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1. AXILLARY ARTERY
Lt Col Supeeti Gupta
Demonstrator
DEPT OF ANATOMY
1
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2. Competencies
• Branch / continuation
• Relations
• Branches
• Applied
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3. AXILLARY ARTERY
3
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4. AXILLARY ARTERY
4
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5. AXILLARY ARTERY
– Continuation
• of 3rd part of Subclavian Art
– Extends from
• outer border of 1st Rib to
• lower border of Teres Maj, then
continue as Brachial art.
5
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6. AXILLARY ARTERY
COURSE
• At outer border of 1st rib ---
• enter axilla ---
• run from apex to base of axilla.
– Close to
• medial wall at apex,
• lat wall at base.
– Acccompanied with
• axillary vein, cords of BP along with branches.
– Enclosed within Axillary sheath.
6
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7. AXILLARY ARTERY
PARTS
1.proximal to Pect
minor
2.Behind Pect
minor
3.Distal to Pect
minor 7
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8. AXILLARY ARTERY
Relation of
Pectoralis
Minor to the
Artery
8
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9. AXILLARY ARTERY
Relation of Axillary
Artery
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10. PART ANTERIOR POSTERIOR MEDIAL LATERAL
First skin, SF, platysma 1,2nd ribs with IC msl Axillary V Lat and Post cord
Suprclavicular N SA (1-2 dig) (ant med)
Deep fascia, P maj Long thoracic N
Clavipect fascia Medial cord BP
(Art crossed anteriorly by Thoraco acromial art, Lat pect N, loop of commn bt medial and lat
Pectoral N)
MEDIAL
AXILLARY ARTERY FIRST PART
10
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11. PART ANTERIOR POSTERIOR MEDIAL LATERAL
Second as above + Subscapularis Medial cord BP Lat cord BP
P minor Post cord BP Axillary V (antmed) Coracobrachialis
(In between Pect maj and minor are Pect branches of Thoracoacromial art, medial Pect N
and Rotter’s LN)
AXILLARY ARTERY SECOND PART
MEDIAL PART
11
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12. ANTERIOR POSTERIOR MEDIAL LATERAL
Third Pect maj (upperpart) LD & T Maj (lat) Axillary V Coracobrachialis
skin & fascia (lower) Subscapularis Medial Cut N Musculocutaneous
Axillary N of arm /forarm Median N
Radial N
AXILLARY ARTERY THIRD PART
UPPER PART
LOWER PART
12
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13. AXILLARY ARTERY- RELATIONS
PART ANTERIOR POSTERIOR MEDIAL LATERAL
First skin, SF, platysma 1,2nd ribs with IC msl, Axillary V Lat and Post cord
Suprclavicular N SA(1-2 dig (ant med)
Deep fascia, P maj Long thoracic N
Clavipect fascia Medial cord BP
(Art crossed anteriorly by Thoraco acromial art, Lat pect N, loop of commn bt medial and lat Pectoral N)
Second as above + P minor Subscapularis Medial cord BP Lat cord BP
Post cord BP Axillary V (antmed) Coracobrachialis
(In between Pect maj and minor are Pect branches of Thoracoacromial art, medial Pect N and Rotter’s
LN)
Third Pect maj (upperpart) LD & T Maj Axillary V Coracobrachialis
skin & fascia (lower) Subscapularis Medial Cut N Musculocutaneous N
of arm/forearm Median N
Axillary N & Radial N
13
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14. AXILLARY ARTERY- BRANCHES
FIRST PART
Superior thoracic
SECOND PART
Thoracoacromial
Lateral thoracic
THIRD PART
Anterior circumflex
humeral
Posterior
circumflex
humeral
subscapular 14
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15. AXILLARY ARTERY- BRANCHES
15
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16. AXILLARY ARTERY- BRANCHES
FIRST PART
1. Superior thoracic
Art
– Smallest br
– Arise above
Pect minor
– Supply :
• 1,2nd IC
space
• Seratus ant
upper part 16
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17. AXILLARY ARTERY-
BRANCHES
SECOND PART
1. Thoracoacromial artery
• Largest br
• Pierce clavipectoral fascia just above
Pect minor and divides
1. clavicular –
• supply sternoclavicular jt and
subclavius
2. Acromial –
• shoulder
3. Deltoid –
• accompany cephalic vein in
delto pectoral groove and
• supply both msl.
4. Pectoral –
• supply both pectorals and
breast. 17
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18. AXILLARY ARTERY- BRANCHES
18
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19. AXILLARY ARTERY-
BRANCHES
2. Lateral thoracic
– Arise deep to P
minor,
– come out at inferior
border of P minor.
