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Discuss the anatomy of the axilla. Include contents, relationships, boundaries, fascial specializations, vascularization, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.

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  • General:
Area between pec muscles, scapula, arm, thoracic wall (armpit); nerves and vessels pass from neck to upper limb thru this area

Content: • Axillary artery and vein • Brachial plexus • Axillary sheeth • Lymph nodes • Fat and connective tissue

Boundaries: • Superior: Apex o Ant: clavicle o Post: scapula o Med: first rib • Inferior: Base of Axilla o Skin and axillary fascia • Lateral: humerus (intertubercular sulcus) • Medial: Serratus Anterior • Anterior: pec major, minor, clavipectoral fascia • Posterior: teres major, latissimus dorsa, subscapularis

Fascial specialization: • Axillary sheeth: connective tissue encasing axillary a. v. (??) and brachial plexus, prolongation of deep cervical fascia • Suspensory lig of axilla, pec minor fascia, costocoracoid fascia, and subclavius fascia are componenets of clavipectoral fascia • Axillary fascia: deep fascia continuous with suspensory lig

Vascularization: • Scapular anastemosis involving circumflex scapular a, doral scapular a, suprascapular a, subscapular a, ant and post circumflex humeral aa • Branches of axillary a. , which is continuation of subclavian a. : o 1st part (medial to pec minor)  Superior thoracic o 2nd part (posterior to pec minor)  Thoracoacromial br. : deltoid, pectoral, clavicular, acromial  Lateral thoracic a. o 3rd part (lateral to pec minor and inferior to teres major)  Subscapular a.  Anterior & posterior circumflex humeral aa • Veins: cephalic vein drains into axillary vein

Lymphatics: • Lateral nodes, posterior nodes, anterior nodes drain to central node (near the base of axilla) which drains into apical nodes which drain into subclavian trunk

Innervation: • Brachioplexus • Ventral rami C5-T1

Muscles: • Pec Major: adduct and medial rotation of arm; lateral and medial pectoral n. • Pec Minor: depress scapula; lateral and medial pectoral n. • Serratus Anterior: protraction, long thoracic n. • Teres Major: medial rotation, subscapular n. • Teres Minor: lateral rotation, axillary n. • Subclavius: depress clavicle, n. to clavius • Subscapularis: medial rotator, subscapular n (upper and lower) • Latissimus dorsa: medial rotation & adduction thoracodoral n. (middle subscapular n)

Compensation in case of nerve injury (I am not sure about this one): • Injury to long thoracic n. results in winged scapula where the medial border of scapula protrudes • Injury to axillary n. around surgical neck: limits abduction and medial rotation o Compensation: pec major & subscapularis for med rotation -- ZahraKarparvar - 27 Sep 2006 - 20:20

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Topic revision: r1 - 28 Sep 2006, UnknownUser
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