Anatomy of the Axilla

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Questions and Answers

Which anatomical term refers to the armpit?

  • Popliteal fossa
  • Antecubital fossa
  • Axilla (correct)
  • Brachium

What shape best describes the axilla?

  • Pyramidal (correct)
  • Cuboidal
  • Oval
  • Circular

Which of the following structures is NOT located within the axilla?

  • Blood vessels
  • Lymph nodes
  • Nerves
  • Cerebrospinal fluid (correct)

Which of the following bones contributes to the apex of the axilla?

<p>Clavicle (D)</p> Signup and view all the answers

The base of the axilla is primarily formed by what?

<p>Skin and fascia (A)</p> Signup and view all the answers

Which muscle primarily forms the anterior axillary fold that bounds the axilla?

<p>Pectoralis major (C)</p> Signup and view all the answers

Which muscles form the posterior axillary fold?

<p>Latissimus dorsi and teres major (B)</p> Signup and view all the answers

Which of the following structures is NOT considered part of the anterior wall of the axilla?

<p>Serratus anterior (A)</p> Signup and view all the answers

What muscle primarily forms the medial wall of the axilla?

<p>Serratus anterior (A)</p> Signup and view all the answers

Which muscle primarily contributes to the formation of the lateral wall of the axilla?

<p>Coracobrachialis (D)</p> Signup and view all the answers

Which muscles are responsible for forming the posterior wall of the axilla?

<p>Subscapularis, latissimus dorsi, and teres major (B)</p> Signup and view all the answers

Which of the following is NOT a primary content of the axilla?

<p>Esophagus (B)</p> Signup and view all the answers

What type of tissue is most abundant within the axilla, surrounding the neurovascular structures?

<p>Adipose tissue (D)</p> Signup and view all the answers

Which structure encloses the neurovascular bundle within the axilla?

<p>Axillary sheath (B)</p> Signup and view all the answers

The brachial plexus originates from which spinal nerve roots?

<p>C5-T1 (D)</p> Signup and view all the answers

The brachial plexus is located in which triangle?

<p>Posterior triangle (D)</p> Signup and view all the answers

What is the correct order of organization of the brachial plexus, from proximal to distal?

<p>Roots, trunks, divisions, cords, branches (A)</p> Signup and view all the answers

Which vein does the basilic vein become after crossing the lower border of teres major?

<p>Axillary vein (D)</p> Signup and view all the answers

Which vein joins the axillary vein?

<p>Cephalic vein (D)</p> Signup and view all the answers

Which of the following is the correct order of lymph node drainage in the axilla?

<p>Lateral → pectoral → central → apical → subclavian (B)</p> Signup and view all the answers

From which artery does the axillary artery directly originate?

<p>Subclavian artery (A)</p> Signup and view all the answers

Where does the axillary artery transition into the brachial artery?

<p>At the lower border of teres major (A)</p> Signup and view all the answers

The axillary artery is divided into three parts based on its relation to which muscle?

<p>Pectoralis minor (C)</p> Signup and view all the answers

How many branches arise from the first part of the axillary artery?

<p>1 (B)</p> Signup and view all the answers

What is the name of the branch that comes off the first part of the axillary artery?

<p>Supreme thoracic artery (C)</p> Signup and view all the answers

How many branches arise from the second part of the axillary artery?

<p>2 (D)</p> Signup and view all the answers

Which of the following arteries does NOT arise from the second part of the axillary artery?

<p>Subscapular artery (D)</p> Signup and view all the answers

How many branches of the axillary artery come from the third part?

<p>Three (B)</p> Signup and view all the answers

Which artery is typically the thickest branch of the axillary artery?

<p>Subscapular artery (A)</p> Signup and view all the answers

Which of the following arteries supplies the head of the humerus and the shoulder joint?

<p>Anterior and posterior circumflex humeral arteries (B)</p> Signup and view all the answers

The cords of the brachial plexus are named in relation to which structure?

<p>Axillary artery (C)</p> Signup and view all the answers

A surgeon is performing a procedure in the axilla and needs to ligate a vessel to control bleeding. If they ligate the axillary artery proximal to the origin of the thoracoacromial artery, what other artery would be MOST crucial in providing collateral circulation to the upper limb?

<p>Subscapular artery (A)</p> Signup and view all the answers

While dissecting a cadaver, a medical student notices a significant variation in the axilla. The lateral thoracic artery arises directly from the third part of the axillary artery instead of its usual origin from the second part. Which of the following structures would MOST likely be at increased risk of iatrogenic injury during a surgical procedure in this variant axilla?

<p>Long thoracic nerve (A)</p> Signup and view all the answers

A patient presents with lymphedema 6 months following axillary lymph node dissection. Which lymphatic group is MOST likely responsible for the condition?

<p>Apical nodes (B)</p> Signup and view all the answers

A surgeon is planning to perform an axillary lymph node dissection for staging breast cancer. To minimize risk of injury to the thoracodorsal nerve, which muscle should the surgeon carefully retract rather than transect?

<p>Latissimus dorsi (B)</p> Signup and view all the answers

A 60-year-old male presents with compression of the brachial plexus within the axilla due to an expanding hematoma. Which anatomical structure, upon compression, would FIRST cause ischemia of the structures of the arm.

<p>Axillary Artery (D)</p> Signup and view all the answers

During a surgical procedure, the axillary sheath is damaged. Which best describes the MOST immediate consequence of this damage?

