Contents of the Axilla 1.Axillary artery and its branches. 2.Axillary vein and its tributaries. 3.Cords of the brachial plexus and their branches. 4.Axillary.

Contents of the Contents of the AxillaAxilla

Contents of the Contents of the AxillaAxilla

1.1. Axillary artery and its branches.Axillary artery and its branches.

2.2. Axillary vein and its tributaries.Axillary vein and its tributaries.

3.3. Cords of the brachial plexus and Cords of the brachial plexus and their branches.their branches.

4.4. Axillary lymph nodes and lymph Axillary lymph nodes and lymph vessels.vessels.

5.5. Axillary tail of the mammary gland.Axillary tail of the mammary gland.

6.6. Axillary fat.Axillary fat.

1.1. Axillary artery and its branches.Axillary artery and its branches.

2.2. Axillary vein and its tributaries.Axillary vein and its tributaries.

3.3. Cords of the brachial plexus and Cords of the brachial plexus and their branches.their branches.

4.4. Axillary lymph nodes and lymph Axillary lymph nodes and lymph vessels.vessels.

5.5. Axillary tail of the mammary gland.Axillary tail of the mammary gland.

6.6. Axillary fat.Axillary fat.

1. Axillary Artery1. Axillary Artery1. Axillary Artery1. Axillary Artery

It is the It is the only arteryonly artery which supplies the upper which supplies the upper limb.limb.

BeginningBeginning:: at the outer border of the first rib as at the outer border of the first rib as a continuation of the subclavian artery.a continuation of the subclavian artery.

EndEnd:: at the lower border of the teres major at the lower border of the teres major muscle, where it continues as the brachial muscle, where it continues as the brachial artery.artery.

Course:Course:

– It is surrounded with cords and branches of It is surrounded with cords and branches of brachial plexus inside the brachial plexus inside the axillary sheathaxillary sheath..

– Pectoralis minorPectoralis minor muscle passes in front of the muscle passes in front of the artery and divides it into artery and divides it into 3 parts3 parts..

It is the It is the only arteryonly artery which supplies the upper which supplies the upper limb.limb.

BeginningBeginning:: at the outer border of the first rib as at the outer border of the first rib as a continuation of the subclavian artery.a continuation of the subclavian artery.

EndEnd:: at the lower border of the teres major at the lower border of the teres major muscle, where it continues as the brachial muscle, where it continues as the brachial artery.artery.

Course:Course:

– It is surrounded with cords and branches of It is surrounded with cords and branches of brachial plexus inside the brachial plexus inside the axillary sheathaxillary sheath..

– Pectoralis minorPectoralis minor muscle passes in front of the muscle passes in front of the artery and divides it into artery and divides it into 3 parts3 parts..

Relations the First partRelations the First partRelations the First partRelations the First part

AnteriorlyAnteriorly:: Skin, Fascia (superficial and Skin, Fascia (superficial and deep), pectoralis major muscle and clavi-deep), pectoralis major muscle and clavi-pectoral fascia.pectoral fascia.

PosteriorlyPosteriorly:: 11stst intercostal space, 1 intercostal space, 1stst digitation of serratus anterior, long thoracic digitation of serratus anterior, long thoracic nerve and medial cord of brachial plexus.nerve and medial cord of brachial plexus.

LaterallyLaterally:: Lateral and posterior cords of the Lateral and posterior cords of the brachial plexus.brachial plexus.

MediallyMedially:: Axillary vein.Axillary vein.

AnteriorlyAnteriorly:: Skin, Fascia (superficial and Skin, Fascia (superficial and deep), pectoralis major muscle and clavi-deep), pectoralis major muscle and clavi-pectoral fascia.pectoral fascia.

PosteriorlyPosteriorly:: 11stst intercostal space, 1 intercostal space, 1stst digitation of serratus anterior, long thoracic digitation of serratus anterior, long thoracic nerve and medial cord of brachial plexus.nerve and medial cord of brachial plexus.

