Plexus brachialis Flashcards
How’s plexus brachialis formed by?
ventral/anterior branches of:
- 4 lower cervical spinal nerves (C5 – C8) and
- the first thoracic spinal nerve (T1).
Where does plexus brachialis locate in ?
The spatium interscalenum between m. scalenus anterior et medialis (costa prima). It takes place behind and above a. subclavia.
How is plexus brachialis divided?
Has 3 large truncus:
- Truncus superior formed by ventral branches of C5 and C6 spinal nerves. n. suprascapularis and n. subclavius
- Truncus medius formed by ventral branch of C7 spinal nerve.
- Truncus inferior formed by ventral branches of C8 and T1 spinal nerves.
–> all truncus join and form fasciculus posterior (fibers from C5 – T1) = Divisiones posteriores
–> Divisiones anteriores of truncus superior et medius join and form fasciculus lateralis (fibers C5 – C7)
–> Division anterior of truncus inferior form fasciculus medialis (fibers C8 – T1)
> > These 3 fasciculi enter apertura superior cavi axillaris (bordered by: clavicula, margo superior scapulae,
costa prima).
Topographically plexus brachialis is divided into pars supraclavicularis et pars infraclaviuclaris.
Pars supraclavicularis plexus brachialis
Placed in trigonum colli laterale (bordered by: m. sternocleidomastioideus, m.trapezius, clavicula) and it can be palpate in fossa supraclavicularis major.
7 brances arise from pars supraclavicularis.
- > innervate:
m. pectoralis major et minor (n. pectorales lateralis et medialis)
m. subclavius (n. subclavius)
m. serratus anterior (n. thoracicus longus)
m. latissimus dorsi (N. thoracodorsalis)
m. levator scapulae (n. dorsalis scapulae)
m. rhomboideus minor et major (n.dorsalis scapulae)
m. supraspinatus (n. suprascapularis)
m. infraspinatus (n. suprascapularis)
m. subscapularis (motor neurons of nn.subscapulares)
m. teres major (motor neurons of nn.subscapulares, also N. thoracodorsalis)
art. humeri (n. suprascapularis/subscapulares sensory)
Pars infraclavicularis plexus brachialis
Placed into the axilla. Formed by 3 fasciculus that surrounds a. axillaris:
- fasciculus lateralis
- N. musculocutaneous
- N. medianus - fasciculus medialis
- N. cutaneus brachii medialis
- N. cutaneous antebrachii medialis
- N. ulnaris - fasciculus posterior
- N. radialis
- N. axillaris
Innervate:
m. coracobrachialis (N. musculocutaneus)
m. biceps brachii (N. musculocutaneus)
m. brachialis (N. musculocutaneus)
m. triceps brachii (N. radialis rami musculares)
m. anconeus (N. radialis rami musculares)
the skin on the posterior region of brachii (N. radialis–> n. cutaneous brachia posterior)
the skin to thenar/ art.cubiti (N. cutaneous antebrachii lateralis, r. superficialis n. radialis, r. dorsalis n. ulnaris, n. cutaneous antebrachii medialis)
art. cubiti (rr. articulares n. ulnaris & medianus)
1st and 2nd mm. lumbricales (nn. digitales
palmares communes rr. musculares from n. medianus)
m. abductor pollicis brevis (nn. digitales
palmares communes rr. musculares from n. medianus)
m. opponens pollicis (nn. digitales
palmares communes rr. musculares from n. medianus)
m. flexor pollicis brevis (caput
superficiale) (nn. digitales
palmares communes rr. musculares from n. medianus)
m. pronator teres (N. medianus gives off rr. musculares)
m. palmaris longus (N. medianus gives off rr. musculares)
m. flexor digitorum superficialis (N. medianus gives off rr. musculares)
m. flexor digitorum profundus (radial side, N. interosseus antebrachii anterior from n. medianus)
m. pronator quadratus (N. interosseus antebrachii anterior from n. medianus)
the skin on the medial surface of antebrachii (N. cutaneous antebrachii medialis)
the skin on the medial surface of brachium (N. cutaneus brachii medialis)
mm. interossei palmares et dorsales (ramus profundus n. ulnaris)
