Anatomy of axilla along with its contents Details of axillary artery, lymph nodes, brachial plexus

1.  Pyramidal space situated between upper chest
wall & medial side of arm
Boundaries
Apex Base Anterior
wall
Posterior
wall
Lateral
wall
Medial
wall
Apex
Base
Ant.
wall
Post .
wall
Lat.
wall
Dr. Sarika S. Chopde, TAMV, Pune

2. Apex
Base
Anterior
wall
Posterior
wall
Medial
wall
Dr. Sarika S. Chopde, TAMV, Pune

3. Apex
 Bounded by superior border of scapula
 Posterior Surface of clavicle
 Outer border of 1st rib
Dr. Sarika S. Chopde, TAMV, Pune

4.  Formed by Skin & fascia.
 Larger at thorax & narrow at arm
Base
Dr. Sarika S. Chopde, TAMV, Pune

5. •Pectoralis major & minor
•Form the anterior axillary fold
• Clavipectoral fascia
Anterior wall
Dr. Sarika S. Chopde, TAMV, Pune

6. Dr. Sarika S. Chopde, TAMV, Pune

7. Posterior wall
•Subscapularis
•Teres major
•Lattissimus dorsi
•Form posterior axillary fold
Dr. Sarika S. Chopde, TAMV, Pune

8. Medial wall
•1st 4 ribs
•Intercostal muscles
•Serratus anterior
Dr. Sarika S. Chopde, TAMV, Pune

9. Lateral wall
• Bicipital groove of humerus
• Biceps
• Coracobrachialis
Dr. Sarika S. Chopde, TAMV, Pune

10.  Axillary artery & its branches
 Axillary vein
 Brachial plexus
 Fat
 Axillary lymph nodes
Dr. Sarika S. Chopde, TAMV, Pune

11.  Continuation of subclavian artery
 Starts- At the outer border of 1st rib
 Ends-At lower border of teres major
 Becomes brachial artery
 Pectoralis minor crosses to divide in 3 parts
Dr. Sarika S. Chopde, TAMV, Pune

12.  1st / Superior part
Relations-
1) Anterior- Pectoralis Major
- Clavipectoral fascia
2) Posterior – 1st intercostal space
- medial cord of brachial plexus
3) Lateral- Lateral & posterior cord of brachial
plexus
4) Medial- Axillary vein
Dr. Sarika S. Chopde, TAMV, Pune

13. Dr. Sarika S. Chopde, TAMV, Pune

14.  2nd / middle part
Relations-
1) Anterior-Pectoralis Major & minor
2) Posterior – Posterior Cord
3) Lateral- Lateral Cord
4) Medial- Axillary vein
-Medial Cord
Dr. Sarika S. Chopde, TAMV, Pune

15.  3rd / middle part
Relations-
1) Anterior- Pectoralis Major
-Medial root of median nerve
2) Posterior – Teres major
-Radial & axillary nerve
3) Lateral- Lateral Root Of median nerve
4) Medial- Axillary vein
- Ulnar nerve
Dr. Sarika S. Chopde, TAMV, Pune

16. 3rd part
2nd part
1st part
• Subscapular
• Anterior circumflex
humeral
• Posterior circumflex
humeral
• Thoracoacromial
• Lateral thoracic
• Superior thoracic
Dr. Sarika S. Chopde, TAMV, Pune

17. Dr. Sarika S. Chopde, TAMV, Pune

18.  Total 5 groups
 Drain different areas of upper limb & trunk
Anterior Posterior
Lateral Central
Apical
Dr. Sarika S. Chopde, TAMV, Pune

19. Group Lateral Anterior Posterior Central Apical
Number of
nodes
4-6 4-5 6-7 3-4 6-12
Position Postero-
Medial To
axillary vein
Near
lateral
thoracic
vessels
Posterior
axillary
wall ( along
subscapular)
Axillary fat Posterior to
superior
part of
pectoralis.
Minor
Drain from Whole limb Skin/muscle
of supra
umbilical,
antero
lateral
body wall ,
mammary
gland
Neck- infero
posterior
region /
dorsal trunk
till iliac
crest
- skin ,
superficial
muscles
All
preceding
groups
All other
nodes
Efferents
to
Central,
deep cervical
nodes
Central ,
apical
Apical
central
Apical Form
subclavian
trunk
Dr. Sarika S. Chopde, TAMV, Pune

20. Dr. Sarika S. Chopde, TAMV, Pune

21.  Formed by spinals nerves -C 8 to T1
 Supply upper limb , pectoral region & upper
back
Dr. Sarika S. Chopde, TAMV, Pune

22. C 5 C 6 T 1
C 8
C 7
Upper trunk
Middle trunk
Lower trunk
Anterior
division
Posterior
division
Lateral cord
Medial cord
Posterior cord
Anterior
division
Posterior
division Posterior
division
Anterior
division
Dr. Sarika S. Chopde, TAMV, Pune

23.  Lateral Cord- Lateral Pectoral nerve
- Musculocutaneus (Lat cutaneous
nerve of forearm)
- Lateral Root of median nerve
 Medial Cord- Medial pectoral
-Medial Cutaneuos nerve of arm
- Medial Cutaneus nerve of forearm
- Medial Root of median nerve
- Ulnar nerve
 Posterior cord – Axillary nerve
- Radial nerve(Lateral. Cutaneous Nerve of
arm)
- Thoracodorsal nerve
- Upper & lower Subscapular nerve
Dr. Sarika S. Chopde, TAMV, Pune

24. Dr. Sarika S. Chopde, TAMV, Pune

25. Dr. Sarika S. Chopde, TAMV, Pune

26.  Axillary lymphadenopathy
 Erb’s palsy(Injury to brachial plexus in
children during childbirth)
 Injury to brachial plexus
 Suppuration in axilla
Dr. Sarika S. Chopde, TAMV, Pune