Axilla ILM
3 major tributaries of the axillary vein
Cephalic vein, Basilic vein, Brachial veins
Medial cord formed by anterior division of:
Inferior trunk (C8-T1)
lateral pectoral branch off of the lateral cord provides motor innervation to: What is a branch that can sometimes occur here?
pectoralis major sometimes there will be a communicating branch b/t the lateral and medial pectoral nerves
Which muscle runs superficial to the axillary artery?
pectoralis minor
the axillary artery can be divided into 3 divisions based on its location to which structure?
pectoralis minor
the axillary artery continues until the inferior border of______________, to where its name then changes to the:
teres major the brachial artery *to reflect that the artery is now in the arm
pyramidal space located between the anatomical arm and the thoracic wall
the axilla aka - the armpit
Which nerve relates to the 'funny bone'?
ulnar nerve it is very superficial and runs posterior to the medial epicondyle of the humerus - it can be compressed
network of nerves in the neck and axilla that gives rise to the nerves of the UE (including pectoral region)
brachial plexus (C5-T1)
The anterior and posterior divisions of the brachial plexus recombine to form the __________
cords
Where are the divisions of the brachial plexus located?
deep to the clavicle
Where are the cords of the brachial plexus located?
distal to the clavicle
Each division of the axillary artery has branches, and the number of branches corresponds to the number of its ____________
division ex) division 2 will have two branches off the axillary nerve
Important landmark located midway between the anterior and posterior axillary folds and runs down the length of the torso
midaxillary line
median nerve provides motor and sensory innervation to which areas?
motor: MOST of the anterior forearm muscles and SOME of the intrinsic hand muscles sensory: skin of hand
musculocutaneous nerve provides motor and sensory to where
motor: muscles of anterior compartment of arm sensory: terminates at elbow to become the lateral cutaneous nerve of forearm and supplies the skin of the lateral forearm
branch off the superior trunk: suprascapular nerve. What does it provide motor innervation to? What artery does it travel with - and what is important about how they course?
motor: supraspinatus and infraspinatus travels w/ suprascapular artery. Travel through the suprascapular notch with artery above the ligament and the nerve below (ARMY over NAVY)
which nerve is involved in carpal tunnel syndrome?
median nerve to get to the hand it passes through the carpal tunnel
Which arteries belong to the 3rd division of the axillary artery? (portion distal to lateral border of pec minor) what do they supply?
1) Subscapular artery - 2 branches- circumflex scapular a. that supplies scapular region, thoracodorsal a. that supplies latissimus dorsi 2) Anterior circumflex humeral artery that supplies the shoulder and arm 3) Posterior circumflex humeral artery - supplies shoulder and arm - anastamoses w/ anterior circumflex -
which arteries and contained to the 2nd division of the axillary artery? (area of axillary artery deep to pec minor) what do they supply?
1) thoracoacromial artery (splits into a thoracic part that supplies the pec muscles, and an acromial part that supplies the deltoid) 2) long thoracic artery - supplies serratus anterior and pectoral muscles (courses along with the long thoracic nerve)
There are 3 trunks in the brachial plexus, what are their names and their ventral rami?
1. Superior trunk (C5-C6) 2. Middle trunk (C7) 3. Inferior trunk (C8-T1)
axillary artery divisions in relation to pectoralis minor
1st division: b/t lateral border of 1st rib and the medial border of pec minor 2nd division: part of the artery that is found deep to pectoralis minor 3rd division: lateral border of pec minor to the inferior border of teres major
How many 'roots' are in the brachial plexus?
5 (C5-C8, T1)
The axillary vein is formed by which two veins merging? Where does this merger occur?
Brachial veins and Basilic veins they merge at the inferior border of teres major
Which ventral rami form the brachial plexus?
C5-T1
The cords of the brachial plexus are named relative to their position to the ________ artery. Name the cords
Lateral, Posterior and Medial cord named by their position to the axillary artery
Dorsal scapular nerve (branch of the roots) provides motor to which muscles? Travels with which artery?
