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The Structural Basis of Medical Practice (SBMP) - Identifications: Axilla and Brachial Plexus
The College of Medicine at The Pennsylvania State University
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Axilla - Boundaries, Arteries, and Brachial Plexus
- Boundaries of Axilla
- Superior boundary - first rib, clavical, upper border of scapula
- Inferior boundary - skin of armpit
- Anterior border - pectoralis major (pectoralis minor)
- Posterior border - teres major, latissimus dorsi, subscapularis
- Medial boundary - thoracic wall (serratus anterior)
- Lateral boundary - intertubercular sulcus (humerus)
- Cephalic vein - entering the axilla by way of the clavipectoral fascia
- Axillary sheath - surrounding the brachial plexus and axillary artery (axillary vein?), invagination of the prevertebral fascia
- Axillary artery - from first rib to inferior border of teres major, divided into 3 parts by anterior relationship of teres minor
- Six branches of the axillary artery
- Superior thoracic artery - first and second intercostal spaces
- Thoracoacromial artery - branches: acromial, deltoid, pectoral, clavicular (acromial and deltoid branches are key players in shoulder anastomosis)
- Lateral thoracic artery - usually off axillary artery (can arise from subscapular or thoracodorsal arteries, runs along thoracic wall about 1-2 inches anterior to long thoracic nerve
- Subscapular artery - terminates as the circumflex scapular (scapular anastomosis) and thoracodorsal arteries
- Posterior humeral circumflex artery - passes through quadrangular space, can arise from subscapular artery, shoulder anastomosis (ascending branch of deep brachial artery)
- Anterior humeral circumflex artery - passes anterior surface of surgical neck of humerus, shoulder anastomosis, can arise from common trunk with posterior humeral circumflex artery
- Cords of the brachial plexus (see the "M" (lonely posterior cord is left out))
- Lateral cord (3) - lateral pectoral n., lateral root median n., musculocutaneous n.
- Medial cord (3) - medial pectoral n., medial root median n., ulnar n., (medial cutaneous nn of arm and forearm)
- Posterior cord (5) - upper subscapular n. (subscapularis), middle subscapular (thoracodorsal n., latissimus dorsi), lower subscapular (subscapularis and teres major)
axillary n. (quandrangular space, deltoid, teres minor), radial n. (triangular interval)
- Long thoracic nerve (nerve to serratus anterior (of Bell)) - vertical descent on thoracic wall about 1.5" posterior to lateral thoracic a.
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The Structural Basis of Medical Practice - Human Gross Anatomy
The College of Medicine
of the The Pennsylvania State University
Email: lae2@psu.edu
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