LaterallyLaterally:: Lateral and posterior cords of the Lateral and posterior cords of the brachial plexus.brachial plexus.

MediallyMedially:: Axillary vein.Axillary vein.

Relations the Second partRelations the Second partRelations the Second partRelations the Second part

AnteriorlyAnteriorly:: Skin, Fascia (superficial and Skin, Fascia (superficial and deep), pectoralis major and minor deep), pectoralis major and minor muscles.muscles.

PosteriorlyPosteriorly:: Posterior cord of brachial Posterior cord of brachial plexus and subscapularis muscle.plexus and subscapularis muscle.

LaterallyLaterally:: Lateral cords of the brachial Lateral cords of the brachial plexus and coraco-brachialis muscle.plexus and coraco-brachialis muscle.

MediallyMedially:: Medial cord of brachial plexus Medial cord of brachial plexus and axillary vein.and axillary vein.

AnteriorlyAnteriorly:: Skin, Fascia (superficial and Skin, Fascia (superficial and deep), pectoralis major and minor deep), pectoralis major and minor muscles.muscles.

PosteriorlyPosteriorly:: Posterior cord of brachial Posterior cord of brachial plexus and subscapularis muscle.plexus and subscapularis muscle.

LaterallyLaterally:: Lateral cords of the brachial Lateral cords of the brachial plexus and coraco-brachialis muscle.plexus and coraco-brachialis muscle.

MediallyMedially:: Medial cord of brachial plexus Medial cord of brachial plexus and axillary vein.and axillary vein.

Relations the Third Relations the Third partpart

Relations the Third Relations the Third partpart

AnteriorlyAnteriorly:: Skin, Fascia (superficial and Skin, Fascia (superficial and deep), pectoralis major and medial root of deep), pectoralis major and medial root of median nerve.median nerve.

PosteriorlyPosteriorly:: Subscapularis, latissimus dorsi Subscapularis, latissimus dorsi and teres major muscles, radial and axillary and teres major muscles, radial and axillary (circumflex) nerves.(circumflex) nerves.

LaterallyLaterally:: C Coraco-brachialis and biceps oraco-brachialis and biceps muscle, humerus, lateral root of median nerve muscle, humerus, lateral root of median nerve and musculo-cutaneous nerve.and musculo-cutaneous nerve.

MediallyMedially:: Axillary vein, ulnar nerve and Axillary vein, ulnar nerve and medial cutaneous nerves of arm and forearm.medial cutaneous nerves of arm and forearm.

AnteriorlyAnteriorly:: Skin, Fascia (superficial and Skin, Fascia (superficial and deep), pectoralis major and medial root of deep), pectoralis major and medial root of median nerve.median nerve.

PosteriorlyPosteriorly:: Subscapularis, latissimus dorsi Subscapularis, latissimus dorsi and teres major muscles, radial and axillary and teres major muscles, radial and axillary (circumflex) nerves.(circumflex) nerves.

LaterallyLaterally:: C Coraco-brachialis and biceps oraco-brachialis and biceps muscle, humerus, lateral root of median nerve muscle, humerus, lateral root of median nerve and musculo-cutaneous nerve.and musculo-cutaneous nerve.

MediallyMedially:: Axillary vein, ulnar nerve and Axillary vein, ulnar nerve and medial cutaneous nerves of arm and forearm.medial cutaneous nerves of arm and forearm.