Motor: rhomboid major and minor, levator scapulae travels w/ dorsal scapular artery, medial to medial border of scapula
long thoracic nerve (branch of the roots) provides motor to which muscles? Travels with what artery and location of path- why is this significant?
Motor: serratus anterior travels w/ lateral thoracic artery along midaxillary line, on superficial surface of serratus anterior injury of long thoracic nerve results in 'winged scapula' - inability to fix scapula on posterior body wall
Which muscles form the anterior and posterior axillary folds?
Pectoralis major forms the anterior axillary fold Latissimus dorsi and teres major form the posterior axillary fold
which artery is contained to the first division of the axillary artery? (b/t 1st rib and proximal pec minor) What does it supply?
Superior thoracic artery supplies the 1st and 2nd intercostal spaces
Posterior cord formed by posterior divisions of:
all trunks (C5-T1)
Each trunk gives rise to:
an anterior and posterior division
In general, the anterior divisions coming off the trunks will give rise to nerves that supply the ______ aspects of the upper extremity including:
anterior including the anterior arm, anterior forearm and palmar hand
posterior circumflex humeral artery travels with _________ nerve through the ___________________.
axillary quadrangular space
Once the subclavian artery passes the lateral border of the 1st rib, its name changes to the:
axillary artery to reflect its new location in the axilla
What is contained within the axillary sheath?
axillary artery, axillary vein, distal portion of the brachial plexus
which 3 arteries participate in an anastomoses on the posterior shoulder blade? (think shoulder arteries - subclavian artery- and axillary artery) Why are anastomoses around the shoulder important?
dorsal scapular artery - medial border of scapula suprascapular artery - superiorly on scapula (BOTH off of subclavian branches) circumflex scapular artery - lateral border of scapula (from subscapular a. of the axillary artery) These alternative pathways can maintain blood flow to the UE if the axillary artery becomes occluded or compromised.
The cephalic vein drains the superficial tissues of the ___________ upper extremity, it will dive deep in the _____________________ to drain into the __________ vein.
lateral deltopectoral triangle (triangle between: clavicle, deltoid, pec major) axillary
Which cords contribute to the median nerve?
lateral and medial cords
The posterior divisions of the brachial plexus give rise to nerves associated with the ___________ compartments of the UE including:
posterior posterior compartments of the arm and forearm and the dorsal hand
What passes through the quadrangular space as they leave the axilla?
posterior circumflex humeral artery & the axillary nerve
Which parts of the brachial plexus are found in the neck?
roots and trunks
5 parts of brachial plexus from proximal (neck) to distal
roots, trunks, divisions, cords, branches (nerves) *Rugby Teams Drink Cold Beer
What are the branches of the subscapular artery and what do they supply?
scapular circumflex artery - supplies the scapula thoracodorsal artery - supplies latissimus dorse
Put in to correct order: a) axillary artery b) subclavian artery c) brachial artery
subclavian a. -> axillary a. -> brachial a. ->
A patient arrives to the emergency room with a stab wound that penetrated a brand of the 3rd division of the axillary artery. What branch was affected? a) dorsal scapular artery b) suprascapular artery c) subscapular artery d) lateral thoracic artery e) superior thoracic artery f) thoracoacromial artery
subscapular artery *part of 3rd division - branches into the circumflex scapular artery and the thoracodorsal artery (supplies the latissimus dorsi)
basilic vein drains the __________ tissues of the _______upper extremity, and when it gets to the _________ it dives deep, then eventually the brachial veins join to basilic vein to form the axillary vein
superfical medial cubital fossa
Lateral cord formed by anterior divisions of:
superior and middle trunks (C5-C7)
Borders of the quadrangular space: superior, inferior, medial, lateral
superior: teres minor inferior: teres major medial: long head of triceps lateral: humerus
what do the anterior and posterior circumflex humoral arteries encircle?
the surgical neck of the humerus
Which is the larger artery, the anterior circumflex humeral artery, or the posterior circumflex humeral artery?
the posterior circumflex artery?