Sem 1 - S - Axilla and brachial plexus - Boundaries/Contents (vessels, lymph, nerves, fat, muscle) of axilla - and brachial plexus Flashcards
What runs in the groove between the deltoid and pectoralis major? What is this groove known as?
Bteween the pec major and deltoid is the deltopectoral groove The cephalic veins runs in this groove to drain into the axillary vein

What is the sheet of connective tissue which is the deep layer of fascia in the pectoral region? Can see it when reflecting the pectoralis major What is its purpose?
This is the clavipectoral fascia It acts to supsend the floor of the axilla

What are the attachments of the pectoralis minor and subclavius? State both their functions and nerve supply
Pectoralis minor - Attaches from ribs 3 to 5 to the coracoid process of the scapula
- * Stabilises the scapula by pulling it anteroinferiorly against the body wall (can also elevate the ribs if the shoulders are fixed)
- * Supplied by the Medial pectoral nerve - C8,T1
Subclavius - Attaches from the sternal end of the 1st rib to the underside of the clavicle
- * Stabilises the clavicle by pulling it down and slightly forward during shoulder abduction
- * Supplied by the nerve to the subclavius (C5,6)
The clavipectoral fascia encloses the pec minor and subclavius muscle and acts as a suspensory ligament of the axilla inferiorly Superiorly, between the 1st rib and coracoid process, the fascia is thickened to form what?
Superiorly, between the 1st rib and coracoid process the clavipectoral fascia thickens (like it does inferiorly to form the supsensory ligament of the axilla) to form the Costocoracoid membrane

The clavipectoral fascia lies below the clavicular head of the pectoralis major. It fills in the space between the clavicle and the pectoralis minor. Again state what the clavipectoral fascia acts as? What two muscles does it enclose?
Clavicpectoral fascia acts as the suspensory ligament to the fascial floor of the axilla (suspends the floor of the axilla) It enclose the pectoralis minor and subclavius minor
Which structures pierce through the clavipectoral fascia? What are they piercing to reach?
This would be the: Thoracoacromial artery - to supply the clavicle, acromion, deltoid and pectoral muscles via its terminal branches Cephalic vein to reach the axillary vein Lateral pectoral nerve - to supply the pectoralis major (C5,6,7)

The axilla has different boundaries The roof, floor, anterior wall, posterior wall, medial and lateral walls What shape is the axilla said to be?
The axilla is said to be pyramidal in shape

What forms the roof and floor of the axilla? (roof and floor are called apex and base respectively in some texts)
Roof of the axilla is formed by the clavicle, 1st rib and the scapula The floor is formed by the skin and into the arm

What forms the anterior wall of the axilla?
The pectoralis minor and major The subclavius and fascia

What forms the posterior wall of the scapula?
The subscapularis, teres major, lattismus dorsi and the long head of the triceps brachii

What forms the medial and lateral walls of the axilla?
Medial wall - serratus anterior and wall of thorax Lateral wall - humerus

State the boundaries of the axilla
Roof- Rib 1, Clavicle and the scapula Floor -skin and into arm Anterior wall - pec minor & major, subclavius & fascia Posterior wall - subscapularis, teres major, lattismus dorsi and long head of triceps brachii Medial wall - serratus anterior &wall of the thorax Lateral wall - Humerus

What are the contents of the axilla? (lloking for 5 things)
* Axillary artery and veins * Brachial plexus * Lymphatics * Adipose tissue * Short head of biceps brachii & coracobrachialis

What vein is the basilic vein continous with and when does it become this? What does the basicilic vein drain?
The basilic vein is continous with the axillary vein - it becomes the axillary vein at the inferior border of the teres major The basilic vein drains the posteromedial surface of the hand and forearm
The basilic vein becomes the axillary vein at the inferior border of the teres major (the basilic becomes axillary as the brachial vein also drains into the axillary) (brachial vein is a deep vein) When does the axillary vein become known as the subclavian vein? Does the axillary vein or artery lie anterior?
The axillary vein becomes the subclavian vein at the lateral border of rib 1 The axillary vein lies anterior to the axillary artery in the axilla (axillary artery is wound up in the brachial plexus)

When does the cepahlic vein drain into the axillary vein?
The cepalic vein runs in the deltopectoral groove before piercing the clavipectoral fascia to enter into the axillary vein in the axilla
Immediately posterior to the axillary vein is the axillary artery When does the subclavian artery become the axillary artery? When does the axillary artery become the brachial artery?
The subclavian artery becomes the axillary artery at the lateral border of rib 1 The axillary artery becomes the brachial artery at the inferior border of the teres major
There are three parts to the axillary artery in relation to the pec minor. How is this so?
1st part of axillary artery - proximal (medial) to pec minor 2nd part of axillary artery - posterior to pec minor 3rd part of axillary artery - distal (lateral) to pec minor

Each part of the axillary artery has arteries coming off it 1st part - 1 branch 2nd part - 2 branches 3rd part - 3 branches Name the branches from each of the parts
1st part of axillary artery - superior thoracic artery 2nd part of axillary artery - thoracoacromial artery and lateral thoracic artery 3rd part of axilllary artery - subscapular artery and anterior and posterior circumflex humeral arteries

The superior thoracic artery comes off the 1st part just after it passes beneath the clavicle * Which branch from the 2nd part pierces the clavipectoral fascia? * Which branch from the 3rd part runs in the quadrangular space? * What is the biggest branch from the 3rd part of the axillary artery?
The thoracoacromial artery pierces the clavipectoral fascia to supply the clavicle, acromion, deltoid and pectoral muscles The posterior circumflex humeral artery branch of the 3rd part of the axillary artery runs in the quadrangular space with axillary nerve Subscapular artery is biggest of the third part branches

Axillary nodes drain upper limb but also drain lateral mammillary tissues, upper back and shoulder, lower neck What tail of breast tissue creates the pathway for breast lymphatic drainage?
This would be the tail of spence - the extension of breast tissue that extends into the axilla

How many axillary nodes are there and how many groups are they split into?
Have roughly 20-30 axillary nodes split into 5 groups
In medicine got told about groups of axillary nodes Anterior, posterior, infraclavicular (only useful for the mnemonic), central, apical, lateral What are the 5 groups of axillary nodes in anatomy? Only anterior, posterior and lateral which have their names changed
Pectoral (was anterior) Subscapular (was posterior) Central Apical Humeral (was lateral)
5 groups Pectoral, subscapular, central, apical and humeral Where are each of these groups of axillary nodes located and what do they drain?
- Pectoral axillary nodes - located at the inferior margin of the pectoralis minor draining the thorax and mammary tissue
- Subscapular axillary nodes - located at the posterior axillary wall on subscapularis draining back, shoulder and neck
- Central axillary nodes- located at the axilllary fat behind the pec minor communicating with other nodes
- Apical axillary nodes - located at the superior margin of the pec minor draining the other nodes and mammary tissue
- Humeral axillary nodes - posterior to axillary vein draining the upper limb