Branches of the Axillary arteryBranches of the Axillary arteryBranches of the Axillary arteryBranches of the Axillary artery

From 1From 1stst part part::

1.1. Highest (superior) thoracic artery.Highest (superior) thoracic artery.

From 2nd partFrom 2nd part::

2.2. Thoracoacromial artery.Thoracoacromial artery.

3.3. Lateral thoracic artery.Lateral thoracic artery.

From 3From 3rdrd part part::

4.4. Subscapular artery.Subscapular artery.

5.5. Anterior circumflex humeral artery.Anterior circumflex humeral artery.

6.6. Posterior circumflex humeral artery.Posterior circumflex humeral artery.

From 1From 1stst part part::

1.1. Highest (superior) thoracic artery.Highest (superior) thoracic artery.

From 2nd partFrom 2nd part::

2.2. Thoracoacromial artery.Thoracoacromial artery.

3.3. Lateral thoracic artery.Lateral thoracic artery.

From 3From 3rdrd part part::

4.4. Subscapular artery.Subscapular artery.

5.5. Anterior circumflex humeral artery.Anterior circumflex humeral artery.

6.6. Posterior circumflex humeral artery.Posterior circumflex humeral artery.

Highest thoracic arteryHighest thoracic arteryHighest thoracic arteryHighest thoracic artery

It is a branch of the 1It is a branch of the 1stst part of part of axillary artery.axillary artery.

It runs along the upper border of It runs along the upper border of pectoralis minor.pectoralis minor.

It supplies the pectoral muscles It supplies the pectoral muscles and thoracic wall.and thoracic wall.

It is a branch of the 1It is a branch of the 1stst part of part of axillary artery.axillary artery.

It runs along the upper border of It runs along the upper border of pectoralis minor.pectoralis minor.

It supplies the pectoral muscles It supplies the pectoral muscles and thoracic wall.and thoracic wall.

Thoraco-acromial arteryThoraco-acromial arteryThoraco-acromial arteryThoraco-acromial arteryIt is a branch of the 2It is a branch of the 2ndnd part of axillary part of axillary

artery.artery.It is a short artery that pierces the It is a short artery that pierces the

clavipectoral fascia and divides into 4 clavipectoral fascia and divides into 4 branches (acromial, pectoral, branches (acromial, pectoral, clavicular and deltoid).clavicular and deltoid).

It supplies the pectoral region, It supplies the pectoral region, thoracic wall and mammary gland.thoracic wall and mammary gland.

It is a branch of the 2It is a branch of the 2ndnd part of axillary part of axillary artery.artery.

It is a short artery that pierces the It is a short artery that pierces the clavipectoral fascia and divides into 4 clavipectoral fascia and divides into 4 branches (acromial, pectoral, branches (acromial, pectoral, clavicular and deltoid).clavicular and deltoid).

It supplies the pectoral region, It supplies the pectoral region, thoracic wall and mammary gland.thoracic wall and mammary gland.

Lateral thoracic arteryLateral thoracic arteryLateral thoracic arteryLateral thoracic arteryIt is a branch of the 2It is a branch of the 2ndnd part of axillary part of axillary

artery.artery.It runs along the lower border of It runs along the lower border of

pectoralis minor.pectoralis minor.It supplies the pectoral muscles, and It supplies the pectoral muscles, and

thoracic wall.thoracic wall.In females, it is larger and gives In females, it is larger and gives

lateral mammary branches.lateral mammary branches.

It is a branch of the 2It is a branch of the 2ndnd part of axillary part of axillary artery.artery.

It runs along the lower border of It runs along the lower border of pectoralis minor.pectoralis minor.

It supplies the pectoral muscles, and It supplies the pectoral muscles, and thoracic wall.thoracic wall.

In females, it is larger and gives In females, it is larger and gives lateral mammary branches.lateral mammary branches.

Subscapular arterySubscapular arterySubscapular arterySubscapular arteryIt is a branch of the 3It is a branch of the 3rdrd part of axillary part of axillary

artery.artery.It is the largest branch of the axillary It is the largest branch of the axillary

arteryarteryIt runs along the lower border of It runs along the lower border of

subscapularis muscle.subscapularis muscle.It gives off circumflex scapular branch.It gives off circumflex scapular branch.It shares in anastomosis around the It shares in anastomosis around the

scapula.scapula.

