The document describes the anatomy of the axilla, subclavian artery, axillary artery, brachial artery, radial artery, ulnar artery, and intermuscular spaces in the arm. Key points include: - The axilla is a pyramidal space between the upper arm and chest wall containing lymph nodes, blood vessels and nerves. - The subclavian artery becomes the axillary artery in the axilla and then the brachial artery in the arm, with named branches along its course. - The radial and ulnar arteries are terminal branches of the brachial artery, running in the forearm and hand. - There are three intermuscular spaces in the arm that contain named

1. Axilla
• Also called armpit.
• It is a pyramidal space situated b/w upper part
of arm and chest wall.
• It resembles four sided pyramid.
• It has-
An apex
A base
And four walls (boundries)-
anterior,posterior, medial, and lateral.

2. • 1) Apex- apex is directed superiorly and
medially towards the neck.
• It is bounded anteriorly by clavicle,
medially by 1st rib and posteriorly by
scapula.
• Superiorly apex is continuous as
canal called cervico-axillary canal.
Through which the axillary artery and
brachial plexus enters the axilla.

3. 2) base- directed downwards, and formed by
skin.
3) anterior wall- formed by pactoralis major,
pactoralis minor, and subclavius muscle.
4) posterior wall- formed by subscapularis,
latissimus dorsi muscles.
5)Medial wall- formed by upper four ribs and
serratus anterior muscle.
6)Lateral wall- formed by upper part of shaft of
humerus and coracobrahiallis and short head
of biceps brachii muscles.

5. • Contents of axilla-
1- axillary artery and its branches.
2- axillary vein and its tributeries.
3- brachial plexus.
4-Axillary lymph nodes.
5-long thoresic nerves.

6. Triangle of auscultation
• It is small triangular interval, in the back. It has
three boundries-
Medial- lateral border of trapezius.
Lateral- medial border of scapula.
Inferior- upper border of latissmus dorsi.
• Respiratory sounds herd through
stethoscope are said to be batter herd
over this triangle.

7. Subclavian artery
• It is a major artery that supply the upper limb.
• Origin-
Right Subclavian artery - rt. Subclavian artery is
branch of brachiocephelic trunk.
left Subclavian artery- lt. Subclavian artery is
direct branch of arch of aorta.
• Course- after its origin it lies behind the
sternoclavicular joint (right and left), then it
takes upward loop into the neck, and leaves
neck by passing into axilla, where it continues
as axillary artery.

9. cont.
• Extent- it extends from its origin to the outer
border of 1st rib.
• Parts of artery- the sclaneus
anterior muscle divides this artery
into three parts-
1st part – it lies medial to the
sclaneus anterior muscle.
2nd part – it lies deep to the
sclaneus anterior muscle.
3rd part – it lies lateral to the sclaneus anterior

10. • Branches of subclavian artery-
V- vertebral artery
I- internal thoracic artery 1st part
T- thyrocervical trunk
C- costo cervical trunk 2nd part
D- dorsal scapular artery 3rd part
• Relations-
1st part-
anterior- Platysma, Sternocleidomastoid, internal
jugular vein, vagus nerve
Below and behind - pleura, apex of the lung, first

11. 2nd part-
Anterior- Scalenus anterior,
below and behind- pleura, subclavian vein,
Scalenus medius.
Superior- brachial plexus.
3rd part-
Anterior- subclavian vein
Posterior- trunk of brachial plexus
Superior- clavicle and subclavius muscle.

12. Axillary artery
• It is continuation of subclavian artery.
• Extent- it extends from outer border of first rib to
lower border of teres major.
• Parts – pactoralis minor muscle crosses the artery
and devides it into three parts-
1st part- superior to the muscle
2nd part- deep to the muscle
3rd part- inferior to the muscle.

