The axilla is the anatomical region under the shoulder joint where the arm connects to the shoulder. The axilla has five anatomic borders: superior, anterior, posterior, lateral, and medial walls. The borders of the axilla are composed of muscles, including the serratus anterior, coracobrachialis, and short head of the biceps The axillary walls are used as landmarks by surgeons to prevent damage to the neurovascular structures within the axilla during surgery The contents of the axilla include muscles, nerves, vessels, and lymphatics The axillary artery and vein, brachial plexus, and axillary lymph nodes are some of the neurovascular structures found in the axilla

3. Learning outcomes of lecture 3
Describing the position, shape of axilla.
Describing the muscles forming the boundaries of
axilla.
Describing the contents of axilla.
Describing the formation, course, and relation of
axillary vessels.
Describing arrangment and groups of axillary
lymph nodes.

5. AXILLA
Boundaries
Contents
Axillary Vessels

6. AXILLA

7. Definition
It is a pyramid shaped space between the
upper part of the arm and the side of the
chest
Important Nerves, Blood and Lymph vessels
travel through it from root of the neck to the
upper limb

8. Walls of axilla

11. Apex
Upper end of axilla or APEX is directed into
the root of neck
Bounded in front by the clavicle
Behind by upper border of scapula
Medially by outer border of the 1st rib

12. Base
The Base of axilla is formed by the skin
stretching between the anterior and
posterior walls

13. Base
Lower end or Base is bounded in front by the
anterior axillary fold formed by pectoralis
major muscle
Behind by posterior axillary fold formed by the
tendons of latissimus dorsi and teres major
muscles
Medially by the chest wall

14. Walls of The Axilla
• Anterior wall:
By the pectoralis major, Subclavius and
pectoralis minor muscles
• Posterior wall:
By the subscapularis, Latissimus dorsi and
teres major muscles

15. Anterior wall of axilla

16. Walls of The Axilla
• Medial wall:
By the upper 4 or 5 ribs and intercostal spaces
covered by serratus anterior muscle
Lateral wall:
By the coracobrachialis and biceps muscles in
the bicipital groove of humerus

17. Contents of Axilla
Axillary artery and its branches
Axillary vein and its tributaries
Lymph vessels and lymph nodes
Important nerve plexus the “Brachial Plexus”
which innervates the upper limb

20. Axillary Artery
• Is a continuation of subclavian artery
• Begins at the lateral border of the 1st
rib
• Ends at the lower border of teres
major

21. • It continues as the brachial artery
• Closely related to brachial plexus cords
• Enclosed with them in the axillary sheath
• Pectoralis minor divides it into 3 parts

22. Subclavian
artery
Axillary artery
Brachial artery

23. 1st Part of Axillary Artery
• Extends from the lateral border of
the 1st rib
to the upper border of pectoralis
minor

25. Relation
• Anterior: Pectoralis major, covering fascia,
skin, cephalic vein
• Posterior: Long thoracic nerve
• Lateral: Three cords of brachial plexus
• Medial: Axillary vein

26. 2nd Part of Axillary Artery
• Lies behind the pectoralis minor muscle

27. Relation
• Anterior: Pectoralis minor and major, covering
fascia and skin
• Posterior: Posterior cord of brachial plexus
• Lateral: Lateral cord of brachial plexus
• Medial: medial cord of brachial plexus and
axillary vein

28. 3rd Part of Axillary Artery
• Extends from lower border of pectoralis minor
to the lower border of teres major

29. Relation
• Anterior: Pectoralis major, medial root of the
median nerve
• Posterior: subscapularis, latissimus dorsi and
teres major
• Lateral: biceps muscle, humerus
• Medial: Ulnar nerve, axillary vein

30. Axillary vein
The axillary vein lies initially
(distally) on the anteromedial
side of the axillary artery,
This large vein is formed by the union of
the brachial vein (the accompanying veins
of the brachial artery) and the basilic vein
at the inferior border of the teres major.
The axillary vein has three parts, which correspond
to the three parts of the axillary artery. Thus the
initial, distal end is the third part, whereas the
terminal, proximal end is the first part.
The axillary vein (first part) ends at
the lateral border of the 1st rib, where
it becomes the subclavian vein.

31. Axillary Lymph Nodes

33. Axillary Lymph Nodes

34. Axillary Lymph Nodes
1. Central Nodes
Lie near the base of the axilla
Receive lymph from the lateral, anterior, and
posterior groups of nodes;
 drain into the apical nodes.

35. Axillary Lymph Nodes

36. Axillary Lymph Nodes
2. Brachial (Lateral) Nodes
 Lie posteromedial to the axillary veins,
receive lymph from the upper limb,
 drain into the central nodes.

37. Axillary Lymph Nodes

38. Axillary Lymph Nodes
3. Subscapular (Posterior) Nodes
Lie along the subscapular vein,
receive lymph from the posterior
thoracic wall and the posterior aspect of
the shoulder
drain into the central nodes.

39. Axillary Lymph Nodes

40. Axillary Lymph Nodes
4. Pectoral (Anterior) Nodes
Lie along the inferolateral border of the
pectoralis minor muscle;
receive lymph from the anterior and lateral
thoracic walls, including the breast; and
drain into the central nodes.

41. Axillary Lymph Nodes

42. Axillary Lymph Nodes
5. Apical (Medial or Subclavicular) nodes
Lie at the apex of the axilla above the upper border
of the pectoralis minor muscle,
receive lymph from all of the other axillary nodes
drain into the subclavian trunks

43. Reaching???
Describing the position, shape of axilla.
Describing the muscles forming the boundaries of
axilla.
Describing the contents of axilla.
Describing the formation, course, and relation of
axillary vessels.
Describing arrangment and groups of axillary
lymph nodes.

45. Give short notes about:
Walls of the axilla

46. Give short notes about:
Lymph nodes groups of
the axilla

47. t.me/BMS2020_AMEERAALHUMIDI
@Dr_Ameeraalhumidi
ameeraalhumidi@gmail.com

48. Chapter 18, Cardiovascular System 48