It is a branch of the 3It is a branch of the 3rdrd part of axillary part of axillary artery.artery.

It is the largest branch of the axillary It is the largest branch of the axillary arteryartery

It runs along the lower border of It runs along the lower border of subscapularis muscle.subscapularis muscle.

It gives off circumflex scapular branch.It gives off circumflex scapular branch.It shares in anastomosis around the It shares in anastomosis around the

scapula.scapula.

Anterior circumflex humeral arteryAnterior circumflex humeral arteryAnterior circumflex humeral arteryAnterior circumflex humeral artery


It is a small artery that runs laterally It is a small artery that runs laterally in front of the surgical neck of the in front of the surgical neck of the humerus.humerus.

It anastomoses with the posterior It anastomoses with the posterior circumflex humeral artery around the circumflex humeral artery around the surgical neck of the humerus.surgical neck of the humerus.


It is a small artery that runs laterally It is a small artery that runs laterally in front of the surgical neck of the in front of the surgical neck of the humerus.humerus.

It anastomoses with the posterior It anastomoses with the posterior circumflex humeral artery around the circumflex humeral artery around the surgical neck of the humerus.surgical neck of the humerus.

Posterior circumflex humeral Posterior circumflex humeral arteryartery

Posterior circumflex humeral Posterior circumflex humeral arteryartery


It is larger than the anterior one and runs It is larger than the anterior one and runs with the axillary nerve to enter the with the axillary nerve to enter the quadrangular muscular space.quadrangular muscular space.

Then it passes behind the surgical neck of Then it passes behind the surgical neck of the humerus.the humerus.

It anastomoses with the anterior circumflex It anastomoses with the anterior circumflex humeral artery around the surgical neck of humeral artery around the surgical neck of the humerus.the humerus.


It is larger than the anterior one and runs It is larger than the anterior one and runs with the axillary nerve to enter the with the axillary nerve to enter the quadrangular muscular space.quadrangular muscular space.

Then it passes behind the surgical neck of Then it passes behind the surgical neck of the humerus.the humerus.

It anastomoses with the anterior circumflex It anastomoses with the anterior circumflex humeral artery around the surgical neck of humeral artery around the surgical neck of the humerus.the humerus.

2. Axillary Vein2. Axillary Vein2. Axillary Vein2. Axillary Vein

Beginning (Formation)Beginning (Formation):: at the lower at the lower border of the teres major muscle, by union border of the teres major muscle, by union of the basilic vein with the venae of the basilic vein with the venae comitantes of the brachial artery.comitantes of the brachial artery.

EndEnd:: at the outer border of the first rib at the outer border of the first rib where it continues as the subclavian vein.where it continues as the subclavian vein.

CourseCourse: : It runs upward on the medial side It runs upward on the medial side of the axillary artery.of the axillary artery.

Tributaries:Tributaries:

1.1. Veins correspond to branches of axillary Veins correspond to branches of axillary artery.artery.

2.2. Cephalic vein (near its termination).Cephalic vein (near its termination).

Beginning (Formation)Beginning (Formation):: at the lower at the lower border of the teres major muscle, by union border of the teres major muscle, by union of the basilic vein with the venae of the basilic vein with the venae comitantes of the brachial artery.comitantes of the brachial artery.

EndEnd:: at the outer border of the first rib at the outer border of the first rib where it continues as the subclavian vein.where it continues as the subclavian vein.

CourseCourse: : It runs upward on the medial side It runs upward on the medial side of the axillary artery.of the axillary artery.

Tributaries:Tributaries:

1.1. Veins correspond to branches of axillary Veins correspond to branches of axillary artery.artery.

2.2. Cephalic vein (near its termination).Cephalic vein (near its termination).

3. Brachial 3. Brachial PlexusPlexus

3. Brachial 3. Brachial PlexusPlexus

Definition: It is a network of nerves concerning with the nerve supply of upper limb..

OriginOrigin:: from the ventral rami of C5,6,7,8 +T1..

