Axilla and Brachial Plexus PDF

Axilla (the armpit)  Borders of Axillary Fossa Prof. Dr. H. Selçuk Sürücü borders Anterior wall Medial pectoralis major m. 1-4 ribs pectoralis minor m. intercostal mm. clavipectoral fascia serratus anterior m. Posterior Lateral...

Axilla (the armpit)  Borders of Axillary Fossa Prof. Dr. H. Selçuk Sürücü borders Anterior wall Medial pectoralis major m. 1-4 ribs pectoralis minor m. intercostal mm. clavipectoral fascia serratus anterior m. Posterior Lateral subscapularis m. intertubercular teres major m. sulcus latissimus dorsi m. apex contents Clavicula (at anterior) Loose connective tissue 1st rib (at medial) Axillary artery superior border of Axillary vein the scapula (at post.) Axillary lymph Base nodes Axillary fascia brachial Plexus skin (infraclavicular part) Base Skin and axillary fascia Apex Clavicula (anterior) 1st rib (medial) The superior border of the scapula (post.) Anterior wall Pectoralis major Pectoralis minor Clavi-pectoral fascia Prof. Dr. H. Selçuk Sürücü Posterior wall Subscapular Teres major Latissimus dorsi Prof. Dr. H. Selçuk Sürücü Medial wall Ribs 1-4 Intercostal mm. Serratus ant. m. Lateral wall Intertubercular sulcus (groove) Contents? Loose connective tissue Axillary a.-v. Axillary lymph nodes Brachial plexus (Infraclavicular part )  Structures piercing clavipectoral fascia 1. Cephalic v. 2. Thoraco-acromial a. 3. Lymph vessels 4. Lat. pectoral n. Axillary Lymph Nodes Anterior group (pectoral group) Posterior group (subscapular group) Lateral group Central group Apical group  Axillary lymph nodes: which group drains where anterior posterior central apical Subclavian trunk lateral Lymph vessels accompanying cephalic vein Axillary sheath is a part of deep cervical fascia In cervical region Axillary sheath Superficial cervical encloses: fascia Axillary a. Deep cervical fascia Superficial Lamina Axillary v. (investing layer) brachial plexus Pretracheal Lamina Prevertebral Lamina (infraclavicular part) Axillary sheath Carotid sheath BRACHIAL PLEXUS Network of nerves extending from the neck into the axilla. It innervates the structures in upper limb. Formed by the union of anterior rami of spinal nerves from C5 to T1.  Nerves from spinal cord to brachial plexus From spinal cord emerges Ant. root+ post. root Unite&form spinal nerve Spinal nerve divides into 2 rami (branches) Rami: plural of “ramus” *Anterior ramus and posterior ramus * *Ant. rami of C5-T1 unite and form the brachial plexus Prof. Dr. H. Selçuk Sürücü Formation of the Brachial Plexus roots trunks divisions cords C5 + C6 Sup. trunk Ant. Post. posterior n e Ant. r C7 Middle trunk v Post. lateral e s C8+T1 Inf.trunk Ant. medial Post.  C4 C5 C6 superior C7 middle C8 inferior T1 lateral posterior superior trunk middle middle trunk inferior trunk lateral cord middle cord posterior cord clavicle Parts of brachial plexus Supraclavicular part - located in the neck Infraclavicular part -located in the axilla clavicle  Nn. from roots Dorsal scapular n. (C5) Rhomboids, levator scapulae Long thoracic n. (C5-7) Prof. Dr. H. Selçuk Sürücü  Nn from trunks (C 5-6) N. to subclavius Suprascapular n. (Accessory phrenic n.)  Nn from Lat. Cord (C 5-7) Lat pectoral n. - Pectoralis major m. Musculocutaneous n. Lateral root to median n.  Nn. form Medial Cord (C8- T1) Medial root of median n. Medial pectoral n.- Pectoralis muscles Medial cutaneous n. of arm Medial cutaneous n. of forearm Ulnar n.  Nn. from post cord Subscapular nn. (C 5-6) Subscapular & teres major m. Thoracodorsal n. (C 5-8) Axillary n. ( C5-6) Radial n. (C5-T1)