Axilla and Pectoral Region
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Questions and Answers

Which muscle is responsible for protraction and rotation of the scapula upward?

  • Serratus Anterior (correct)
  • Teres Major
  • Pectoralis Minor
  • Latissimus Dorsi

    • Which nerve innervates the Serratus Anterior muscle?

  • Axillary Nerve
  • Radial Nerve
  • Long Thoracic Nerve (correct)
  • Medial Pectoral Nerve

    • What action does the Pectoralis Minor muscle perform on the shoulder?

  • Retracts scapula
  • Depresses scapula (correct)
  • Elevates ribs
  • Protracts scapula

    • Which anatomical space contains the circumflex scapular artery?

    <p>Triangular Space</p> Signup and view all the answers

    What is the role of the Long Thoracic Nerve in relation to the scapula?

    <p>Protracts the scapula</p> Signup and view all the answers

    Which muscle in the posterior wall of the pectoral region is responsible for extending the elbow joint?

    <p>Long Head of Triceps Brachii</p> Signup and view all the answers

    What is the clinical importance of arterial anastomoses at the shoulder?

    <p>Provides alternative pathways in case of blockages</p> Signup and view all the answers

    In terms of origins, insertions, actions, innervations, and blood supply, which muscle is part of the pectoral region?

    <p>Teres Major</p> Signup and view all the answers

    What feature facilitates winging of the scapula?

    <p>Inferior Angle</p> Signup and view all the answers

    Which structure acts as a passageway between the neck and upper limb?

    <p>Axilla</p> Signup and view all the answers

    What is the primary innervation of the deltoid muscle in the shoulder region?

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

    Which feature of the scapula is crucial for the attachment of the long head of triceps muscle?

    <p>Infraglenoid Tubercle</p> Signup and view all the answers

    Where does the Brachial Artery begin?

    <p>At the inferior border of teres major</p> Signup and view all the answers

    Which artery travels in the spiral groove of the humerus with the radial nerve?

    <p>Deep artery of the arm (profunda brachii)</p> Signup and view all the answers

    Which artery supplies muscles in the 1st and 2nd intercostal spaces?

    <p>Superior thoracic artery</p> Signup and view all the answers

    Which artery has branches that include acromial, deltoid, pectoral, and clavicular?

    <p>Thoracoacromial trunk</p> Signup and view all the answers

    Where does the Subscapular artery have two terminal branches?

    <p>Posterior to pectoralis minor muscle</p> Signup and view all the answers

    Which vessel is a terminal branch off the brachiocephalic trunk?

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

    What is the primary function of the axillary sheath?

    <p>To provide a protective layer around the axillary vessels and brachial plexus</p> Signup and view all the answers

    What is the primary role of the brachial plexus in the axillary region?

    <p>To innervate the muscles of the shoulder and upper arm</p> Signup and view all the answers

    What is the primary function of the axillary artery in the axillary region?

    <p>To distribute blood flow to the muscles of the shoulder and upper arm</p> Signup and view all the answers

    What is the primary function of the axillary vein in the axillary region?

    <p>To return deoxygenated blood from the upper limb to the heart</p> Signup and view all the answers

    What is the significance of the axillary artery being divided into three parts by the pectoralis minor muscle?

    <p>It provides a reference point for identifying the location of specific branches of the axillary artery</p> Signup and view all the answers

    What is the significance of the axillary vein being located on the medial/anterior side of the axillary artery?

    <p>It enables the axillary vein to effectively return deoxygenated blood from the upper limb to the heart</p> Signup and view all the answers

    Which artery supplies blood to the anterior forearm and palm?

    <p>Ulnar artery</p> Signup and view all the answers

    What is the clinical importance of the collateral circulation around the scapula?

    <p>It allows for ligation of the subclavian or axillary artery without compromising blood flow to the upper extremity.</p> Signup and view all the answers

    Which of the following arteries is NOT involved in the collateral circulation around the scapula?

    <p>Ulnar artery</p> Signup and view all the answers

    What is the consequence of ligating the axillary artery distal to the subscapular artery and proximal to the profunda brachii artery?

    <p>It will severely compromise blood flow to the upper extremity, potentially leading to gangrene.</p> Signup and view all the answers

    Which artery supplies blood to the dorsum of the hand and palm?

    <p>Radial artery</p> Signup and view all the answers

    Which of the following statements about the arterial anastomoses around the elbow is correct?