– Supply Pect msl and
Breast
• through Lateral
mammary branches
– Anastomose with
• pectoral br of Thoraco
acromial art
19
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20. AXILLARY ARTERY-
BRANCHES
THIRD PART
1. Anterior circumflex
humeral artery
– Small br
– Run infront of surgical
neck of humerus and
winds around it.
– Anastomoses with
• post circumflex humeral art
– Gives ascending branch
• goes through
Intertubercular groove and
supply shoulder jt.
H
20
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21. AXILLARY ARTERY-
BRANCHES
2. Post circumflex humeral
art
– Larger br
– Winds around posterior
aspect of surgical neck of
humerus, leaves axilla
with axillary N in the
quadrangular space.
– Anastomose with
• anterior circumflex art.
– Give descending br which
anastomose with deltoid
br of Profunda brachii
21
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22. Post circumflex
passes thro post
axillary wall bt
subscapularis
and T maj
22
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23. AXILLARY ARTERY- BRANCHES
3. Subscapular artery
– Largest br
– Run along post axillary
wall, give off circumflex
scapular br
– Main artery continue
down as
• Thoracodorsal art
• upto Inferior angle of
scapula. Supply LD.
– Circumflex scapular
br –
• winds around lateral
border of scapula after
piercing T minor and
reach infraspinatus
fossa.
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24. AXILLARY ARTERY- BRANCHES
Circumflex art passes
through post wall
of axilla bt subscapularis and
T Maj
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25. AXILLARY ARTERY- SCAPULAR ANASTOMOSIS
Collateral anastomosis :
between branches of
– 1st part of Subclavian and
– 3rd part of Axillary artery.
Sites of scapular anastomosis
1. In subscapular,
2. supraspinous and
3. infraspinous fossae
Other small anas
• Over acromial process
26
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26. AXILLARY ARTERY- SCAPULAR ANASTOMOSIS
1. In subscapular, supraspinous and infraspinous
fossae
– 1st part of Subclavian (thyrocervical trunk):
• Suprascapular art
• Deep branch of transverse cervical artery
– 3rd part of Axillary
• Circumflex scapular art
27
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27. AXILLARY ARTERY- SCAPULAR ANASTOMOSIS
2. Other small anas : Over acromial
process
– 1st part of Subclavian (thyrocervical
trunk)
• Acromial branch of suprascapular artery
– Branches of axillary
• Thoracoacromial
• Post circumflex humeral artery
28
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28. AXILLARY ARTERY- SCAPULAR ANASTOMOSIS
29
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29. AXILLARY ARTERY-
SCAPULAR
ANASTOMOSIS
30
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30. AXILLARY ARTERY- APPLIED
1. most susceptible to laceration/ trauma
2. To arrest bleeding : compressed against the shaft
of humerus (upper part)
3. Aneurysms : can compress cords of BP due to
axillary aneurysms and thin axillary sheath.
4. Axillary vein
• Bleeding and air embolism in injuries to proximal part
• Subclavian vein puncture
5. Scapular anastomosis 31
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31. Subclavian puncture
Needle passed in the axillary vein uptil the junc of IJV and subclavian vein
Axillary vein is Anterior to artery and excessive posterior push may penetrate
artery
32
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32. 5. Axillofemoral graft
• Used for salvaging
pregangrenous limb
with bilateral iliac
obstruction
• PFTE 8mm graft
tunneled
subcutaneously from
axillary art proximally
to femoral art distally
grafts
33
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33. 6. Axillary vein thrombosis
1. May occur following
• Excessive exercise
• Complication of thoracic outlet syn
• Associated with cervical rib
2. Presentation
• Swollen arm with collateral circulation
• Treatment with anticoagulants, fibrinolytic therapy
34
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34. ASSESSMENT
• Which of the following is most correct?
(A) subscapular artery arises from third part of axillary
artery & contributes to blood supply of muscles near the
scapula & humerus
(B) second part of axillary artery typically gives two
branches—thoracoacromial artery & superior thoracic
artery
(C) first part of axillary artery lies posterior to pectoralis
minor
(D) thoracoacromial artery supplies pectoral muscles,
axillary lymph nodes, & most importantly lateral part of
mammary gland in women
(E) lateral thoracic artery divides into acromial, deltoid,
pectoral, & clavicular branches
SUPEETI 35

35. ASSESSMENT
Which among the following is a branch from
the trunk of brachial plexus?
a. Suprascapular nerve
b. Long thoracic nerve
c. Anterior thoracic nerve
d. Nerve to subclavius
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36. ASSESSMENT
• Axillary vein is ---------- to Axillary artery
• Scapular anastomosis is between ----- part
of subclavian and ----- part of axillary
artery
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37. thankyou
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