Composition and siteComposition and site::– Root:Root: in the posterior triangle of the neck in the posterior triangle of the neck– Trunks:Trunks: in the posterior triangle of the neck. in the posterior triangle of the neck.– Divisions:Divisions: behind the clavicle. behind the clavicle.– Cords:Cords: in the axilla (related to 1 in the axilla (related to 1stst and 2 and 2ndnd

parts of axillary artery.parts of axillary artery.– Branches:Branches: in the axilla (related to the 3 in the axilla (related to the 3rdrd

part of axillary artery).part of axillary artery).

Definition: It is a network of nerves concerning with the nerve supply of upper limb..

OriginOrigin:: from the ventral rami of C5,6,7,8 +T1..

Composition and siteComposition and site::– Root:Root: in the posterior triangle of the neck in the posterior triangle of the neck– Trunks:Trunks: in the posterior triangle of the neck. in the posterior triangle of the neck.– Divisions:Divisions: behind the clavicle. behind the clavicle.– Cords:Cords: in the axilla (related to 1 in the axilla (related to 1stst and 2 and 2ndnd

parts of axillary artery.parts of axillary artery.– Branches:Branches: in the axilla (related to the 3 in the axilla (related to the 3rdrd

part of axillary artery).part of axillary artery).

Formation of the Formation of the plexusplexus

Formation of the Formation of the plexusplexus

ROOTSROOTSROOTSROOTSThey are formed by the ventral rami of the They are formed by the ventral rami of the

55thth, 6, 6thth, 7, 7thth, 8, 8thth cervical and 1 cervical and 1stst thoracic thoracic spinal nerves.spinal nerves.

It may take origin from the 4It may take origin from the 4thth cervical nerve cervical nerve (prefixied plexus), or from the 2(prefixied plexus), or from the 2ndnd thoracic thoracic nerve (postfixed plexus).nerve (postfixed plexus).

They lye in the posterior triangle of the They lye in the posterior triangle of the neck.neck.

They unites together to form the trunks.They unites together to form the trunks.

They are formed by the ventral rami of the They are formed by the ventral rami of the 55thth, 6, 6thth, 7, 7thth, 8, 8thth cervical and 1 cervical and 1stst thoracic thoracic spinal nerves.spinal nerves.

It may take origin from the 4It may take origin from the 4thth cervical nerve cervical nerve (prefixied plexus), or from the 2(prefixied plexus), or from the 2ndnd thoracic thoracic nerve (postfixed plexus).nerve (postfixed plexus).

They lye in the posterior triangle of the They lye in the posterior triangle of the neck.neck.

They unites together to form the trunks.They unites together to form the trunks.

TrunksTrunksTrunksTrunksThey are formed by the roots of the plexus.They are formed by the roots of the plexus.They are 3 (upper, middle and lower).They are 3 (upper, middle and lower).Upper trunk Upper trunk (C5,6)(C5,6) is formed by the union of is formed by the union of

the ventral rami of the 5the ventral rami of the 5thth and 6 and 6thth cervical cervical nerves.nerves.

Middle trunk Middle trunk (C7)(C7) is formed by the ventral is formed by the ventral ramus of the 7ramus of the 7thth cervical nerve alone. cervical nerve alone.

Lower trunk Lower trunk (C8, T1)(C8, T1) is formed by the union is formed by the union of the ventral rami of 8of the ventral rami of 8thth cervical and 1 cervical and 1stst thoracic nerves.thoracic nerves.

They lye in the posterior triangle of the neck.They lye in the posterior triangle of the neck.Each trunk divides to give anterior and Each trunk divides to give anterior and

posterior division.posterior division.

They are formed by the roots of the plexus.They are formed by the roots of the plexus.They are 3 (upper, middle and lower).They are 3 (upper, middle and lower).Upper trunk Upper trunk (C5,6)(C5,6) is formed by the union of is formed by the union of

the ventral rami of the 5the ventral rami of the 5thth and 6 and 6thth cervical cervical nerves.nerves.

