Axilla and brachial plexus

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  1. axilla
    • between the arm and thoracic wall
    • has a base, four walls, and an apex
    • contains brachial plexus and axillary artery
  2. base of axilla
    skin and fascia of the concave armpit
  3. anterior wall of axilla
    pectroalis major and minor
  4. anterior axillary fold
    formed by the lateral border of the pectoralis major
  5. medial wall of axilla
    upper portion of the serratus anterior muscle on thoracic wall
  6. posterior wall of axilla
    • subscapularis muscle above
    • teres major and latissimus dorsi below
  7. posterior axillary fold
    teres major and latissimus dorsi
  8. lateral wall
    intertubercular groove of humerus
  9. apex of axilla
    • 1st rib medially
    • clavicle anteriorly
    • superior border of the scapula posteriorly
    • nerves and blood vessels pass through the apex
  10. axillary sheath
    Extension of the cervical fascia that surrounds the nerves and blood vessels to form a neurovascular bundle
  11. Contents of the axilla
    • lower infraclavicular part of the brachial plexus and branches
    • axillary artery and branches
    • axillary vein and tributaries
    • axillary lymph nodes (20-30 in 5 groups)
    • longhead of biceps
    • short head of biceps
    • coracobrachialis
    • fat and loose areolar tissue
  12. axillary artery
    • from subclavian
    • from lateral border of 1st rib to the lower border of the teres major
    • divided into 3 parts
  13. 1st part axilary artery
    • superior thoracic artery
    • supplies upper part of the thoracic wall including pectoral muscles
  14. 2nd part of axillary artery
    • thoracoacromial artery
    • lateral thoracic artery
  15. thoracoacromial artery
    • 4 branches
    • supply primarily the pectoral muscles and the anterior part of the deltoid
    • CADP
  16. Lateral thoracic artery
    • supplies the pectoral muscles and serratus anterior
    • female - lateral mammary branches to the breast
  17. third part
    • subscapular artery
    • anterior humeral circumflex
    • posterior humeral circumflex
  18. subscapular artery
    • larget branch of the axillary
    • circumflex scapular and thoracodorsal artery
    • supplies the subscapularis, latissimus dorsi, and adjacent muscles
  19. anterior humeral circumflex artery
    runs anteriorly around the surgical neck of humerus and anasomoses with the posterior humeral circumflex
  20. posterior humeral circumflex artery
    runs posteriorly around the humerus and supplies the shoulder joint and adjacent muscles
  21. Formation of the brachial plexus
    • unions of ventral rami and C5-8, and greater part of the ventral ramus of T1.
    • (small contribution may be made by the C4 and T2)
  22. Formations has 5 stages
    Roots, Trunks, Divisions, Cords, Branches

    Robert Taylor Drinks Cold beer
  23. Roots of the plexus
    • five segmentral ventral rami
    • (C5-T1)
  24. Trunks
    • Upper trunk - C5 and 6
    • Middle Trunk - C7
    • Lower Trunk - C8 and T1
    • Each split to form an anterior and posterior division
  25. Lateral cord
    • C5-7
    • Anterior division of upper and middle trunks unite
  26. Medial cord
    • C8 T1
    • Anterior division of the lower trunk continues alone
  27. Posterior cord
    • C5-T1
    • posterior divisions of all 3 trunks unite
  28. Terminal branches
    • Musculocutaneous
    • median nerve
    • ulnar nerve
    • axillary nerve
    • radial nerve
  29. Location of roots and trunks
    • above the clavicle in the posterior trianlge of the neck
    • roots emerge between salenus anterior and scalenus medius muscles
  30. Location of divisions
    behind the clavicle in the apex of the axilla
  31. chords location
    • below the clavicle in the axilla where they are found behind the pectoralis minor muscle
    • surround the 2nd part of the axillary artery on 3 sides
  32. terminal branch location
    lower part of the axilla cords split to form terminal branches
  33. Supraclavicular branches of the plexus
    • from roots:
    • muscular branches for scaleni muscles and longus colli (C5-8)
    • branch that joins the phrenic nerve (C5)
    • Dorsal scapular nerve (C5)
    • Long Thoracic nerve (C5-7)
    • From trunks:
    • Nerve to subclavius (C5,6)
    • Suprascapular nerve (C5, 6)
  34. Infaclavicular
    derived from the 3 cords of plexus, but may be traced through the plexus to the spinal nerves
  35. Lateral Cord Offspring
    • lateral pectoral nerv (C5-7)
    • Musculocutaneous nerve (c5-7)
    • lateral root of median nerve (C5-7)
  36. Medial cord Offspring
    • Medial pectoral nerv (C8 T1)
    • Medial Cutaneous Nerve of Arm (C8 T1)
    • Medial cutaneous nerve of forearm (C8 T1)
    • Ulnar nerve (C7,8 T1)
    • Medial root of median nerve (C8 T1)
  37. Posterior Cord
    • Upper subscapular (C5,6)
    • Thoracodorsal nerve (C6-8)
    • Lower subscapular nerve (C5-6)
    • Axillary nerve (C5-6)
    • Radial Nerve (C5-8 T1)
Card Set:
Axilla and brachial plexus
2011-11-17 05:37:00
arm brachial plexus

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