    <p>The ulnar collateral arteries participate in the anastomotic network around the elbow.</p> Signup and view all the answers

    Match each muscle to the part of the scapula it is associated with

    <p>Supraglenoid tubercle = Long head of biceps brachii Clavicle = Trapezius, deltoid, pectoralis major Coracoid process = Pectoralis minor, coracobrachialis, short head of biceps femoris Subscapular fossa = Subscapularis</p> Signup and view all the answers

    Match each muscle to the scapular structure it's associated with

    <p>Lesser tubercle = Subscapularis Medial lip = Teres major Deltoid tuberosity = Deltoid Intertubercular groove = Latissimus dorsi</p> Signup and view all the answers

    Which of the following is not a movement of the scapula?

    <p>Circumduction</p> Signup and view all the answers

    Match each border of the axilla with its contents

    <p>Apex = Cervicoaxillary canal (communication between neck and axilla) Anterior = Pectoralis major and minor Anterior axillary fold = P. major m. Posterior = Subscapularis (scapula), teres major, latissimus dorsi</p> Signup and view all the answers

    Match each border of the axilla with its contents

    <p>Posterior axillary fold = Latissimus Dorsi &amp; Teres major mm. Medial = Serratus anterior Lateral = Intertubercular groove (housing tendon of the long head of biceps brachii) Base = Skin and axillary fascia between arm and thoracic wall</p> Signup and view all the answers

    Which of the following are not contents of the Axilla?

    <p>All of the following are found in the axilla</p> Signup and view all the answers

    Match each muscle of the axilla to its origin/ insertion

    <p>Pectoralis major = O: Clavicular head (anterior surface of medial 1/2 of clavicle; sternocostal head (anterior surface of sternum and upper 7 costal cartilages; sternal end of 6th rib/aponeurosis of external abdominal oblique/ I: Lateral lip of intertubercular groove/sulcus of humerus Pectoralis minor = O: Ribs 3-5 and deep fascia of related intercostal muscles/ I: Coracoid process Subclavius = O: 1st rib/ I: Groove on inferior surface of middle third of clavicle Serratus anterior = O: Lateral surfaces of ribs 1-8 and deep fascia of related intercostal muscles/ I: Costal surface of medial border of scapula</p> Signup and view all the answers

    Match each muscle to its origin/insertion

    <p>Subscapularis = O: Medial two-thirds of subscapular fossa/ I: Lesser tubercle of humerus Teres Major = O: Elongate oval area on posterior surface of inferior angle of scapula (lower lateral border)/ I: Medial lip of intertubercular groove/ sulcus of humerus Latissimus dorsi = O: Spinous processes and interspinous ligaments of T6-T12; via thoracolumbar fascia to lumbar spinous processes and interspinous ligaments, iliac crest, lower 3 or 4 ribs/ I: floor of intertubercular groove/sulcus Long head of triceps brachii = O: Infraglenoid tubercle of scapula/ I: Olecranon process</p> Signup and view all the answers

    Match each muscle of the axilla with its innervation

    <p>Pectoralis minor = Medial pectoral nerve (C5-T1) Subclavius = Nerve to subclavius (C5-C6) Serratus Anterior = Long thoracic nerve (C5-C7) Pectoralis major = Lateral/medial pectoral nerves (clavicular head C5-C6); sternocostal head (C6-T1)</p> Signup and view all the answers

    Match each muscle of the axilla to its innervation

    <p>Latissimus dorsi = Thoracodorsal nerve (C6-C8) Long head of triceps brachii = Radial nerve (C6-C8) Subscapularis = Upper/ lower subscapular nerves (C5-C6) Teres major = Lower/inferior subscapular nerve (C5-C6)</p> Signup and view all the answers

    Match each muscle to its innervation

    <p>Pectoralis major = Adduction and medial rotation of arm at glenohumeral joint; clavicular head; flexes extended arm; sternocostal head; extends flexed arm Pectoralis minor = Depresses scapula (pulls tip of shoulder down), protracts scapula, anteriorly tilts scapula, elevates ribs, accessory muscle of respiration Subclavius = Depresses scapula (pulls tip of shoulder down); pulls clavicle medially to stabilize sternoclavicular joint, anteriorly tilts scapula Serratus anterior = Protracts and rotates scapula upward (glenoid-up); keeps medial border and inferior angle of scapula apposed to thoracic wall</p> Signup and view all the answers

    Match each muscle of the axillary to its action

    <p>Subscapularis = Medial rotation and extension of arm at glenohumeral joint Teres major = Medial rotation and extension of arm at glenohumeral joint Latissimus dorsi = Adduction, medial rotation, extension of arm at glenohumeral joint Long head of triceps brachii = Extension of forearm at elbow; accessory adductor and extensor of arm at glenohumeral joint</p> Signup and view all the answers