III and IV mm. lumbricales (ramus profundus n. ulnaris)
M. adductor pollicis (ramus profundus n. ulnaris)
m. flexor pollicis brevis (ramus profundus n. ulnaris)
m. flexor carpi ulnaris (rr. musculares n. ulnaris)
m. flexor digitorum profundus (pars ulnaris, rr. musculares n. ulnaris)
antebrachii lateral, posterior 1st and 2nd layer muscles (ramus profundus n. radialis )
skin of the posterior surface of antebrachii (n. cutaneous antebrachii posterior n. radialis)
M. deltoideus
M. teres minor
Art. humeri (N. axillaris together with n. suprascapularis/subscapulares sensory)
the skin of the upper arm at the lateral region (n. cutaneous brachii lateralis n. axillaris)
Arteriae membri superioris
a. subclavia
- Arises at the left side from arcus aortae and at the right side from truncus brachiocephalicus
- Continues as a. axillaris behind clavicula
- Extends to cavitas axillaris and becomes a. brachialis
- At fossa cubiti a. brachialis divides into the terminal branches: a. radialis and a. ulnaris
- On the palmar side of the wrist the terminal branches of a. radialis and a. ulnaris from arcus palmaris superficialis et profundus
- These palmar arches supply the hand and the fingers with oxygenated blood
Supply:
m. supraspinatus (a. suprascapularis)
m. infraspinatus (a. suprascapularis branch from a.subclavia)
the upper portion of m. trapezius (r. superficialis a. transversa colli)
mm. superficialis pars posterior colli (r. superficialis a. transversa colli)
mm. rhomboidei (r. profundus or a. dorsalis scapulae from a. transversa colli)
mm. superficialis dorsi (r. profundus or a. dorsalis scapulae from a. transversa colli)
m. subclavius (r. clavicularis of a.thoracoacromialis)
rete acromiale (r. acromialis of a.thoracoacromialis)
m. deltoideus (r. deltoideus of a.thoracoacromialis, a. circumflexa humeri posterior)
m. pectoralis major et minor (rr. pectorals of a.thoracoacromialis)
m. serratus anterior (a. thoracica lateralis, a. thoracodorsalis)
m. pectoralis major et minor (a. thoracica lateralis)
–> skin above them (a. thoracica lateralis)
glandula mammaria (rr. mammarii lateralis of a.thoracica lateralis)
m. subscapularis (a. thoracodorsalis)
m. latissimus dorsi (a. thoracodorsalis)
art. humeri (a. circumflexa humeri posterior)
mm. anterior brachii superficialis (rr. musculares a. brachialis)
mm. posterior brachii (rr. musculares a. profunda brachii from a. brachialis)
mm. antebrachii anterior et lateralis (rr. musculares of a. radials both and of a. ulnaris anterior
mm. profundi antebrachii anterior (rr. musculares a. interossea anterior of ulnaris)
mm. digiti minimi and overlying skin (r. palmaris profundus a. ulnaris)
Lymph vessels of the upper extremity
Lymp vessels of the upper extremity are arranged in 2 networks: deep and superficial.
Supeficial lymph vessels collect the lymph from the skin and subcutaneous tissue. There are 3 groups of
superficial lymp vessels: lateral, medial and anterior. Lymph vessels are divided into 2 groups according to their location and lymph flow direction:
1- Lateral superficial lymph vessels collect the lymph from lateral side of the wrist (1-3 fingers) and
drain it to axillary lymph nodes.
2- Medial superficial lymph vessels collect the lymph from medial side of the wrist (4-5 fingers),
medial side of antebrachii and drain it to the cubital lymph nodes
3- Anterior superficial lymph vessels collect the lymph from the wrist, ventral side of antebrachii and
drain it to the cubital lymph nodes
The deep lymph vessels accompany the deep blood vessels. They collect the lymph from the muscles, tendons,
joints and bones and drain it to the deep lymph nodes.
The lymph nodes of the upper extremity
The lymph nodes of the upper extremity are divided into 2 groups: superficial and deep lymph nodes.