Middle trunk Middle trunk (C7)(C7) is formed by the ventral is formed by the ventral ramus of the 7ramus of the 7thth cervical nerve alone. cervical nerve alone.

Lower trunk Lower trunk (C8, T1)(C8, T1) is formed by the union is formed by the union of the ventral rami of 8of the ventral rami of 8thth cervical and 1 cervical and 1stst thoracic nerves.thoracic nerves.

They lye in the posterior triangle of the neck.They lye in the posterior triangle of the neck.Each trunk divides to give anterior and Each trunk divides to give anterior and

posterior division.posterior division.

DivisionsDivisionsDivisionsDivisionsThey are formed from the trunks.They are formed from the trunks.

They are 6 in number (3 anterior and They are 6 in number (3 anterior and

3 posterior).3 posterior).

They lye behind the middle third of They lye behind the middle third of

the clavicle (apex of the axilla).the clavicle (apex of the axilla).

The divisions unite to form the cords The divisions unite to form the cords

of the brachial plexus.of the brachial plexus.

They are formed from the trunks.They are formed from the trunks.

They are 6 in number (3 anterior and They are 6 in number (3 anterior and

3 posterior).3 posterior).

They lye behind the middle third of They lye behind the middle third of

the clavicle (apex of the axilla).the clavicle (apex of the axilla).

The divisions unite to form the cords The divisions unite to form the cords

of the brachial plexus.of the brachial plexus.

CordsCordsCordsCords They are formed by union of the divisions of the They are formed by union of the divisions of the

plexus.plexus. They are 3 (lateral, medial and posterior).They are 3 (lateral, medial and posterior). Lateral Cord Lateral Cord (C5,6,7)(C5,6,7) is formed by the union of is formed by the union of

the anterior divisions of the upper and middle the anterior divisions of the upper and middle trunks.trunks.

Medial Cord Medial Cord (C8, T1)(C8, T1) is formed by the anterior is formed by the anterior division of the lower trunk alone.division of the lower trunk alone.

Posterio Cord Posterio Cord (C5,6,7,8, T1)(C5,6,7,8, T1) is formed by the is formed by the union of the posterior divisions of the upper, union of the posterior divisions of the upper, middle and lower trunks.middle and lower trunks.

They lye in the axilla (opposite 1They lye in the axilla (opposite 1stst and 2 and 2ndnd parts parts of axillary artery).of axillary artery).

Each cord gives off the braches of the plexus.Each cord gives off the braches of the plexus.

They are formed by union of the divisions of the They are formed by union of the divisions of the plexus.plexus.

They are 3 (lateral, medial and posterior).They are 3 (lateral, medial and posterior). Lateral Cord Lateral Cord (C5,6,7)(C5,6,7) is formed by the union of is formed by the union of

the anterior divisions of the upper and middle the anterior divisions of the upper and middle trunks.trunks.

Medial Cord Medial Cord (C8, T1)(C8, T1) is formed by the anterior is formed by the anterior division of the lower trunk alone.division of the lower trunk alone.

Posterio Cord Posterio Cord (C5,6,7,8, T1)(C5,6,7,8, T1) is formed by the is formed by the union of the posterior divisions of the upper, union of the posterior divisions of the upper, middle and lower trunks.middle and lower trunks.

They lye in the axilla (opposite 1They lye in the axilla (opposite 1stst and 2 and 2ndnd parts parts of axillary artery).of axillary artery).

Each cord gives off the braches of the plexus.Each cord gives off the braches of the plexus.

Relations of the Cords Relations of the Cords to the axillary arteryto the axillary artery

Relations of the Cords Relations of the Cords to the axillary arteryto the axillary artery

Lateral CordLateral Cord:: Lateral to the 1Lateral to the 1stst and 2 and 2ndnd parts of the artery. parts of the artery.

