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Axilla
(the armpit)
Prof. Dr. Selda Önderoğlu
Department of Anatomy
borders
Anterior wall
pectoralis major m.
pectoralis minor m.
Clavipectoral fascia
Posterior
Subscapularis m.
teres major m.
latissimus dorsi m.
Medial
1-4 ribs
İntercostal mm.
serratus anterior m.
Lateral
ıntertubercular
Sulcus
apex
Clavicula (anterior)
1st rib (medial)
superior border of
scapula (post.)
Base
Axillary fascia
skin
contents
Loose connective
tissue
Axillary artery
Axillary vein
Axillary lymph
nodes
brachial Plexus
(infraclavicular
part)
Borders of Axillary Fossa
Prof. Dr. H. Selçuk Sürücü
Base
Skin and axillary fascia
Apex
Anterior wall
Pectoralis major
Pectoralis minor
Clavi-pectoral fascia
Posterior wall
Subscapular
Teres major
Latissimus dorsi
Prof. Dr. H. Selçuk Sürücü
Medial wall
Ribs 1-4
Intercostal mm.
Serratus ant. M.
Lateral wall
Intertubercular
sulcus (groove)
What is inside the fossa?
Loose connective tissue
Axillary a-v
Axillary lymph nodes
brachial plexus
(Infraclavicular part )
Axillary artery
Axillary Artery
(continuation of subclavian a.)
1st part - 1 branch
subclavian a.
after 1st rib becomes
Axillary artery
After teres major m.
becomes
brachial a.
axillary artery is
divided into 3 parts
according to its
position to pectoralis
minor m.
Supreme ( 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 a
Lateral thoracic a
3rd part
of axillary
artery
Anterior circumflex
humeral a
Posterior circumflex
humeral a
Subscapular a
(Thickest branch)
Thorocodorsal a
Circumflex scapular a
Thoracodorsal a
axillary vein
Basilic vein
After:teres major
m.
continues as the
Axillary vein
1st rib
Continues as the
Subclavian vein
Cephalic vein
joins
the axillary vein
Structures piercing clavipectoral fascia
Cephalic v
Thoraco-acromial a
Lymph vess
Lat pectoral n
Axillary Lymph Nodes
Anterior group (pectoral) 4-5
Posterior group (subscapular) 6-7
Lateral group 4-6
Central group 3-4
Apical Group 6-12
Axillary lymph nodes: which group drains where
anterior
posterior
central
apical
Subclavian trunk
lateral
Lymph vessels accompanying cephalic vein
Axillary sheath
deep cervical fascia
Superficial Lamina
Pretracheal Lamina
Prevertebral 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
limb
Formed by the union of anterior rami
of spinal nerves from C5 to T1
Nerves From spinal cord to brachıal plexus
From Spinal cord emerges
Ant. Root+ post. root
Unite&form spinal nerve
Spinal nerve divides into 2 rami (branches)
Anterior ramus and posterior ramus
Rami: plural of “ramus”
Ant. Rami of C5-T1 unite and form the brachial plexus
Prof. Dr. H. Selçuk Sürücü
Brachial plexus
roots
trunks
C5 + C6
Sup. trunk
C7
Middle trunk
C8+T1
Inf.trunk
divisions
Ant
Post
Ant
post
Ant
post
cords
posterior
lateral
medial
n
e
r
v
e
s
C4
C5
C6
C7
C8
T1
superior trunk
middle trunk
inferior trunk
lateral cord
Medial cord
Posterior 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
scapulae
Long thoracic n (C 5-7)
Prof. Dr. H. Selçuk Sürücü
Nn from Trunks (C 5-6)
N to subclavius
Suprascapular n
(Accessory phrenic n)
Nn from Lat Cord (C 5-7)
Lat pectoral n Pectoralis major m
Musculocutaneous n
Lateral root to median n
Nn form Medial Cord (C 8- T1)
Medial root of median n
Medial pectoral nPectoralis muscles
Medial cutaneous n of
arm
Medial cutaneous n of
forearm
Ulnar n
Nn from post cord
Subscapular nn (C 5-6)
Subscapular & teres
major m
Thoracodorsal 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