Axilla And Brachial Plexus (Lecom)

Front 1

Breast Cancer

Metastasis and

the Axilla

Back 1

Over 75% of lymph drainage of the breast is in axilla. Enlargement of he axilla nodes is an early indication of metastasis.

Excision risks damage to the long thoracic and thoracodorsal nerves, and may result in lympedema in the upper limb.

Front 2

What is A?

Back 2

Tail of Spence- a lateral extension of mammary tissues and glands into the axillary area.

Front 3

Serratus Anterior

Back 3

Proximal attachment-Ribs

Distal Attachment-Scapula

Innervation-long thoracic nerve

Action-protracts scapula, holds scapula against the body wall, assists in the rotation of the scapula.

Front 4

What muscle is shown?

Back 4

Serratus Anterior

Front 5

What nerve is most likely affected and what makes it vulnerable?

Back 5

The long thoracic nerve. It is vulnerable because it is superficial to the muscle it innervates. (patient will only be able to abduct to 90 degrees)

Front 6

Pectoralis Major

Back 6

Proximal attachment- (2 heads) sternum and clavicle.

Distal attachment- intertubicular groove.

Innervation- lateral and medial pectoral nerves.

Action- Adducts and medially rotates the humerus.

Front 7

Back 7

Pectoralis Major

Front 8

Pectoralis Minor

Back 8

Proximal attachment-3rd-5th ribs near costal cartilage

Distal attachment- corocoid process

Innervation- medial pectoral nerve

Action-Stabilize scapula during upper limb movements.

Front 9

Back 9

Pectoralis minor

Front 10

Subclavious muscle

Back 10

Proximal attachment- 1st rib near costal cartilage.

Distal attachment- inferior third of clavicle.

Innervation- Subcalvious

Action- Anchor and stabilize clavicle

Front 11

Back 11

Subclavious muscle

Front 12

What is this region called and why is it important?

Back 12

The axilla- a major site for arteries, veins, nerves, and lymphatics of the upper limb and shoulder.

Front 13

four walls of the axillary space

Back 13

Anterior- lateral pectoralis muscle and the underlying minor subclavian muscle

Posterior wall- scapula, subscapularis muscle, teres major, lattissimus dorsi.

Lateral wall-intertubicular groove

Medial wall- thoracic wall, 1st-4th ribs, intercostal muscles, serratus anterior

Front 14

Apex and Base of the axillary space

Back 14

Apex- 1st rib, clavicle, superior subscapularis

Base-skin, subcutaneous tissue

Front 15

Contents of the Axillary Space

Back 15

Brachial plexus, Axillary artery, Axillary vein, lymph nodes.

Front 16

Branches of the Axillary Artery

(Sixties Teens Love Sex And Pot)

Back 16

Supreme Thoracic (Sixties are in the past, so down in time.)

Thoracoacromial(Teens grow up and die)

Lateral thoracic (when you Love someone you go down on them)

Subscapular (you may also go down on someone when you have Sex with them)

Anterior humoral circumflex (And Pot makes you high so you go up)

Posterior humoral circumflex

Front 17

Branches of the Thorachoromial

(Teens grow up and die.)

(Cadavers Are Dead People)

Back 17

Upward branch, breaks into four smaller arteries

Clavicular

Acromial

Deltoid

Pectoral

Front 18

Branches of the Subscapular branch.

(When you have Sex it's great, you may go down on

someone and in the end you have STds)

Back 18

Greatest branch, downward, breaks into two more arteries

Scapular circumflex

Thoracodorsal

Front 19

Sections of the Brachial plexus

(Read That Damn Cadaver Book!)

Back 19

Roots, Trunks,Divisions, Cords, Branches

Front 20

Comic Relief!

Back 20

Front 21

Roots of the Brachial Plexus

Back 21

C5-T1 spinal nerves.

C5 gives off Dorsal scapular (inervates levetator scapulae and Rhomboids.)

C5,C6,C7 give off the long thoracic nerve (innervates the anterior serratus)

Front 22

Trunks of the Brachial Plexus

Back 22

Superior trunk- C5 and C6, gives off the suprascapular nerve (innervates supraspinatus and infraspinatis)

Middle trunk- C7, no branches

Inferior trunk- C8 and T1, no branches

Front 23

Divisions of the brachial plexus.

Back 23

Each trunk gives rise to an anterior and a posterior division. Anterior divisions from the superior and the middle trunk form the lateral cord.Posterior divisions from all three thunks form the posterior cord. Anterior division of the posterior trunk forms the medial curve.

Front 24

Cords of the brachial plexus

Back 24

Cords are named in relation to the Axillary artery (this is helpful for recognizing them on a cadaver or in patient) Lateral cord has contributions from C5, C6 and C7, Medial cord contains axons from C8 and T1, posterior cord contains all five.

Front 25

Branches of the Lateral Cord

Back 25

Lateral Pectoral Nerves ( innervate Pectoralis Major)

Musculocutaneous Nerve (Innervates coraco brachialis, biceps bracii, and brachialis.

Medial nerve (contributes with medial cord) (Innervates most of the anterior compartment of the forarm)

Front 26

Branches of the Medial Cord

Back 26

Medial Pectoral Nerve (innervates pectoralis major and minor)

Medial Cutaneous Nerve of the Arm

Medial Cutaneous Nerve of the Forearm

Medial Nerve (Contributes with lateral cord) (Innervates anterior compartment of the forearm. Ulnar Nerve (innervates flexor carpi ulnaris, medial flexor digitorum profundus, all of intrinsic hand.)

Front 27

Branches of the Posterior Cord

Back 27

Superior Subscapular Nerve (innervates subscapularis)

Thoracodorsal Nerve- Innervates Rhomboids and Lattissimus dorsi)

Inferior Subscapular Nerve (Innervates subscapulares and teres major)

Axillary Nerve (innervates deltoid and teres minor)

Radial Nerve (innervates tricepts, extensor compartment, brachiradialis)

Front 28

Electromyography

Back 28

Used to assess the precise location of a brachial plexus region

Front 29

Name and describe the condition may result from this improper delivery?

Back 29

Erbs Palsy. Upper brachial plexes injury effects the muscles of the shoulder and arm though grasp is normal. Typically C5-C7 deficits. Results in "Waiters tip" Pronated arm and flexed wrist.

Front 30

Describe Klumpkes Palsy.

Back 30

A lower brachial plexus that usually results from a lower brachial plexus injury. Often claw hand is observed. Typically cause by swinging a child by their arms, or breaking a fall by catching in to something. May also present with Horners Syndrome if T1 is effected.

Front 31

Describe the symptoms and suspected diagnosis given the brachial plexus was involved

Back 31

T1 nerve injury. Smooth muscle in the eyelid is effected causing drooping and pupil dilation.

Front 32

What is the muscle shown in the lower half of the image?

Back 32

Serratus Anterior

Front 33

Back 33

Pectoralis Major

Front 34

Back 34

Pectoralis minor