    Match each space of the pectoral region to its contents

    <p>Suprascapular foramen = Suprascapular artery/nerve Triangular space = Circumflex scapular artery Triangular interval = Radial nerve/ Profunda brachii artery Quadrangular space = Axillary nerve/ posterior circumflex humeral artery/vein</p> Signup and view all the answers

    Match each part of the axillary artery to its branches

    <p>Axillary artery part 1 = Superior thoracic artery: supplies muscles in the 1st and 2nd intercostal spaces Axillary artery part 2 = Thoracoacromal trunk - pierces the clavipectoral fascia has four branches: - acromial, deltoid, pectoral, clavicular Axillary artery part 3 = Subscapular: has two terminal branches: Circumflex scapular (in triangular space), Thoracodorsal (to latissimus dorsi) Axillary artery part 2 = Lateral thoracic a. - supplying the pectoral muscles, lymph nodes and the breast</p> Signup and view all the answers

    The union of which veins form the axillary vein?

    <p>A &amp; C</p> Signup and view all the answers

    Study Notes

    Shoulder Muscles and Movements

    • Serratus Anterior muscle is responsible for protraction (pulling forward) and upward rotation of the scapula.
    • The Long Thoracic Nerve innervates the Serratus Anterior muscle.
    • Pectoralis Minor muscle depresses and protracts the scapula.
    • The Circumflex Scapular Artery is located in the quadrangular space.
    • The Long Thoracic Nerve is crucial for scapular stability and preventing winging.
    • Latissimus Dorsi muscle, located on the posterior wall of the pectoral region, extends the elbow joint.

    Arterial Anastomoses at the Shoulder

    • Arterial anastomoses around the shoulder provide collateral circulation, ensuring blood supply to the upper limb even if one major artery is blocked.

    Pectoral Region Muscles

    • The Pectoralis Major muscle is part of the pectoral region.
      • Origin: Clavicle, sternum, and costal cartilages.
      • Insertion: Intertubercular groove of the humerus.
      • Actions: Adduction, flexion, and medial rotation of the arm.
      • Innervation: Lateral and Medial Pectoral Nerves.
      • Blood Supply: Thoracic Acromial Artery.

    Scapular Anatomy

    • Serratus Anterior muscle weakness can lead to winging of the scapula.
    • The thoracic outlet acts as a passageway between the neck and upper limb.

    Shoulder Innervation

    • Axillary Nerve is the primary innervation of the Deltoid muscle.
    • Inferior angle of the scapula is the attachment point for the long head of the triceps muscle.

    Arterial Anatomy

    • Brachial Artery begins at the lower border of the Teres Major muscle.
    • Deep Brachial Artery travels in the spiral groove of the humerus with the Radial Nerve.
    • Superior Thoracic Artery provides blood supply to muscles in the 1st and 2nd intercostal spaces.
    • Thoracoacromial Artery has branches that include the acromial, deltoid, pectoral, and clavicular arteries.
    • Subscapular Artery has two terminal branches: Circumflex Scapular Artery and the Thoracodorsal Artery.
    • Subclavian Artery is a terminal branch off the brachiocephalic trunk.

    Axilla Anatomy

    • Axillary Sheath encloses the axillary artery, vein, and brachial plexus.
    • Brachial Plexus provides motor and sensory innervation to the upper limb.
    • Axillary Artery supplies blood to the shoulder, axilla, and upper arm.
    • Axillary Vein drains blood from the upper limb.
    • Pectoralis Minor Muscle divides the axillary artery into three parts:
      • 1st part: Proximal to the muscle, supplies branches to the pectoral region.
      • 2nd part: Behind the muscle, supplies branches to the shoulder and scapula.
      • 3rd part: Distal to the muscle, supplies branches to the arm.
    • Axillary Vein is located medial and anterior to the axillary artery.

    Arterial Supply of the Forearm and Hand

    • Brachial Artery supplies blood to the anterior forearm and palm.

    Collateral Circulation

    • Collateral circulation around the scapula is essential for providing alternate blood flow to the upper limb if a main artery is blocked.
    • Thoracodorsal Artery is not part of the collateral circulation around the scapula.
    • Ligating (tying off) the axillary artery distal to the subscapular artery and proximal to the profunda brachii artery will not obstruct blood flow to the upper limb due to the presence of collateral arteries.
    • Radial Artery supplies blood to the dorsum of the hand and palm.

    Arterial Anastomoses around the Elbow

    • Arterial anastomoses around the elbow provide collateral circulation, ensuring blood flow to the forearm even if one major artery is blocked.

