axilla (the armpit) prof. dr. selda Önderoğlu department of anatomy
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Axilla(the armpit)
Prof. Dr. Selda ÖnderoğluDepartment of Anatomy
borders
Anterior wallpectoralis major m.pectoralis minor m.Clavipectoral fascia
PosteriorSubscapularis m.teres major m.latissimus dorsi m.
Medial1-4 ribsİntercostal mm.serratus anterior m.
Lateralıntertubercular Sulcus
apexClavicula (anterior)1st rib (medial)superior border of scapula (post.)
BaseAxillary fasciaskin
contentsLoose connective tissueAxillary arteryAxillary veinAxillary lymph nodesbrachial Plexus (infraclavicular part)
Borders of Axillary Fossa
Prof. Dr. H. Selçuk Sürücü
Base
Skin and axillary fascia
Apex
Anterior wall
Pectoralis majorPectoralis minorClavi-pectoral fascia
Posterior wall
SubscapularTeres majorLatissimus dorsi
Prof. Dr. H. Selçuk Sürücü
Medial wall
Ribs 1-4Intercostal mm.Serratus ant. M.
Lateral wall
Intertubercular sulcus (groove)
What is inside the fossa?
Loose connective tissueAxillary a-vAxillary lymph nodesbrachial plexus (Infraclavicular part )
Axillary artery
Axillary Artery(continuation of subclavian a.)
subclavian a.after 1st rib becomesAxillary artery
After teres major m. becomes
brachial a.
axillary artery is divided into 3 parts according to its position to pectoralis minor m.
1st part - 1 branchSupreme ( highest) thoracic a.
2nd part – 2 brs.Thoracoacromial a.Lateral thoracic a.
3rd part - 3 brs.Subscapular a. (the thickest br. of axill.a.
circumflex scapular a.Thoracodorsal a.
Ant. humeral circumflex a.post. humeral circumflex a.
Ist part of axillary artery
Superior (highest) (supreme) thoracic
a
2nd part of axillary artery
Thoraco-acromial aLateral thoracic a
3rd part of axillary artery
Anterior circumflex humeral aPosterior circumflex humeral aSubscapular a(Thickest branch)
Thorocodorsal aCircumflex scapular a
Thoracodorsal a
axillary vein
Basilic veinAfter:teres major m.continues as the
Axillary vein1st ribContinues as the
Subclavian vein
Cephalic vein joins the axillary vein
Structures piercing clavipectoral fascia
Cephalic vThoraco-acromial aLymph vessLat pectoral n
Axillary Lymph Nodes
Anterior group (pectoral) 4-5Posterior group (subscapular) 6-7Lateral group 4-6Central group 3-4Apical Group 6-12
central
anterior
posterior
lateralapical Subclavian trunk
Lymph vessels accompanying cephalic vein
Axillary lymph nodes: which group drains where
Axillary sheath
deep cervical fasciaSuperficial LaminaPretracheal LaminaPrevertebral Lamina
Axillary sheath
carotid sheath
Axillary sheath encloses:Axillary a.Axillary v.brachial plexus (infraclavicular part)
So: axillary sheath is a part of deep cervical fascia
BRACHIAL PLEXUS
Network of nerves extending from the neck into the axilla It innervates the structures in upper limbFormed by the union of anterior rami of spinal nerves from C5 to T1
Nerves From spinal cord to brachıal plexus
Ant. Root+ post. root
Unite&form spinal nerve
Spinal nerve divides into 2 rami (branches)
Anterior ramus and posterior ramus
From Spinal cord emerges
Ant. Rami of C5-T1 unite and form the brachial plexus
Rami: plural of “ramus”
Prof. Dr. H. Selçuk Sürücü
C5 + C6 Sup. trunk
C7 Middle trunk
C8+T1 Inf.trunk
roots trunks
Brachial plexus
divisionsAntPost
Ant post
Antpost
cords
posterior
lateral
medial
nerves
Trunks
Ant.rami of spinal nn
cordsAnt+post divisions
C4
C5
C6
C7
C8
T1
superior trunk middle trunk inferior trunk
lateral cordMedial cordPosterior cord
clavicle
Parts of brachial plexus
Supraclavicular part- located in the neck
Infraclavicular part-Located in the axilla
clavicle
Nn from Roots
Dorsal scapular n (C5) Rhomboids, levator scapulaeLong thoracic n (C 5-7)
Prof. Dr. H. Selçuk Sürücü
Nn from Trunks (C 5-6)
N to subclaviusSuprascapular n(Accessory phrenic n)
Nn from Lat Cord (C 5-7)
Lat pectoral n - Pectoralis major mMusculocutaneous nLateral root to median n
Nn form Medial Cord (C 8- T1)
Medial root of median nMedial pectoral n- Pectoralis musclesMedial cutaneous n of arm Medial cutaneous n of forearmUlnar n
Nn from post cord
Subscapular nn (C 5-6) Subscapular & teres major mThoracodorsal n (C 5-8)Axillary n ( C5-6)Radial n (C5-T1)
Prof. Dr. H. Selçuk Sürücü
Prof. Dr. H. Selçuk Sürücü
Erb-Duchenne Paralysis(C5-C6)
Klumpke’s paralysis (C8-T1)
Winged scapula: result of damaged long thoracic nerve
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