Download compression of the axillary artery and vein and

COMPRESSION OF THE AXILLARY
ARTERY AND VEIN AND CORDS OF THE
BRACHIAL PLEXUS
AXILLARY ARTERY
• The continuation of the subclavian artery
• Begins at the lateral border of the first rib and
ends at the teres major
• Divided into 3 parts by the pectoralis minor
muscle
• Cords of the brachial plexus are named
according to their position relative to the
axillary artery
Compression of the axillary artery
• The axillary artery can be palpated in the inferior
part of the lateral wall of the axilla.
• Compression of the third part of this artery
against the humerus may be necessary when
profuse bleeding occurs[e.g resulting from a stab
or bullet wound in the axilla]
• If compression is required at a more proximal
site,the axillary artery can be compressed at its
origin[as the subclavian artery crosses the first
rib] by extending downward pressure in the angle
between the clavicle and the inferior attachment
of the sternocladomastoid joint
COMPRESSION OF THE AXILLARY
ARTERY
COMPRESSION OF THE THIRD
PORTION OF AXILLARY ARTERY
AXILLARY VEIN
• Begins at the lower border of the teres major
muscle
• Anterior and medial to the artery
• Continuation of the brachial vein
• Formed from the union of the brachial veins
and basilic vein
• Ends at the lateral border of 1st rib-the
subclavian
COMPRESSION OF THE AXILLARY VEIN
• It is well recognised that after unaccoustomed
use of the arm the axillary vein may thrombose
• The vein intima is thought to be damaged by
excessive movement between the clavicle and
first rib
• Thrombosis produces painful congestion and
oedema of the arm which subside as the
collateral veinous circulation develops
• The serious sequale of veinous thrombosis[e.g
pulmonary embolism] are common following the
axillary vein thrombosis
Compression of the axillary vein cont’d
• A case reported of effort thrombosis of the
axillary vein caused by violent abduction of
the arm raising a 40kg weight above the head
• The close relationship between the axillary
vessels and surrounding anatomical structures
may during violent effort and in a particular
position,cause compression of the vein with
damage to the intima and clot formation
PRE & POST AXILLARY VEIN
COMPRESSION
PHLEBOGRAPHY SHOWING
COMPLETE COMPRESSION OF
THE LEFT AXILLARY VEIN
HEAD OF THE HUMERUS MAY
COMPRESS THE AXILLARY VEIN
COMPRESSION OF THE AXILLARY
VEIN
BRACHIAL PLEXUS
• The brachial plexus is a network of nerve
fibres,running from the spine,formed by
ventral rami of the lower four cervical and first
thoracic nerve roots[C5-C8,T1]
• It proceeds through the neck,the axilla[armpit
region],and into the arm
• It is a network of nerves passing through the
cervico-axillary canal to reach axilla and
supplies brachium,antebrachium and hand.
COMPRESSION OF THE BRACHIAL
PLEXUS
• It may result from prolong hyperabduction of the
arm during performance of manual task over the
head such as painting a ceiling
• The cords are inpinged or compressed between
the coracoid process of the scapula and the
pectoralis minor tendon
• Common neurologic symptoms are pain radiating
down the
arm,numbness,paresthesia[tingling],erythema[re
dness of the skin caused by capillary dilation] and
weakness of the hands
• Compression of the axillary artery and vein
causes Ischema of the upper limbs and
distension of the superficial veins
• The 3 spaces where the brachial plexus can be
compressed in the thoracic outlet
are:Costoclavicular space,interscalene
space,and the retro pectoralis minor space
Thoracic outlet syndrome as a result of
compression of the brachial plexus
T1 weighted magnetic resonance
imaging scan
The 3 spaces where the brachial plexus
can be compressed in the thoracic
outlet