    Scapula and its Muscles

    • Serratus Anterior muscle is associated with the anterior surface of the scapula.
    • Trapezius muscle is associated with the posterior surface of the scapula.
    • Rhomboid Major muscle is associated with the medial border of the scapula.
    • Rhomboid Minor muscle is associated with the medial border of the scapula.
    • Levator Scapulae muscle is associated with the superior angle of the scapula.
    • Scapular Protraction: Moving the scapula forward and away from the spine
    • Scapular Retraction: Moving the scapula backward towards the spine
    • Scapular Elevation: Lifting the scapula upwards
    • Scapular Depression: Lowering the scapula downwards
    • Scapular Upward Rotation: Rotating the scapula so the inferior angle moves laterally
    • Scapular Downward Rotation: Rotating the scapula so the inferior angle moves medially
    • Note: There is no movement of the scapula called scapular internal rotation.

    Axilla Anatomy

    • Anterior Border of the Axilla: Pectoralis Major and Minor muscles
    • Posterior Border of the Axilla: Subscapularis, Latissimus Dorsi, and Teres Major muscles
    • Medial Border of the Axilla: Serratus Anterior muscle
    • Lateral Border of the Axilla: Intertubercular groove of the humerus
    • Contents of the Axilla:
      • Axillary Artery and its Branches
      • Axillary Vein and its Tributaries
      • Brachial Plexus
      • Lymphatics
      • Loose Connective Tissue and Fat

    Axilla Muscles

    • Teres Minor originates from the lateral border of the scapula and inserts on the greater tubercle of the humerus.
    • Teres Major originates from the inferior angle of the scapula and inserts on the lesser tubercle of the humerus.
    • Latissimus Dorsi originates from the spinous processes of the lower thoracic and lumbar vertebrae, the iliac crest, and the sacrum and inserts on the inter tubercular groove of the humerus.
    • Subscapularis originates from the subscapular fossa of the scapula and inserts on the lesser tubercle of the humerus.
    • Pectoralis Major originates from the clavicle and sternum and inserts on the intertubercular groove of the humerus.
    • Pectoralis Minor originates from ribs 3-5 and inserts on the coracoid process of the scapula.
    • Coracobrachialis originates from the coracoid process of the scapula and inserts on the medial surface of the humerus.
    • Serratus Anterior originates from the ribs 1-9 and inserts on the anterior surface of the scapula.

    Axilla Muscle Innervation

    • Axillary Nerve: Deltoid and Teres Minor
    • Suprascapular Nerve: Supraspinatus and Infraspinatus
    • Subscapular Nerve: Subscapularis and Teres Major
    • Long Thoracic Nerve: Serratus Anterior
    • Thoracodorsal Nerve: Latissimus Dorsi

    Axilla Muscle Innervation

    • Axillary: Deltoid, Teres Minor
    • Subscapular: Subscapularis, Teres Major
    • Thoracodorsal: Latissimus Dorsi
    • Suprascapular: Supraspinatus, Infraspinatus
    • Long Thoracic: Serratus Anterior

    Axilla Muscle Actions

    • Deltoid: Abducts, flexes, and extends the arm.
    • Teres Minor: Rotates the arm externally and helps with adduction.
    • Teres Major: extends, adducts, and rotates the arm medially.
    • Latissimus Dorsi: Extends, adducts, and rotates the arm medially, drawing the arm toward the back.
    • Subscapularis: Rotates the arm internally (medially) and helps with adduction.
    • Pectoralis Major: Adducts, flexes, and rotates the arm medially (internal rotation).
    • Pectoralis Minor: Depresses and protracts the scapula.
    • Coracobrachialis: Flexes and adducts the arm.
    • Serratus Anterior: Protracts and rotates the scapula upward.

    Pectoral Region Spaces

    • Clavipectoral Triangle: Contains the cephalic vein and the deltoid branch of the thoracoacromial artery.
    • Infraclavicular Fossa: Contains the brachial plexus, axillary artery, and axillary vein.

    Axillary Artery Branches

    • 1st Part:
      • Superior Thoracic Artery
    • 2nd Part:
      • Thoracoacromial Artery
      • Lateral Thoracic Artery
      • Subscapular Artery
    • 3rd Part:
      • Anterior Circumflex Humeral Artery
      • Posterior Circumflex Humeral Artery

    Axillary Vein Formation

    • Axillary Vein is formed by the union of the basilica vein and the brachial vein.

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    Description

    Test your knowledge on the boundaries and contents of the axilla, muscles of the pectoral region, axillary artery and its branches, axillary lymph nodes, quadrangular space, triangular space, triangular interval, winging of the scapula, and their clinical importance.

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