MGA Pectoral Region & Axilla 5

pectoralis major

What do #1 and #2 make up?

anchors and depresses clavicle

action of subclavius

anterior axillary fold

formed by the pectoralis major

subclavian artery

label #2 (hint: an artery)

apical, pectoral, subscapular

what are the three primary areas of the lymph nodes in the axillary region?

clavipectoral fascia

what does the question mark represent?

yes

does the axillary vein parallel to the axillary artery?

subscapular artery, anterior and posterior circumflex humeral arteries

what are the three arteries that come off the three divisions of the axillary artery?

axillary artery

what does the subclavian artery turn into?

circumflex scapular and thoracodorsal arteries

what does the subscapular artery bifurcate into?

superior transverse scapular ligament

what does the suprascapular artery go over?

winged scapula

what is the clinical condition of the picture shown?

brachiocephalic trunk

what is the first branch off of the aortic arch from the heart?

cervico-axillary canal (axillary inlet)

what is the name of the red region?

lateral thoracic artery

what is the other artery (besides the thoracoacromial) comes off the second division of the axillary artery?

anterior and posterior walls of axilla

which two walls are the most important to know of the axilla?

axillary inlet

Gateway to the upper limb, lies on each side of the superior thoracic aperture

x = central y = apical z = subclavian lympathic trunk

Humeral, subscapular, and pectoral nodes flow into "x"? Define x. "x" flows into "y". Define "y". "y" turns into the infraclavicular nodes which then turn into "z"? Define "z". Z goes into the right lympathic duct on the right side, and the thoracic duct on the left side.

1; 2; 3

The first division of the axillary artery has ________ main artery coming off of it; the second division has _________ main arteries coming off of it; the third division has ___________ main arteries coming off of it.

damage to the long thoracic nerve and paralysis of the serratus anterior muscle

What causes the medial border of the scapula to protrude away from the thoracic wall producing a "winged scapula"?

flexes an extended arm (not that high yield)

What is the action of pectoralis major's clavicular head specifically?

extends a flexed arm (not that high yield)

What is the action of pectoralis major's sternocostal head?

fascia

a band or sheet of fibrous connective tissue that covers, supports, and separates muscle

when both heads contract together: flexes, adducts, and medially rotates arm

action of pectoralis major

stabilizes scapula by pulling it inferior and anterior

action of pectoralis minor

protracts scapula upward rotation of glenoid helps keep medial border and inferior angle opposed to thoracic wall

action of serratus anterior

the boxer's muscle

another name for serratus anterior

posterior axillary fold

formed by the latissimus dorsi and the teres major muscles

nerve to subclavius (C5, C6)

innervation of subclavius

lateral lip of the intertubercular sulcus

insertion of pectoralis major

coracoid process of scapula

insertion of pectoralis minor

medial border of scapula (anterior surface)

insertion of serratus anterior

middle 1/3 of clavicle

insertion of subclavius

yes

is the dorsal scapular artery one of the major branches that comes off the subclavian artery?

yes

is the suprascapular artery one of the major branches that comes off the thyrocervical trunk?

cords of the brachial plexus

label #1

pectoralis minor

label #1

superior thoracic a.

label #1

brachiocephalic trunk

label #1 (hint: a trunk)

pectoralis major clavicular head

label #1 - specifically which head

lateral pectoral nerve; innervates pectoralis major only

label #1 and what muscle(s) it innervates?

axillary artery and vein

label #2

thoracoacromial a.

label #2

pectoralis major sternocostal head

label #2 - specifically which head

medial pectoral nerve; innervates pectoralis major and pectoralis minor

label #2 and what muscle(s) it innervates?

anterior and posterior circumflex humeral arteries

label #3

axillary lymph nodes

label #3

deltopectoral triangle

label #3

axillary artery

label #3 (hint: an artery)

cephalic vein

label #4

subscapular a.

label #4

brachial artery

label #4 (hint: an artery)

circumflex scapular a.

label #5

radial artery

label #5 (hint: an artery)

thoracodorsal a.

label #6

ulnar artery

label #6 (hint: an artery)

lateral thoracic a.

label #7

medial 1/2 of clavicle (clavicular head); sternum; costal cartilages; aponeurosis of external abdominal oblique (sternoclavicular head)

origin of pectoralis major

ribs 3-5 near costal cartilages

origin of pectoralis minor

ribs 1-8 (or 9)

origin of serratus anterior

rib 1 near costal cartilage

origin of subclavius

armpit region

the axilla is another name for what region?

