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Axilla & Brachial Pl
MSK
| Question | Answer |
|---|---|
| Pyramidal-shaped space between upper arm and thorax | Axilla |
| found between: • clavicle • coracoid process and superior margin of scapula • 1st rib | Axilla |
| Pectoralis major and minor | Anterior (anterior fold) of axilla |
| Teres major, latissimus dorsi, subscapularis | Posterior (posterior fold) of axilla |
| Serratus anterior, ribs | Medial axilla |
| Intertubercular (bicipital) groove of humerus | Lateral axilla |
| Axillary fascia | Floor axilla |
| • Flexion, adduction, and medial rotation of the arm • Medial and lateral pectoral nerves | Pectoralis major |
| • Pulls tip of shoulder down • Medial pectoral nerve | Pectoralis minor |
| • Medial rotation of the arm • Upper and lower subscapular nerves | Subscapularis |
| • Medial rotation, adduction and extension of the arm • Lower subscapular nerve | Teres major |
| • Medial rotation, adduction and extension of the arm • Thoracodorsal nerve | Latissimus dorsi |
| • Rotates scapula upward to allow lifting arm above 90° • Protracts the scapula to keep the medial border against the thoracic wall | Serratus anterior |
| Loss of function of long thoracic nerve causes the medial border, and particularly the inferior angle, of the scapula to elevate away from the thoracic wall, resulting in characteristic “winging” of the scapula, on pushing forward with the arm | Winged Scapula |
| Axillary artery and vein | Vessels of axilla |
| Cords of brachial plexus: lateral, posterior, medial | Nerves of axilla |
| Passageway for the neurovascular bundle from the neck to the upper limb and vice versa | Cervicoaxillary Canal |
| • Divided into 3 parts by the anterior scalene muscle • 1st part: medial to anterior scalene • 2nd part: Posterior to anterior scalene • 3rd part: Lateral to anterior scalene | Subclavian artery |
| (medial to scalene) • Vertebral • Internal thoracic • Thyrocervical trunk a) Transverse cervical i) Deep ii) Superficial b) Suprascapular c) Inferior thyroid | Subclavian artery – 1st part |
| (posterior to scalene): Costocervical (lateral to scalene): Dorsal scapular (if present) | Subclavian artery – 2nd & 3rd parts |
| Continuation of subclavian artery • Begins at 1st rib lateral border (proximal) • Ends at inferior margin of teres major (distal) • Divided into 3 parts by pectoralis minor Proximal Posterior Distal | Axillary artery |
| Superior thoracic | Axillary artery – proximal part |
| a) Thoracoacromial trunk i) acromial ii) pectoral iii) clavicular iv) deltoid • b) Lateral thoracic | Axillary artery – posterior part |
| • a) Subscapular i) thoracodorsal ii) circumflex scapular • b) Posterior circumflex humeral • c) Anterior circumflex humeral | Axillary artery – distal part |
| Deep branch of transverse cervical or Dorsal scapular • branch of thyrocervical trunk • from subclavian artery | Scapular anastomoses |
| • branch of thyrocervical trunk • from subclavian artery | Suprascapular artery |
| • branch of subscapular artery • from distal part of axillary artery | Circumflex scapular artery |
| • circumflex scapular artery | Triangular space |
| • axillary nerve • posterior humeral circumflex artery | Quadrangular space |
| • radial nerve • deep brachial artery | Triangular interval |
| • Formed by basilic vein and paired brachial veins • Begins at inferior margin of teres major • Ends at lateral border of 1st rib • Receives cephalic vein | Axillary vein |
| • Axillary vein may be used for entry into the subclavian vein • Used during insertion of a subclavian venous catheter | Axillary artery and vein |
| Receive lymph from anterolateral thoracic wall and breast | Pectoral (anterior) nodes |
| Receive from posterior thoracic wall, posterior shoulder, and back | Subscapular (posterior) nodes |
| Receive from medial aspect of upper limb accompanying the basilic vein | Humeral (lateral) nodes |
| Receive from anterior, lateral, and posterior groups | Central nodes |
| Receive from all other axillary nodes and superficial lymphatics from lateral aspect of upper limb accompanying cephalic vein | Apical nodes |
| • Surrounds arteries, veins, nerves and lymphatics • Can be used for brachial plexus blocks | Axillary sheath |
| • Thoracic ventral rami innervating trunk remain separate from each other • Ventral rami innervating limbs merge w/adjacent rami to form somatic plexuses • Named nerves arise from plexus & contain fibers from 2/more rami | Somatic Plexus |
| • Formation of the brachial plexus can lead to variations • May be pre-fixed (C4-C8) • Superiormost root is C4 • Inferiormost root is C8 • May be post-fixed (C6-T2) • Superiormost root is C6 • Inferiormost root is T2 | Brachial Plexus Contributions |
| Dorsal scapular • rhomboids • levator scapulae • C4,5 Contribution to phrenic • diaphragm • C5 Long thoracic • serratus anterior • C5-7 | Brachial Plexus: 5 Root |
| Nerve to subclavius • subclavius • C5,6 Suprascapular • supraspinatus • infraspinatus • C5,6 | Brachial Plexus: 3 Trunks |
| Divisions • 3 anterior (AD) • 3 posterior (PD) | Brachial Plexus: 6 Divisions |
Created by:
Zariea
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