<p>Greater potential of injury to the components within the bundle (A)</p> Signup and view all the answers

A patient reports numbness in their lateral arm and difficulty abducting their arm past 15 degrees after a bike accident. Imaging reveals compression of a nerve in the axilla. Which specific nerve is MOST likely compressed, considering the patient's symptoms?

<p>Axillary nerve (B)</p> Signup and view all the answers

What combination of anatomical structures create the cervicoaxillary canal, that connects the neck with the axilla?

<p>The middle third of the clavicle, the upper border of the scapula, and the outer border of the first rib (B)</p> Signup and view all the answers

Flashcards

Axilla

A pyramid-shaped space between the upper arm and chest via which major neurovascular structures pass.

Axilla Apex

The upper part of the axilla directed medially, connecting to the neck's posterior triangle.

Axilla Base

Formed by skin and axillary fascia, creating the lower wall of the axilla.

Anterior wall of axilla

Pectoralis major and minor muscles plus clavi-pectoral fascia. It protects vessels and nerves

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Posterior wall of axilla

Subscapularis, latissimus dorsi, and teres major muscles.

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Medial wall of axilla

Serratus anterior, upper ribs and intercostal muscles.

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Lateral wall of axilla

Coracobrachialis and biceps brachii muscles, and bicipital groove of the humerus.

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Axillary Fossa Contents

Loose connective tissue (fat), axillary artery and vein, axillary lymph nodes, and brachial plexus.

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Brachial Plexus

Cords and branches of the brachial plexus which innervates the structures in upper limb.

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Axillary Artery

Axillary artery and its branches that supply blood to the axilla and upper arm.

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Axillary Vein

Drains blood from the upper limb and joins the axillary vein.

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Axillary Lymph Nodes

Filter lymph fluid and play a role in immune response.

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Axillary Sheath

A sheath enclosing the axillary artery and vein, and brachial plexus (infraclavicular part).

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Brachial Plexus Location

The region in posterior triangle where the brachial plexus is present.

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Brachial Plexus Formation

Formed by the union of anterior rami of spinal nerves from C5 to T1

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Axillary Artery Definition

Continuation of subclavian artery past the first rib, becoming the brachial artery after the teres major muscle

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Axillary Artery Parts

Categorized into three parts based on position relative to the pectoralis minor muscle.

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Posterior Circumflex Humeral Artery

Branches that supply the head of the humerus and the shoulder joint.

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Axillary Vein Connections

Receives basilic vein and continues as the subclavian vein.

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Study Notes

  • The axilla, commonly known as the armpit, is explored to understand its anatomical location, boundaries, and clinical importance.

Axilla

  • A pyramid-shaped space located between the upper arm and the side of the chest
  • Allows neurovascular structures to pass between the neck, thorax, and upper limbs
  • Has an apex, a base, and four walls

Apex

  • Bounded by the middle and anterior scalene muscles
  • The superior border of the scapula and the first rib also define its borders

Base

  • Formed by skin that stretches between the anterior and posterior walls
  • Bounded by the anterior axillary fold, the posterior axillary fold, and the upper 4 to 5 ribs along with the chest wall

Anterior wall

  • Consists of the pectoralis major, pectoralis minor, and clavi-pectoral fascia

Posterior wall

  • Formed by the subscapularis, latissimus dorsi, and teres major muscles

Medial wall

  • A wide structure formed by the serratus anterior muscle
  • Includes the upper 4-5 ribs and intercostal muscles

Lateral wall

  • A narrow structure formed by the coracobrachialis and biceps brachii muscles
  • The bicipital groove of the humerus also contributes to its formation

Contents of the Axilla

  • Loose connective tissue including fat
  • Axillary artery and vein
  • Axillary lymph nodes
  • Brachial plexus which includes cords and branches

Axillary Sheath

  • Encloses the neurovascular bundle in the axilla, which consists of connective tissue
  • Encloses the axillary artery and vein, and the brachial plexus
  • Part of the deep cervical fascia

Brachial Plexus

  • A network of nerves that extends from the neck into the axilla
  • Innervates structures in the upper limb
  • Formed by the union of the anterior rami of spinal nerves C5 to T1
  • Located in the posterior triangle of the neck and axilla.
  • Anterior rami of C5 and C6 unite to form the upper trunk
  • The root of C7 continues as the middle trunk
  • Roots of C8 and T1 unite to form the lower trunk

Axillary Vein

  • Formed by the basilic vein, after it passes the teres major muscle and continues as the axillary vein
  • The axillary vein continues as the subclavian vein, above the 1st rib
  • The cephalic vein joins the axillary vein

Axillary Nodes

  • Include central, pectoral (anterior), humeral (lateral), and subscapular (posterior) nodes
  • Axillary lymph nodes drain in the following way:
    • Anterior and Lateral -> Central -> Apical -> Subclavian trunk
    • Posterior -> Central -> Apical -> Subclavian trunk

Axillary Artery

  • Continuation of the subclavian artery, becoming the axillary artery after the 1st rib
  • Becomes the brachial artery after the teres major muscle
  • Divided into 3 parts based on its position relative to the pectoralis minor muscle.
  • 1st part has 1 branch
    • Supreme (highest) thoracic artery
  • 2nd part has 2 branches
    • Thoracoacromial artery
    • Lateral thoracic artery
  • 3rd part has 3 branches
    • Subscapular artery (thickest branch of the axillary artery)
    • Circumflex scapular artery
    • Thoracodorsal artery
    • Anterior humeral circumflex artery
    • Posterior humeral circumflex artery

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