The superficial lymph nodes:
- Nodi lymphoidei supratrochleares
o Placed in fossa cubiti above epicondylus medialis humeri
o Number are from 1 to 2
o Afferent lymph vessels collect the lymph from wrist and medial side of antebrachii
o Efferent lymph vessels accompany v. basilica and deep blood vessels
- Nodi lymphoideideltopectorales
o Number are from 1 to 2
o Lie in sulcus deltoideopectoralis near v. cephalica near clavicula
o Afferent lymph vessels collect lymph from lateral side of antebrachii
The deep lymph nodes:
- Nodi lymphoidei antebrachii
o Lie in upper third of antebrachii along a. ulnaris
- Nodi lymohoidei cubitales profundi
o Placed in fossa cubiti near blood vessels
- Nodi lymphoidei brachiales
o Situated in the middle part of upper arm along a. brachialis
Nodi lymphoidei axillares
high in number (30-45).
- Nodi lymphoidei pectorals
o From 4 to 5
o Lie along the lower border of m. pectoralis minor near a. thoracica lateralis
o Afferent lymph vessels collect the lymph from anterior side of chest, upper part of anterior
abdominal wall, glandulae mammaria.
o Efferent lymph vessels flow into nodi lymphatici centrales and nodi lymphatici subclaviculares - Nodi lymphoidei subscapularis
o From 6 to 7
o Placed along dorsal wall of cavum axillare near a. subscapuralis
o Afferent lymph vessels collect the lymph from the dorsal wall of chest, the upper part of dorsal
abdominal wall, glandulae mammaria
o Efferent lymph vessel flow into nodi lymphoidei centrales - Nodi lymphoidei laterales s. nodi lymphoidei humerales
o From 4 to 6
o Placed near v. axillaris
o Afferent lymph vessels collect the lmph from upper extremity
o Efferent lymph vessels flow into nodi lymphoidei centrales, nodi lymphoidei subclaviculares and
nodi lymphoidei cervicales profundi - Nodi lymphoidei centrales
o From 3 to 4
o Placed in corpus adiposum axillare of the base of the cavum axillare
o Afferent lymph vessels drain the lymph from all lymph nodes of cavum axillare
o Efferent lymph vessels flow into nodi lymphoidei subclaviculares - Nodi lymphoidei infraclaviculares
o From 6 to 12
o Placed above m. pectoralis minor
o Collect afferent lymph vessels that accompanied v. cephalica, the afferent lymph vessels from
glandulae mammaria and other lymph nodes from cavum axillare - Nodi lymhoidei apicales
o Placed at the top of apex cavi axillaris behind clavicula near v. axillaris
o Collect the afferent lymph vessels from other lymph nodes of cavum axillare
o Efferent lymph vessels form truncus subclavius, which flow into ductus lymphaticus dexter or
ductus thoracicus
v. mediana antebrachii
o Ascendes in the middle of the anterior aspect of the antebrachii between v. basilica and v.
cephalica
o In fossa cubiti it flows into v. mediana cubiti
o Sometimes it divides into 2 veins, which join v. cephaliva or v. basilica
v. basilica
o Begins from rete venosum dorsale manus at the ulnar side
o At first passes on the dorsal side of the antebrachii
o On the proximal third of the antebrachii it reaches the anterior side of antebrachii
o In the region of upper arm it lodges in sulcus bicipitalis medialis
o In the middle region it passes together with n. cutaneous antebrachii medialis through fascia
brachii and flows to v. brachialis
- accompanied by efferent lymph vessels coming from nodi lymphoidei supratrochleares and nodi lymphoidei deltopectorales near clavicle
v. cephalica
o Formed on the radial side of rete venosum dorsale manus
o Reachs art. radiocarpalis
o Continues to the anterior side of antebrachii and passes along the radial border till fossa cubiti
o Forms a slanting anasthomose v. mediana cubiti
o Joins to vv. brachiales
o Flows into v. basilica
o In the region of upper arm lodges into sulcus bicipitalis lateralis
o Continues along sulcus deltoideopectoralis
o Reches trigonum clavicopectorale, where it penetrates fascia clavicopectoralis
o Flows into v. axillaris
o In the region of antebrachii it receives unconstant v. cephalica accessoria
o The latter arises from rete venosum dorsale manus
o Form the dorsal side of antebrachii
o Flows into v. cephalica distally from art. cubiti
vv. superficiales s. vv. subcutaneae
Form rete venosum dorsale manus on the dorsal surface of the wrist, the latter being formed by networks of
vv. digitales dorsaes and the vein continuations of vv. metacarpales dorsales.
v. cephalica
v. basilica
v. mediana antebrachii
N. musculocutaneous
(C5 – C7)
Passes sidelong, penetrates m.coracobrachialis. Passes between m. biceps brachii and m. brachialis.
