Axillary Artery PDF

Anatomy of Upper Limb Axillary Artery By Dr. Hassan Mohammed Rizk (Ph.D.) Associate Professor of Human Anatomy and Embryology VESSELS OF UPPER LIMB Anatomy Course in M2-Respiration & Circulation 17...

Anatomy of Upper Limb Axillary Artery By Dr. Hassan Mohammed Rizk (Ph.D.) Associate Professor of Human Anatomy and Embryology VESSELS OF UPPER LIMB Anatomy Course in M2-Respiration & Circulation 17 1 Lectures Lab 9 8 Vessels of Vessels of Vessels of Vessels of Upper Limb Lower Limb Upper Limb Lower Limb Axillary Artery By Dr. Hassan Rezk August 29, 2024 2  Theoretical VESSELS OF UPPER LIMB Exams Lectures (Mid & Final) OSPE Objective Structured Lectures & Labs Practical Exam Axillary Artery By Dr. Hassan Rezk August 29, 2024 3  Objectives: by the end of this lecture the student must understand the following knowledge: VESSELS OF UPPER LIMB ▪ Identify and demonstrate the Axillary Artery, Regarding: 1)Origin. 2)Termination. 3)Course and Relation. 4)Branches and Distribution. Axillary Artery By Dr. Hassan Rezk August 29, 2024 4 VESSELS OF UPPER LIMB Essential Revision Not Included in Exam Axilla (Boundaries and Its Contents Axillary Artery By Dr. Hassan Rezk August 29, 2024 5  Case Study VESSELS OF UPPER LIMB Peripheral angiogram of occluded right axillary artery Axillary Artery By Dr. Hassan Rezk August 29, 2024 6  Introduction Map for the Arterial Supply of the Whole Upper Limb VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 7 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 8  Axillary Artery VESSELS OF UPPER LIMB Direct continuation of subclavian artery. ▪ Origin: At the level of outer border of the 1st rib. It continues as Brachial artery. ▪ Termination: At the level of distal border of teres major muscle. It runs deep to Pectoralis minor muscle. ▪ Course and the Pectoralis minor muscle divides the course of axillary artery into: important ▪1st part of axillary artery: Proximal to (above) the pectoralis minor muscle. ▪2nd part of axillary artery: Deep to pectoralis minor muscle. relations: ▪3rd part of axillary artery: Distal to (below) the pectoralis minor muscle. Axillary Artery By Dr. Hassan Rezk August 29, 2024 9 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 10 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 11 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 12 VESSELS OF UPPER LIMB Essential Revision Stages of formation of Brachial Plexus: 1. Roots. 2. Trunks (3 trunks): A. Superior Trunk. B. Middle Trunk. C. Inferior Trunk. 3. Divisions. 4. Cords (3 cords): A. Lateral Cord. B. Posterior Cord. C. Medial Cord. 5. Branches. Axillary Artery By Dr. Hassan Rezk August 29, 2024 13  Essential Revision Branches of Brachial Plexus VESSELS OF UPPER LIMB A – Supraclavicular Branches B – Infraclavicular Branches (1) From Roots (2) From Superior Trunk (3) From Cords 1) Long Thoracic nerve. 1) Suprascapular nerve A. Lateral Cord B. Medial Cord C. Posterior Cord 2) Dorsal scapular 2) Subclavius nerve M.L.L. 4M & U S.T.A.R. nerve 1) Musculocutaneous 1) Medial Pectoral 1) Subscapular nerve nerve. nerve. (upper and lower). 2) Lateral Pectoral 2) Medial Root of 2) Thoracodorsal median nerve. nerve. nerve. 3) Lateral Root of 3) Medial Cutaneous 3) Axillary nerve. nerve of arm. 4) Radial nerve. median nerve 4) Medial Cutaneous nerve of forearm. 5) Ulnar nerve. Axillary Artery By Dr. Hassan Rezk August 29, 2024 14 VESSELS OF UPPER LIMB Essential Revision In Axilla Behind Clavicle In the Neck Axillary Artery By Dr. Hassan Rezk August 29, 2024 15 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 16  Relations of Brachial Plexus to Axillary artery Cords & Branches Only VESSELS OF UPPER LIMB ❑ 1st part of axillary artery: Three cords of the brachial plexus lie posterior to the artery. ❑ 2nd part of axillary artery (Typical relations to the names of the cords) ✓ Posterior cord of the brachial plexus lies posterior to axillary artery. ✓ Lateral cord of the brachial plexus lies lateral to axillary artery. ✓ Medial cord of the brachial plexus lies medial to axillary artery. ❑ 3rd part of axillary artery: (Relations to the branches of the cords) ✓ Axillar artery is crossed superficially (anteriorly) by medial root of median nerve from medial to lateral to form median nerve. ✓ Median nerve lies lateral to axillary artery. ✓ All branches of posterior cord of brachial plexus (S2.T.A.R) lie posterior to axillary artery. ✓ All branches of lateral cord of brachial plexus (M.L.L.) lie lateral to axillary artery. ✓ All branches of