Medial CordMedial Cord:: Posterior to the 1Posterior to the 1stst part of the artery. part of the artery. Medial to the 2Medial to the 2ndnd part of the artery part of the artery

Posterio CordPosterio Cord:: Lateral to the 1Lateral to the 1stst part of the artery. part of the artery. Posterior to the 2Posterior to the 2ndnd part of the artery. part of the artery.

Lateral CordLateral Cord:: Lateral to the 1Lateral to the 1stst and 2 and 2ndnd parts of the artery. parts of the artery.

Medial CordMedial Cord:: Posterior to the 1Posterior to the 1stst part of the artery. part of the artery. Medial to the 2Medial to the 2ndnd part of the artery part of the artery

Posterio CordPosterio Cord:: Lateral to the 1Lateral to the 1stst part of the artery. part of the artery. Posterior to the 2Posterior to the 2ndnd part of the artery. part of the artery.

Branches of the Branches of the brachial plexusbrachial plexusBranches of the Branches of the brachial plexusbrachial plexus

Branches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusFrom the RootsFrom the Roots::

1.1. Dorsal scapular nerveDorsal scapular nerve (C5) supplies the (C5) supplies the levator scapulae and rhomboid muscles (major levator scapulae and rhomboid muscles (major and minor).and minor).

2.2. Long thoracic nerveLong thoracic nerve (C5,6,7) descends (C5,6,7) descends superficial to the serratus anterior muscle superficial to the serratus anterior muscle which it supplies.which it supplies.

From the trunksFrom the trunks: : 1.1. Nerve to subclaviusNerve to subclavius (5,6) which sometimes (5,6) which sometimes

gives off accessory phrenic nerve (C5).gives off accessory phrenic nerve (C5).2.2. Suprascapular nerveSuprascapular nerve (C5,6) which supplies (C5,6) which supplies

suprasinatus and infraspinatus muscles.suprasinatus and infraspinatus muscles.

From the RootsFrom the Roots:: 1.1. Dorsal scapular nerveDorsal scapular nerve (C5) supplies the (C5) supplies the

levator scapulae and rhomboid muscles (major levator scapulae and rhomboid muscles (major and minor).and minor).

2.2. Long thoracic nerveLong thoracic nerve (C5,6,7) descends (C5,6,7) descends superficial to the serratus anterior muscle superficial to the serratus anterior muscle which it supplies.which it supplies.

From the trunksFrom the trunks: : 1.1. Nerve to subclaviusNerve to subclavius (5,6) which sometimes (5,6) which sometimes

gives off accessory phrenic nerve (C5).gives off accessory phrenic nerve (C5).2.2. Suprascapular nerveSuprascapular nerve (C5,6) which supplies (C5,6) which supplies

suprasinatus and infraspinatus muscles.suprasinatus and infraspinatus muscles.

Branches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusFrom the lateral cordFrom the lateral cord::

1.1. Lateral pectoral nerveLateral pectoral nerve (C5,6,7) pierces the (C5,6,7) pierces the clavipectoral fascia and supplies the clavipectoral fascia and supplies the pectoralis major muscle.pectoralis major muscle.

2.2. Musculocutaneous nerveMusculocutaneous nerve (C5,6,7) (C5,6,7) supplies corachobrachialis, biceps brachii supplies corachobrachialis, biceps brachii and brachialis muscles and ends as the and brachialis muscles and ends as the lateral cutaneous nerve of the forearm.lateral cutaneous nerve of the forearm.

3.3. Lateral root of median nerveLateral root of median nerve (C5,6,7) (C5,6,7) which receives the medial root to form the which receives the medial root to form the median nerve on the lateral side of the median nerve on the lateral side of the axillary artery.axillary artery.

From the lateral cordFrom the lateral cord:: 1.1. Lateral pectoral nerveLateral pectoral nerve (C5,6,7) pierces the (C5,6,7) pierces the

clavipectoral fascia and supplies the clavipectoral fascia and supplies the pectoralis major muscle.pectoralis major muscle.