> Nerve is placed into sulcus bicipitalis lateralis
> runs laterally from distal tendon of m. biceps brachii above
epicondylus lateralis
> penetrates fascia brachii
> passes downwards to the anterior antebrachii region as n.cutaneous antebrachii lateralis.
> N. musculocutaneus gives off rr. musculares (= plur. =“rami”, sing.
= “ramus”, muscular branches), supply:
o m. coracobrachialis
o m. biceps brachii
o m. brachialis
> N. cutaneous antebrachii lateralis innervate the skin on the lateral region of forearm till thenar and art. cubiti
> Skin branches can join
o r. superficialis n. radialis
o r. dorsalis n. ulnaris
o n. cutaneous antebrachii medialis
N. medianus
A mixed nerve and it is formed by joining of radix lateralis C6
– C7 and radix medialis C8 – T1.
> Nerve is placed in axilla in front of a. axillaris
> Passes together with vasa brachialia along sulcus bicipitalis medialis
> In fossa cubiti n. medianus is below aponeurosis of m. biceps brachii, where it penetrates m. pronator teres
> Lodges between m. flexor digitorum superficialis et profundus and reaches sulcus medianus antebrachii
> Enters through canalis carpi and divides into nn. digitales palmares communes
N. medianus branches
- rr. musculares
-to the anterior group of
forearm muscles:
o m. pronator teres: flexio et pronatio antebrachii
o m. flexor carpi radialis: flexio et abductio manus
o m. palmaris longus: flexio manus
o m. flexor digitorum superficialis: flexio phanalx mediae et proximalis, flexio manus - N. interosseus antebrachii anterior
- to the mm. profundi antebrachii
o m. flexor digitorum profundus (radial side): flexio phalanx distalis, mediae et proximalia, flexio manus
o m. pronator quadratus: pronatio antebrachii et manus - rr. articulares
- arise from n. medianus that innervates art. cubiti and art. radiocarpalis - nn. digitales palmares communes
- Placed beneath aponeurosis palmaris at the level of 1st, 2nd, 3rd spatium intermetacarpales.
- All these 3 nerves gives of motor
fibers rr. musculares
–> innervate:
» 1st and 2nd mm. lumbricales (flexio phalangis proximalis, extensio phalanx mediae et distalis)
» m. abductor pollicis brevis (abductio pollicis)
» m. opponens pollicis (oppositio pollicis)
» m. flexor pollicis brevis (caput
superficiale, flexio pollicis) - nn. digitales palmares communes:
- divides into 7 nn. digitales palmares proprii
1st nn. digitales palmares communes gives of 3 nn. digitales palmares proprii
- medial and
- lateral side of pollicis
- radial side of indicis.
2nd nn. digitales palmares communes divides into 2 nn. digitales palmares proprii
- ulnar side of indicis
- radial side of middle finger
3rd nn. digitales palmares communes divides into 2 nn. digitales palmares proprii
- ulnar side of third finger
- radial side of ring finger.