medial cord of brachial plexus (4M & U) lie medial to axillary artery. Axillary Artery By Dr. Hassan Rezk August 29, 2024 17 VESSELS OF UPPER LIMB L M Axillary Artery By Dr. Hassan Rezk August 29, 2024 18 VESSELS OF UPPER LIMB Anterior View of Right Axilla Cross section through left axilla showed Relations of (anterior wall and clavicle were removed to show the relation of 1st part of axillary artery to brachial plexus) the 1st part of Axillary Artery ( A ) Axillary Artery By Dr. Hassan Rezk August 29, 2024 19 VESSELS OF UPPER LIMB Cross section through left axilla showed Relations of the 2nd part of Axillary Artery ( A ) Axillary Artery By Dr. Hassan Rezk August 29, 2024 20 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 21 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 22  Branches of Axillary artery One branch from 1st part,: Superior thoracic artery: appears at upper border of pectoralis minor VESSELS OF UPPER LIMB Two branches of 2nd part, gives: 1) Thoraco-acromial artery: appears just above the pectoralis minor. 2) Lateral thoracic artery: along the lower border of pectoralis minor. Three branches from 3rd part, gives: 1) Anterior circumflex humeral artery: Encircles the surgical neck of the humerus anteriorly. 2) Posterior circumflex humeral artery: ▪ Encircles the surgical neck of the humerus posteriorly accompanied by axillary nerve. ▪ Both appears in the quadrangular space. ▪ It anastmose with Anterior circumflex humeral artery to form arterial circle around surgical neck. 3) Subscapular artery: (Largest branch) ▪ Runs along the lower border of subscapularis muscle. ▪ Encircles the lateral border of the scapula. Divides into: 1) Circumflex scapular artery: ✓ appears in triangular space. ✓ It shares in the anastmosis around the scapula. 2) Thoracodorsal artery runs with thoracodorsal nerve to supply latissimus dorsi muscle. Axillary Artery By Dr. Hassan Rezk August 29, 2024 23 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 24 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 25 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 26 VESSELS OF UPPER LIMB Contents of Gateway to the posterior scapular region Axillary Artery By Dr. Hassan Rezk August 29, 2024 27  Thoraco-acromial artery From second part of the axillary VESSELS OF UPPER LIMB ▪ It appears at the superior margin of pectoralis minor muscle. ▪ penetrates the clavipectoral fascia. ▪ immediately divides into four branches: 1) Acromial 2) Pectoral. 3) Clavicular. 4) Deltoid. ▪ Supplies: ✓ anterior axillary wall. ✓ pectoral branch supply to the breast. ✓ deltoid branch passes into the clavipectoral triangle where it accompanies the cephalic. Axillary Artery By Dr. Hassan Rezk August 29, 2024 28 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 29  Clinical Correlation Fracture of 1st rib VESSELS OF UPPER LIMB ▪ First rib fracture tear the distal part of the subclavian artery or the first part of the axillary artery. ▪ Fortunately, there are anastomotic connections between branches of the subclavian artery and the axillary artery, which form a network: (SEE LATER) 1. Around the scapula. 2. Proximal end of the humerus. Axillary Artery By Dr. Hassan Rezk August 29, 2024 30 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 31  Anterior dislocation of the Clinical Correlation humeral head VESSELS OF UPPER LIMB ▪ Anterior dislocation of the humeral head may compress: 1. axillary artery, resulting in vessel occlusion. 2. Brachial plexus Axillary Artery By Dr. Hassan Rezk August 29, 2024 32 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 33  Case Scenario (Staff Question) VESSELS OF UPPER LIMB 67 A 41-year-old woman is scheduled for a latissimus dorsi muscle flap to cosmetically augment the site of her absent left breast, postmastectomy. Part of the latissimus dorsi muscle is advanced to the anterior thoracic wall, based upon arterial supply provided in part by the artery that passes through the triangular space of the axilla. What artery is forming the vascular base of this flap? A. Circumflex scapular artery. B. Transverse cervical artery. C. Lateral thoracic artery. D. Thoraco-acromial artery Axillary Artery By Dr. Hassan Rezk August 29, 2024 34  Reference VESSELS OF UPPER LIMB Gray's anatomy for students, 3rd edition. ISBN: 978-0-7020-5131-9 Copyright© 2015, 2010, 2005 by Churchill Livingstone, an imprint of Elsevier Inc. Chapter 7 Axillary Artery By Dr. Hassan Rezk August 29, 2024 35 VESSELS OF UPPER LIMB Axillary Artery By Dr. Hassan Rezk August 29, 2024 36