascap and circumflex scap
dorsal scap and circumflex scap
dorsal scap and thoracodorsal
what does the circumflex scapular a supply
the infraspinatus and the teres minor
what does the thoracodorsal a supply
the lat dorsi and t major
whre does the suprascapular a run anterior to
clavicular notch (transverse lig of the scapula)
what do the ant and post circumflex hum aa supply
the humeral head/neck, joint capsule, deltoid
what does the subscapular a supply
subscapularis
where does the subscapular a branch of
3rd part of axillary a
what are the humeral anatstomeses
a/p circumflex hukmreal aa
why is it important to have superficial veins
help with thermal regularion/dissapeat heat
what are the basillic v and cephalic v linked by
median cubital v
where do we do venipuncture
medial cubital v
what are the superficail v
dorsal venous arch
cephalic vein
basilic v
where does the cephalic vein pass thru (anatomical location)
deltopectoral groove
where is the axillary vein loation (anatominal)
axillary sheath
which sup vein is located lateral
cephalic vein
whihch sup vein is located medial
basiclic
what veins drain into the basicallic
paired brachial vv
when does it become axillary v
when the basilic v and paired brach v meet
subclavian goes thry what
the thoracic inlet
basically drains into what
axillary
where does the cephalic v drain
into the axilalry through the clavipectoral fascia
explain the draining of basicallic
basilic v joining paired brachial vv (deep run with the brachian a) to form the axillary vein
explain the draining of cephalic
drains into the axillary veing through the clavipectoral fascia
true or false: deep venous systems typically closely parrello the lymphatic supply
false, arterial suppy
where do some of the veins of the scapula drain into
axillary vein
the deep brachial veins join what to form the axillary vein
basilic
the deep brachial veins join what basically to form twhat
he axillary vein
be able to name the venous supply of the scapula
.
what are the 3 major functions of the lymphatic system
1) removal of excess interstitial fluids (lymph,blood plasma and other fluids extruded thru the cap
2) transports which blood cells (lymphocytes)
3) large role in immune system, nodes in strategic locations
what are some of the stragetic locates for lymph nodes
axilla
knee
elboe
what brings lymph into the lymph node
lymphatic ducts/vessels
lymphatic draining matches what system
venous direction
how many axillary lymph nodes are there
6
whcih 3 nodes join to form the central node
humeral
pectoral
subscapular
what are the 6 axillary nodes
humerall
pectoral
subscapular
centra
apical
supraclavicular
what is the venous angle
convergence of the internal jugular v and the subclavian v
wwhere does the subclavian v drain from
blood fro mthe upper lumb
what does the brachiocephalic v drain
drain bloods from the head, neck, upper lumb
what 2 vessels join to form brachiocephalic
subclavian and internal jugular
convergence of the R/L brachiocephalic veins forms that
superior vena cava
what doe sthe sup vena cava drain into
into the right atrium of heart
where does the internal jugular drain blood from
head neck and brain
where do the axillary lymph nodes drain
the venous angle
what does brachial plexus provude innervation to
provide motor and sensory innervation to upper limb from shoulder to the tip if the fingers
what spinal nerves is the brachial plesux derived from
spinal nerves c5-t1
where is the brachial plexus located
funnels through the axila in close relationship with the axillary artery
true or false: the axillary artery is wrapped by brachial plexus
yes
Subclavian a passes deep to what muscle
Anterior scalene