> > nn. digitales palmares proprii wing from palmar side of the fingers to dorsal side
supply the skin on the:
o palmar side of pollicis, index finger and middle finger
o radial side of ring finger
o dorsal surface of phalangis distalis et media (for these fingers)
a. radialis branches
1) a. recurrens radialis
- Arises at fossa cubiti laterally from a. radialis
- Runs along sulcus cubitalis anterior lateralis
- Forms anastomosis with a. collateralis radialis from a. profunda bachii
> Both take part in the formation of rete articulare cubiti
2) rr. musculares
Supply mm. antebrachii anterior et lateralis
3) r. palmaris superficialis
Arises from a. radialis at the level of processus styloideus radii
On the palmar side of the wrist it gives blood supply to thenar muscles group and the skin over them
- Makes anastomosis with with terminal branch of a. ulnaris
x Form arcus palmari superficialis
4) r. carpalis palmaris
- Arises from a. radialis at the lower part of antebrachii
- Forms anastomosus with r. carpalis palmaris from a. ulnaris
- Branches from rete carpi palmare
5) r. carpalis dorsalis
- Arise from a. radialis at the dorsal side of the wrist in the “snuff box”
- Gives off 3 branches aa. digitales dorsales
x Supply the dorsal side of index finger from radial side and the pollicis
6) a. metacarpals dorsalis prima
- arises from a.radialis at the dorsal side of the wrist in the snuff box
- gives off 3 branches: aa. digitalis dorsal that supply the dorsal side of the index finger from radial side and the thumb
7) a. princeps pollicis
- Arise from a. radialis at the palmar side of the wrist
- Gives off 3 branches aa. digitales palmares
x Supply the palmar side of the thumb
and the radial side of the index finger
Anastomosis
- N. cutaneus brachii medialis to the
skin branches of the 2nd n. intercostalis. - with a. subscapularis from a. axillaris
- to a. suprascapularis from a. subclavia’’
- with a. circumflexa humeri posterior & -“- anterior
- a. collaterals radialis from a. profunda brachii (brachialis) with a. recurrens radialis from a. radialis
- a. collaterals medialis from a. brachialis to a. interossea recurrens from a. interossea
posterior
–> both aa. Collaterialis and their anastomoses form rete articulare cubiti - a. collateralis ulnaris inferior from a. brachialis to ramus anterior from a. recurrens ulnaris
- a. radialis with r. palmaris profundus from a. ulnaris
- r. palmaris superficialis with terminal branch of a. ulnaris = arcus palmari superficialis
- r. anterior of a. recurrens ulnaris with a. collateralis ulnaris inferior from a. brachialis
- r. posterior of a. recurrens ulnaris with a. collateralis ulnaris superior from a. brachialis
- a. interossea posterior with a. collateralis media from a. profunda brachii –> Terminates in rete carpale dorsale
- r. palmaris profundus with terminal part of a. radialis to form arcus palmaris profundus
- v. thoracoepigastrica between v. cava superior et inferior
Spatium interscalenum
m. scalenus anterior
m. scalenus medius
costa prima
behind it arteria subclavia –> a. transversa colli
nerves of plexus brachialis
Fasciculus posterior
n. radialis / axillaris
nn. subscapularis and n. thoracodorsalis
N. radialis (also branches)
In cavitas axillaris behind a. axillaris
> In brachial region it passes in Canalis humeromuscularis s. canalis n. radialis
- in canalis n. radialis gives off motor branches rr. musculares to:
- m. triceps brachii: (extensio antebrachii, caput longum – extensio et adductio brachii)
- m. anconeus (extensio antebrachii)
- Gives also n. cutaneous brachii posterior –> Supply the skin on the posterior region of brachii
- Leaves canalis n. radialis through lower opening, lodges in sulcus cubitalis anterior lateralis where it divides into 2 braches: ramus superficialis
- Passes along sulcus radialis antebrachii downwards
- Runs beneath the tendon of m. brachioradialis
- Reach the dorsal surface of the wrist, divides into - > > 5 nn. digitales dorsales, supply the skin on:
- The dorsal surface of the wrist at radial side over
phalanx proximalis pollicis et indicis
- Radial side of phalanx proximalis of middle finger - et ramus profundus
- Passes through m. supinator
- With rr. musculares innervate posterior and lateral muscle groups of antebrachii
* Lateral muscle group
o M. brachioradialis
o M. extensor carpi radialis longus
