Axilla

Question 0

Apex of axilla

Answer 0

Cervico- axillary canal
Passageway between neck and axilla
Bounded by 1st rib, clavicle, and superior edge of the scapula
Arteries, veins, lymphatics and nerves transverse superior opening to pass to or from arm

Question 1

Axilla

Answer 1

Pyramidal space inferior to glenohumeral joint and superior to the skin and axillary fascia at the junction of the arm and thorax

Question 2

Base of axilla

Answer 2

Formed by the concave skin, subcutaneous tissue, and axillary (deep) fascia extending from the arm to the thoracic wall forming the axillary fossa (armpit)

Question 3

Anterior wall of axilla

Answer 3

Formed by pectoralis major and minor and pectoral and Clavipectoral fascia associated with them
Anterior axillary fold is inferior most part of anterior wall

Question 4

Posterior wall of axilla

Answer 4

Formed chiefly by scapula and subscapularis on its anterior surface and inferiorly by teres major and latissimus dorsi
Posterior axillary fold is inferior most part of posterior wall that may be grasped

Question 5

Medial wall of axilla

Answer 5

Formed by thoracic wall and overlying serratus anterior

Question 6

Lateral wall of axilla

Answer 6

Narrow bony wall formed by intertubercular sulcus of humerus

Question 7

Axilla contains

Answer 7

Axillary artery and branches, axillary vein and tributaries, nerves of cords and branches of brachial plexus, lymphatic vessels and axillary lymph nodes all embedded in axillary fat
Proximally, neurovascular structures are ensheathed in a sleeve like extension of the cervical prevertebral fascia, the axillary sheath

Question 8

Axillary artery

Answer 8

Begins at lateral border of 1st rib as continuation of subclavian artery and ends at inferior border of teres major
Passes posterior to pectoralis minor into the arm and becomes the brachial artery when it passes distal to the inferior border of the teres major

Question 9

First part of axillary artery

Answer 9

Located between lateral border of first rib and medial border of pectoralis minor
It is enclosed in axillary sheath and has one branch: superior thoracic artery

Question 10

Second part of axillary artery

Answer 10

Posterior to pectoralis minor and has two branches: thoraco acromial artery and lateral thoracic artery, which pass medial and lateral to the muscle, respectively

Question 11

Third part of axillary artery

Answer 11

Extends from lateral border of pectoralis minor to inferior border of teres major and has three branches
Subscapular artery is largest branch
Opposite origin of this artery: anterior circumflex humeral artery and posterior circumflex humeral artery arise

Question 12

Axillary vein

Answer 12

Lies initially on the anteromedial side of axillary artery, with its terminal part anteroinferior to the artery
Formed by the union of the accompanying brachial veins and the basilic vein at the inferior border of the teres major
It ends at the lateral border of the first rib where it becomes the subclavian vein
Veins of axilla are more abundant, highly variable, and more likely to anastamose

Question 13

Compression of axillary artery

Answer 13

Compression of third part against humerus may be necessary with profuse bleeding
If need it at more proximal site, can be compressed at its origin at lateral border of first rib by exerting downward pressure in angle between clavicle and attachment of SCM

Question 14

Injury to axillary vein

Answer 14

Very easy because large and exposed

Dangerous because bleeding and air emboli

Question 15

Five principal groups of axillary lymph nodes

Answer 15

Pectoral, subscapular, humeral, central and apical

Question 16

Pectoral (anterior) nodes

Answer 16

Consist of three to five nodes that lie along the medial wall of the axilla, around the lateral thoracic vein and inferior border of the pectoralis minor
Pectoral nodes receive lymph mainly from the anterior thoracic wall, including most of the breast

Question 17

Subscapular (posterior) nodes

Answer 17

Consist of six or seven nodes that lie along the posterior axillary fold and subscapular blood vessels
Receive lymph from the posterior aspect of the thoracic wall and scapular region

Question 18

Humeral (lateral) nodes

Answer 18

Consist of four to six nodes that lie along the lateral wall of the axilla, medial and posterior to the axillary vein
Receive nearly all the lymph from the upper limb, except that carried by lymphatic vessels accompanying the Cephalic vein, which primarily drain to the apical axillary and infra clavicular nodes

Question 19

Central nodes

Answer 19

Efferent lymphatic vessels from pectoral, subscapular and humeral nodes pass here
Consist of three or four large nodes situated deep to the pectoralis minor near the base of the axilla, in association with the second part of the axillary artery
Efferent vessels from the central nodes pass to the apical nodes

Question 20

Apical nodes

Answer 20

Receive efferent vessels from the central nodes
Located at the apex of the axilla along the medial side of the axillary vein and the first part of the axillary artery
Receive lymph from all other groups of axillary nodes as well as from lymphatics accompanying proximal Cephalic vein

Question 21

Lymphatic ducts

Answer 21

Efferent vessels from apical nodes transverse Cervico axillary canal and unite to form the subclavian lymphatic trunk, although some vessels may drain en route through the clavicular (infra clavicular and supraclavicular) nodes. The subclavian lymphatic trunk may be joined by the jugular and Bronchomediastinal trunks on the right side to form right lymphatic duct, or it may enter the right venous angle independently. On the left side, the subclavian trunk most commonly joins the thoracic duct

Question 22

Lymphangitis

Answer 22

Inflammation of lymph vessels

Characterized by warm, red streaks in the skin of the limb