14. Continue...
• Relations-
1st part-
Anterior- platysma, medial and lateral pectoral nerve, pacroralis
major muscle.
Posterior- 1st intercostal space, medial cord.
Laterally- lateral and medial cord.
Medial- axillary vein.
2nd part-
Anterior- pacroralis major and pacroralis minor muscle.
Posterior- posterior cord of brachial plexus
Medial- medial cord.
Lateral- lateral cord

15. • 3rd part-
Anterior- pactoralis major muscle.
Posterior- radial and axillary nerve.
Lateral-musculocutaneous nerve, lateral cord.
Medial- axillary vein, medial cutaneous nerve.
BRANCHES OF ARTERY-
(Save The Lions And Protect Species)
1-Superior thoracic artery – arises from 1st part
2-Thoracoacromial artery- arises from 2nd part
3-Lateral thoracic artery -arises from 2nd part
4-Anterior circumflex humeral artery- arises from 3rd part
5-Posterior circumflex humeral artery- arises from 3rd part
6-Subscapular artery - arises from 3rd part (Largest branch)

16. Brachial artery
• It is the continuation of axillary artery.
Extent- it extends from lower border of teres major muscle to
neck of radius/ medial to the tendon of biceps.
Relations-
Anterior- in upper part- medial cuteneous nerve of forearm.
In middle part- median nerve.
In lower part- bicipital aponeurosis.

18. Continue..
Posterior- triceps, radial nerve and profunda brachii
artery.
Medial- ulnar nerve
Lateral- coracobrachialis and biceps muscle.
Branches-
1- muscular branches
2- profunda brachii artery-Largest branch
3- superior ulnar collateral artery
4- inferior ulnar collateral artery
5- terminal branches- radial and ulnar artery.

19. Radial artery
• Radial artery is smaller direct continuation
of brachial artery.
Course and extent-
• it is quite superficial in its course.
• Runs downwards in lateral aspect of
forearm.
• Leaves forearm by turning posteriorly and
entering anatomical snuff box.
• In hand it ends by forming superficial and
deep palmer arch.

20. Cont...
RELATIONS-
Anterior- Brahioradialis muscle and skin.
Posteriorly- Muscles attacahed on ant. Surface of
radius.
Medially- in U 1/3- pronator teres.
in L 2/3 by flexior carpi radialis
Laterally- Brachioradialis and Radial nerve.

21. Relations

22. BRANCHES – in forearm-
1. Radial recurrent branch- runs upward and anastomose
with radial collateral artery.
2. Muscular branches
3. Palmer carpal branch- arises near the lower border of
pronator quadratus, and supplies the wrist joint.
4. Superficial palmer branch- forms Superficial palmer
arch.
In hand-
1. 1st dorsal metacarpal branch
2. Princeps pollicis artery- supplies to thumb.
3. Radial indicis artery- radial side of index finger.

23. Branches of radial artery

24. Ulnar artery
• Ulnar artery is the larger terminal branch of brachial artery.
It runs downwards in forearm and enters in palm by passing
superficial to the flexor retinaculum.
Relations-
in upper part- muscles of flexor group
Anteriorly-
in lower part- skin and fascia
Posteriorly- flexor digitorum profundus.
Medially- Ulnar nerve.
Lateral- Flexor digitorum superficialis.

25. Cont...
BRANCHES- (in forearm)
1. anterior and posterior ulnar recurrent artery- anastomose with
superior and inferior ulnar collateral artery.
2. Common interosseous artery- runs along the anterior surface of
interosseous membrane.
3. Muscular branch-
4. Palmar and dorsal carpal branch- anastomose with palmar branch of
radial artery.
(in palm)
1. Muscular branch
2. Superficial branch
3. Deep branch

26. Inter muscular spaces in arm
• There are three intermuscular spaces in arm-
1-Superior triangular space
2-Superior quadrangular space
3-Inferior triangular space

27. Boundaries and content
1-Superior triangular space
Boundaries-
Superior- teres minor
Inferior- teres major
Lateral- long head of triceps.
Contents- circumflex scapular vassels. Med. Lat.
2- superior quadrangular space-
Boundaries-
Superior- teres minor and capsule of shoulder joint.
Inferior- teres major
Medial- long head of triceps
Lateral – shaft of humerus.
Contents- axillary nerve and post. Circumflex humeral vessels.

28. Continue..
3-Inferior triangular space
Boundaries-
Superior- teres major
Medial- long head of triceps
Lateral- shaft of humerus
med. Lat.
Contents- radial nerve and profunda brachii vessels.