o M. extensor carpi radialis brevis
* Posterior muscle group 1st layer
o M. extensor digitorum
o M. extensor digiti minimi
o M. extensor carpi ulnaris
* Posterior muscle group 2nd layer
o M. abductor pollicis longus
o M. extensor pollicis brevis
o M. extensor pollicis longus
o M. extensor indicis
o M. supinator - > > Gives off n. cutaneous antebrachii posterior
- Innervate skin of the posterior surface of antebrachii - > > > Terminal end n. interosseus antebrachii posterior passes along the dorsal side
of membrana interossea antebrachii, innervate
o Mm. profundi antebrachii posterior
o Gives off rr. articulares to articulation of the wrist at radial side
retinaculum musculorum extensorum
6 canals, 9 muscles
- m. abductor pollicis longus & m. extensor pollicis brevis
- m. extensor carpi radialis longus & brevis
- m. extensor pollicis longus
- m. extensor digitorum & indices
- m. extensor digiti minimi
- m. extensor carpi ulnaris
sulcus deltoipectoralis
b. m. deltoideus / m. pectoralis major
Nodi lymphoideideltopectorales lie there near v. cephalica near clavicula
trigonum clavipectorale
clavicula, m. pectoralis minor, sternum
- v. cephalica
- a. axillaris to
1) a. thoracica superior - Branches out at 1st and 2nd spatium intercostale
2) a. thoracoacromialis
- Short trunk that wings around upper border of m. pectoralis minor medially
- Penetrates fascia clavicopectoralis
Divides into 4 branches:
x r. acromialis, from rete acromiale
x r. clavicularis, supplies m. subclavius
x r. deltoideus, passes to m. deltoideus
x rr. pectorals, run to m. pectoralis major et minor and supply them
trigonum pectorale
m. pectoralis minor
a. axillaris –> a. thoracica lateralis
- arise at the lateral border of m. pectoralis minor
- passes along external side of m. serratus anterior below fascia pectoralis
- supplies m. serratus anterior, m. pectoralis major et minor and skin above them
- rr. mammarii lateralis supplies glandula mammaria
glandula mammaria
nodi lymphoidei pectoralis / infraclavicularis / subscapularis
supplied by rr. mammarii lateralis a. thoracica lateralis
The anatomical snuff box
Snuff box is limited by tendons of m. abductor pollicis longus et m. extensor pollicis brevis from
the one side. From the other side limited by tendon of m. extensor pollicis longus.
a. radialis
- -> r. carpalis dorsalis
- -> a. metacarpals dorsalis prima
- arises from a.radialis at the dorsal side of the wrist in the snuff box
- gives off 3 branches: aa. digitalis dorsal that supply the dorsal side of the index finger from radial side and the thumb
trigonum subpectorale
m. pectoralis minor: lower border
m. pectoralis major; upper border
m. deltoideus: anterior border
a. axillaris:
- -> a. subscapularis: short/largests
- -> a. circumflexa humeri anterior
- -> a. cirrcumflexa humeri posterior
1) a. subscapularis
- Largest branch of a. axiilaris, a short vessel
- At the level of lateral border of m. subscapularis gives off 2 branches
* 1. a. thoracodorsalis
o accompanied by n. thoracodorsalis
o extends to lateral border of scapula between m. serratus anterior, m. subscaularis and m. latissimus dorsi
–> supplies these muscles
* 2. a. circumflexa scapulae o passes through foramen trilaterum o extends to fossa infraspinata o forms anastomosis to a. suprascapularis from a. subclavia o forms rete dorsalis scapulae
2) a. circumflexa humeri anterior
- A small branch in front of collum chirurgicum humeri
- Extends behind m. coracobrachialis and m. biceps brachii
- Lodges along sulcus intertubercularis to art. humeri
- Forms anastomosis with a. circumflexa humeri posterior
3) a. circumflexa humeri posterior
- a. circumflexa humeri posterior passes through foramen quadrilaterum with n. axillaris
- Supplies art. humeri and m. deltoideus
- Anastomosis with a. circumflexa humeri anterior
fascia brachii
v. basilica passing together with –> n. cutaneous antebrachii medianus (and flows too v. brachialis)
n. musculocutaneous penetrates it
fossa infraspinata
- a. subclavia –> a. suprascapularis
o Arises from truncus thyrocervicalis
o Extends to venter inferior m. omohyoidei and n. suprascapularis to incisura scapulae
o Passes above lig. transversum scapulae superius
o Supply the muscles in fossa supraspinata and fossa infraspinata
o At collum scapulae there is anastomosis with a. subscapularis from a. axillaris