cervical, axilla, inguinal

what are the three common sites for swollen lymph nodes?

superior thoracic artery

what artery comes off of the first division of the axillary artery?

infection, disease, or cancer

what causes swollen lymph nodes in the cervical, axillary, and inguinal regions?

brachial artery

what does the axillary artery eventually become?

posterior axillary fold

what does the axillary artery have to pass for it to become the brachial artery?

radial and ulnar arteries

what does the brachial artery bifurcate into the forearm?

the first rib

what does the subclavian artery have to pass for it to become the axillary artery?

pectoralis major

what is the primary muscle involved with the anterior wall of the axilla?

anterior axillary fold

what is the question mark pointing to?

posterior axillary fold

what is the question mark pointing to?

thoracoacromial artery or trunk

what is the trunk that comes off the second division of the axillary artery?

seratus anterior

what muscle is most prominent in these pictures?

long thoracic nerve

what nerve is #2?

long thoracic nerve; serratus anterior

what nerve is damaged and what muscle is paralyzed in this picture?

thyrocervical trunk

what trunk comes off the subclavian artery?

subclavian artery and carotid artery

what two arteries does the brachiocephalic trunk bifurcate into?

arm region

where does the apical region of lymph nodes in the axillary region collect up from?

lateral border of the first rib to the medial border of the pectoralis minor muscle

where does the first division of the axillary artery start and end?

anterior thorax

where does the pectoral region of lymph nodes in the axillary region collect up from?

posterior thorax

where does the subscapular region of lymph nodes in the axillary region collect up from?

deep to the pectoralis minor muscle

where is the second division of the axillary artery?

lateral border of pectoralis minor muscle to the posterior axillary fold

where is the third division of the axillary artery?

dorsal scapular artery, circumflex scapular artery,suprascapular artery

which arteries produce a rich anastomoses around the scapula?

lateral wall

which boundary of the axilla is formed by this picture?

medial wall

which boundary of the axilla is formed by this picture?

intertubercular sulcus

which muscle primarily makes up the lateral wall of the axilla?

serratus anterior

which muscle primarily makes up the medial wall of the axilla?

central

All three sets of axillary region lymph nodes (apical, pectoral, subscapular) flow to or from a set called the ____________ lymph nodes.

Clavipectoral Fascia

Both the pectoralis minor and subclavius muscles are invested by the __________________________ which lies deep to the pectoralis major muscle.

superficial

Does the long thoracic nerve run superficial or deep to the serratus anterior?

axillary sheath

Note: The axillary artery, vein and cords of the brachial plexus are surrounded by an extension of the prevertebral cervical fascia known as __________

axilla

Structure passing from the neck region into the arm generally pass through the...

TRUE

TRUE OR FALSE. The dorsal scapular artery runs on the deep surface of the rhomboids.

FALSE. Medial pectoral nerve innervates pectoralis major and minor; lateral pectoral nerve innverates pectoralis major only. Remember: Medial does MORE, lateral does LESS.

TRUE OR FALSE: Medial pectoral nerve innervates pectoralis major only; lateral pectoral nerve innervates pectoralis major and minor.

neck and arm

The Axilla is the gateway between the...

subclavian vein; brachial vein

What vein does the axillary vein come from, and what does the axillary vein turn into?

when a patient is asked to push on a wall with an outstretched (flexed) arm

When is the winged appearance of a winged scapula accentuated?

3

how many divisions does the axillary artery have?

medial and lateral pectoral nerves

innervation of pectoralis major

medial pectoral nerve (C8, T1)

innervation of pectoralis minor

long thoracic nerve (C5, C6, C7)

innervation of serratus anterior

subclavius

label #2

inlet, anterior wall, lateral wall, posterior wall, floor, medial wall

list all 6 of the boundaries of the axilla

pectoral, deltoid, acromial, clavicular

list all four of the thoracoacromial branches

pectoralis major mainly, pectoralis minor, subclavius

what are the borders of the anterior wall of the axilla?

superior border of scapula, 1st rib, clavicle

what are the borders of the axillary inlet?

suscapularis, teres major, latissimus dorsi, long head of triceps

what are the borders of the posterior wall of the axilla?

serratus anterior

what muscle is #1?