2. Abnormal Branching Pattern Of The
Axillary Artery-A Case Study
Ramendra Raman Hasmatullah
Md Shafique A.Ghaffar
M Sc Medical Anatomy
(Students)
D e p a r t m e n t o f A n a t o m y,
H i - Te c h M e d i c a l C o l l e g e & H o s p i t a l ,
H e a lth Pa rk , Ra s ulgarh , B h u b anes hwar-751025
Odisha

3. Introduction
The axillary artery commences at the
lateral border of the first rib, as a
continuation
of the subclavian, and ends at the lower
border of the axilla (i.e. the lower border
of teres major) to become the brachial
artery. It is divided into three parts;.

4. 1st Part: Above the pectoralis minor;
Superior Thoracic Artery.
2nd Part: Directly deep to the Pectoralis
Minor;
Thoracoacromial Artery & Lateral
Thoracic Artery.
3rd Part: Below the pectoralis minor;
Anterior Circumflex Humeral Artery,
Posterior Circumflex Humeral Artery &
Subscapular Artery.

5. Case Report
During routine dissection of upper
limb in a 45 years old male cadaver. We
observed the branching pattern of
axillary artery was abnormal.
At dissection the following features
are noted;

6. The 1st part of the axillary artery gave only one
branch Superior thoracic artery at the normal
level near the lower border of subclavias muscle
and it supply the lymph node,muscle of the upper
portion of the thoracic wall
The 2nd part of the axillary artery gave off two
branches
I.Thoracoacromial artery arises from the 2nd
part of the axillary artery deep to the medial
margin of the pectoralis minor muscle and run
upward then pierces the clavipectoral facia and
divided in to four branches

8. Pectoral branch supply the pectoral muscles
Acromial branch it goes toward the acromion
processes of the scapula and anastomosis of the
another artery
Deltoid branch its run in the delto pectoral groove
II. A large common trunk it is runs down medial
to the axillary vein
Common trunk gives following branches
(a) Muscular branch
(b) Lateral thoracic artery
(c) Sub scapular artery
(d) Thoracodorsal artery
(e) Circumflex scapular artery
(f) Posterior circumflex humeral artery

9. Lateral thoracic artery arises from the common trunk
deep to the pectoralis minor muscle .Descend on the
chest wall and supply the lower part of the front of
the chest wall .
Circumflex scapular artery passes through the
triangular space and emerges out the posterior side
near the lateral border of scapula.
Before passing through triangular space it give a
thoracodorsal branch.

11. Posterior circumflex humeral artery is a
continuation of sabscapullar artery passes through
the quadrangular space along with axillary nerve
and emerges out posterior side and round the
surgical neck of the humerus below the deltoid
muscle.
Anterior circumflex humeral artery arises from the
3rd part of the axillary artery running laterally in
front of the surgical neck of the humerus deep to
the coracobrachialis and biceps brachial it give one
ascending branch in the intertubarcular sulcus to
supply the shoulder joint

13. During routine dissection for
undergraduate teaching. Between years
2008 to 2010 we observed unique
anomalies in the right axilla of 45 years
old male cadavers after dissection of 16
cadavers at the department of anatomy,
Hi-Tech Medical College and Hospital,
Health Park, Bhubaneswar Orissa

14. Branches of axillary artery vary.sometimes subscapular artery,
circumflex humeral artery and arteria profunda brachii arise
from Common trunk.But in our case lateral thoracic artery,
thoracodorsal artery, subscapular artery, circumflex scapular
artery and posterior circumflex humeral artery arise common
trunk.
Venieratos D and Lolis ED reported another case in
which subscapular artery, anterior and posterior circumfl
ex humeral arteries, profunda brachii artery and ulnar
collateral artery originated from a common trunk which
was named by them as common subscapular trunk2.

15. Occasionally the subscapular, circumflex humeral and
profunda brachii arteries arise in common, branches of
the brachial plexus surround this common vessel
instead of axillary artery. The posterior circumflex
humeral artery may arise from the profunda brachii
artery and pass back below the teres major instead of
passing through the quadrangular space (Johnson &
Ellis,2005).
Venieratos & Lolis (2001) shows common subscapular
trunk gave origin to circumflex scapular,
thoracodorsal, anterior and posterior circumflex
humeral, profunda brachii and ulnar collateral arteries.

16. In another report by Samuel et al. (2006) the
third part of the axillary artery gave a common
arterial trunk, which further gave anterior and
posterior circumflex humeral, subscapular, radial
collateral, middle collateral and superior ulnar
collateral arteries with absence of profunda
brachii artery.
Magden et al. (2007) observed "abnormal"
branching pattern of the axillary artery and
unusual branch to the serratus anterior muscle,
which originated directly from the first part of
the axillary artery as the first branch..

18. The lateral thoracic and thoracodorsal arteries
arose together from the third part of the
axillary artery as "a lateral
thoracicthoracodorsal"common trunk. The
superior thoracic artery was out of the
position. The circumflex scapular artery
originated directly from the third part of the
axillary artery.The subscapular artery was not
present.
Our present report differs from this earlier
report in branching pattern as well as course
of these branches.

19. The knowledge of variation of axillary artery is
important for surgeons.Awarness about details
and topographic anatomy of variation of the
axillary artery may serve as a useful guide for
both radiologist and vascular surgeons .it may
help to prevent diagnostic error .during time of
surgeries for the lymph node in the axilla,and
surgeries for the pactoral region presence of
such anomalous branch ought to keep in mind.

20. 1.Johnson, D. & Ellis, H. Pectoral girdle and upper limb. In:Standring,
S. Ed. Gray's Anatomy. 39th ed. Edinburgh,Elsevier, 2005. p. 845
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