- a. circumflexa scapulae (from a. subscapularis from a. axillaris)
o passes through foramen trilaterum
o extends to fossa infraspinata
o forms anastomosis to a. suprascapularis from a. subclavia
o forms rete dorsalis scapulae
Spatium interscalenum
m. scalenus anterior
m. scalenus medius
costa prima
arteria subclavia
nerves of plexus brachialis
a. subclavia –> a. transversa colli
cavum axillare
apertura superior: clavicula, margo superior scapulae, costa prima
apertura inferior: A m. pectoralis major, P m. latissiimus dorsi, M m. serratus anterior, L m. coracobrachialis
Lateral wall: m. coracobrachialis & humerus
Medial wall: m. serrates anterior
Anterior wall; m. pectoralis minor & major
Posterior wall: m. teres minor & major, m. subscapularis, m. triceps brachii caput longum, m. latissiimus dorsi
- n. axillaris enters it
- a. axillaris enters and passes through and then continues as a. brachialis
a. subclavia
- -> a. brachialis
- 2 vv. brachialis flow into one v. axillaris
The lymph nodes in cavum axillare are high in number (30-45). Nodi lymphoidei axillares are divided into
following groups:
Nodi lymphoidei pectorals / subscapularis / laterales s. humerales / centrales / infraclaviculares / apicales
Foramen trilaterum
m, teres minor
/major,
m. triceps brachii caput longum
a. circumflexa scapulae
o extends to fossa infraspinata
o forms anastomosis to a. suprascapularis from a. subclavia
o forms rete dorsalis scapulae
Foramen quadrilaterum
Humerus, m, teres minor/major, m. triceps brachii caput longum
n. axillaris
a. circumflexa humeri posterior
- Supplies art. humeri and m. deltoideus
- Anastomosis with a. circumflexa humeri anterior
VENA CIRCUMFLEXA HUMERI POSTERIOR
Sulcus bicipitalis medialis
a. brachialis
a. collaterals ulnaris superior (branch from a. brachialis)
n. ulnaris
n. medianus
vasa brachilia
v. basilica
fossa cubiti
lateral border: m. brachioradialis
medial: m. pronator teres
base: m. brachialis
Sulcus cubitalis anterior lateralis:
- n.radialis —> rr. superficialis & profundus
- a. collateralis radialis from a. brachialis
- a. recurrens radialis from a. radialis
Sulcus cubitalis anterior medialis:
- a. collateralis ulnaris inferior from a. brachialis
- r. anterior from a. recurrens ulnaris from a. ulnaris
Sulcus cubitalis posterior medialis:
- n. ulnaris
- a. collateralis ulnaris superior from a.brachialis
- r. posterior from a. recurrens ulnaris from a. ulnaris
sulcus cubitalis posterior lateralis:
- a. interossea recurrens from a. interossea posterior from a. interossea communis from a. ulnaris
- a. collateralis medialis from a. profunda brachii from a. brachialis
- nodi lymphoidei supratrochleares/cubitales profundi (2)
- a. brachialis
- > a. radialis -> a. recurrens radialis
- > a. ulnaris
- v. cephalica forms anastomose with v. mediana cubiti
- v. mediana antebrachii flows into v. mediana cubiti
- n. medianus (below aponeurosis of m. biceps brachii)
- n.radialis —> rr. superficialis & profundus,
sulcus bicipitalis lateralis
continuation of sulcus deltoideopectoralis
n. musculocutaneous
v. cephalica
canalis n. radialis
s. canalis humeromuscularis
sulcus n. radialis
a. profunda brachii divides into a. collaterals radialis and medialis
M. subscapularis
a. subscapularis
–> a./ n. thoracodorsalis (supplied by the artery)
–> a. circumflexa scapulae
(also some supply from a. suprascapularis and a. thoracica lateralis)
n. axillaris passes along
nn. subscapulares and its motor neurone innervate it
(on posterior wall of cavum axillare)
M. serratus anterior
Supplied by a. thoracica lateralis (below fascia pectoralis)
Innervated by N. thoracicus longus (elevatie brachii)
a. thoracodorsalis from a. subscapularis trigononum subpectorale from a. axillaris (also some supply + a. thoracica superior from a. axillaris in trigononum clavipectorale)
M. biceps brachii
innervation: rr. muscular from n. musculocutaneous goes below and in the lateral sulcus
n. medianus and a. brachialis (supply) below its aponeurosis
extends behind a. circumflexa humeri anterior (from trigononum subpectorale a. axillaris) = supply
sulcus medianus antebrachii
n. medianus b. m. flexor digitorum superficialis et profundus
sulcus ulnaris antebrachii
n. / a. / 2 vv. ulnaris
sulcus radialis antebrachii
a. radialis / 2 vv. radiales / r. superficialis n. radialis
collum scapulae
a. suprascapularis has anastomosis with a. subscapularis from a. axillaris