Anatomy of axilla.pptx

Anatomy of axilla

1. Inderbir Singh’s Textbook of Anatomy AXILLA By V Subhadra Devi SEVENTH EDITION Volume 1 Upper Limb 3 VOLUME SET

2. It is a fat filled, pyramidal-shaped space with apex, a base and four walls Apex: Triangular in shape Also called cervico -axillary canal Boundaries: Anterior—posterior border of clavicle Posterior—upper border of scapula Medial—outer border of 1st rib Lateral—coracoid process. Direction: It is directed upward and medially and continues into the root of the neck, thereby forming cervicoaxillary canal Axilla Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers

3. Axilla Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers

4. Cervico -axillary Canal Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers

5. Structures passing through cervico -axillary canal/apex of axilla : Axillary vessels cords of brachial plexus (both in axillary sheath) BASE/FLOOR: Formation: It is formed by the skin and the thick layer of axillary fascia Shape: When the arm is abducted, it becomes concave due to pull of suspensory ligament of axilla Boundaries: Anterior—anterior axillary fold Medial—chest wall Posterior—posterior axillary fold Axilla Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers

6. Four Walls 1 . Anterior Wall - It is formed by Pectoralis major—whole extent Pectoralis minor—central part Subclavius Clavipectoral fascia Suspensory ligament of the axilla 2 . Posterior Wall - It is formed by Scapula Subscapularis in upper part Teres Major in middle part Latissimus dorsi in lower part Axilla– Four Walls Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers

7. Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers

8. 3 . Medial Wall - It is convex and formed by Upper five ribs Intercostal muscles in the upper four intercostal spaces Serratus anterior muscle—upper 4 or 5 digitations Long thoracic nerve Intercostobrachial nerve 4 . Lateral Wall - It is formed by convergence of anterior and posterior walls and is formed by Upper part of shaft of humerus : Bicipital groove Posterior (teres major) axillary folds. Biceps brachii: Long head Coracobrachialis Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers Axilla– Four Walls

9. 1 . Axillary artery and its six branches. 2. Axillary vein and its tributaries 3. Brachial plexus ( infraclavicular part): 3 cords , 13 branches 4. Long thoracic nerve 5. Intercostobrachial nerve 6. Axillary group of lymph nodes 7. Loose areolar tissue with axillary pad of fat 8. Axillary tail of Spence in female adult mammary gland Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers Contents

10. Dislocation of shoulder results in damage to the neurovascular structures in the axilla . Axillary lymphadenitis due to infections or malignancy of limb, breast and abdominal wall above umbilicus. Compression of long thoracic nerve of Bell by enlarged central group of axillary lymph nodes can result in paralysis of serratus anterior muscle. Thrombosis of axillary vein because of prolonged hyperabducted arm, e.g. in painting or plastering the ceiling, postoperative mastectomy with removal of axillary lymph nodes can lead to venous stasis and edema of upper limb. Thoracic outlet syndrome: Compression of vessels and nerves in axilla between clavicle, 1st rib and scapula is called thoracic outlet syndrome. Surgical approach to axilla: The medial and posterior walls of the axilla have bones covered with muscles; the lateral wall is bony; and only the anterior wall is devoid of bones and is fleshy or covered with muscles only and the base is facial (axillary fascia). Hence, approaches to axilla are usually through the anterior wall or through the base. The usual surgical procedures in the axilla are drainage of an axillary abscess or removal of an axillary lymph node. Inderbir Singh’s Textbook of Anatomy, 7/e by V Subhadra Devi © Jaypee Brothers Medical Publishers Clinical Importance