2.2. Musculocutaneous nerveMusculocutaneous nerve (C5,6,7) (C5,6,7) supplies corachobrachialis, biceps brachii supplies corachobrachialis, biceps brachii and brachialis muscles and ends as the and brachialis muscles and ends as the lateral cutaneous nerve of the forearm.lateral cutaneous nerve of the forearm.

3.3. Lateral root of median nerveLateral root of median nerve (C5,6,7) (C5,6,7) which receives the medial root to form the which receives the medial root to form the median nerve on the lateral side of the median nerve on the lateral side of the axillary artery.axillary artery.

Branches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusFrom the medial cordFrom the medial cord::

1.1. Medial pectoral nerveMedial pectoral nerve (C8, T1) supplies (C8, T1) supplies and pierces the pectoralis minor muscle and pierces the pectoralis minor muscle then supplies the pectoralis major muscle.then supplies the pectoralis major muscle.

2.2. Medial cutaneous nerve of the armMedial cutaneous nerve of the arm (C8, (C8, T1) supplies the skin of the medial side of T1) supplies the skin of the medial side of the arm. It may communicate with the the arm. It may communicate with the intercostobrachial nerve (T2).intercostobrachial nerve (T2).

3.3. Medial cutaneous nerve of the forearmMedial cutaneous nerve of the forearm (C8, T1) runs on the medial side of the (C8, T1) runs on the medial side of the axillary artery, it supplies the medial side of axillary artery, it supplies the medial side of the forearm.the forearm.

From the medial cordFrom the medial cord:: 1.1. Medial pectoral nerveMedial pectoral nerve (C8, T1) supplies (C8, T1) supplies

and pierces the pectoralis minor muscle and pierces the pectoralis minor muscle then supplies the pectoralis major muscle.then supplies the pectoralis major muscle.

2.2. Medial cutaneous nerve of the armMedial cutaneous nerve of the arm (C8, (C8, T1) supplies the skin of the medial side of T1) supplies the skin of the medial side of the arm. It may communicate with the the arm. It may communicate with the intercostobrachial nerve (T2).intercostobrachial nerve (T2).

3.3. Medial cutaneous nerve of the forearmMedial cutaneous nerve of the forearm (C8, T1) runs on the medial side of the (C8, T1) runs on the medial side of the axillary artery, it supplies the medial side of axillary artery, it supplies the medial side of the forearm.the forearm.

Branches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusFrom the medial cordFrom the medial cord::

4.4. Ulnar nerveUlnar nerve (C7,8, T1) runs on the (C7,8, T1) runs on the medial side of the axillary artery and medial side of the axillary artery and supplies some muscles and skin of the supplies some muscles and skin of the forearm and hand.forearm and hand.

5.5. Medial root of median nerveMedial root of median nerve (C8, T1) (C8, T1) crosses in front of the 3crosses in front of the 3rdrd part of axillary part of axillary artery (from medial to lateral) to join the artery (from medial to lateral) to join the lateral root and forms the median nerve lateral root and forms the median nerve which supplies some muscles and skin of which supplies some muscles and skin of the forearm and handthe forearm and hand

From the medial cordFrom the medial cord:: 4.4. Ulnar nerveUlnar nerve (C7,8, T1) runs on the (C7,8, T1) runs on the

medial side of the axillary artery and medial side of the axillary artery and supplies some muscles and skin of the supplies some muscles and skin of the forearm and hand.forearm and hand.

5.5. Medial root of median nerveMedial root of median nerve (C8, T1) (C8, T1) crosses in front of the 3crosses in front of the 3rdrd part of axillary part of axillary artery (from medial to lateral) to join the artery (from medial to lateral) to join the lateral root and forms the median nerve lateral root and forms the median nerve which supplies some muscles and skin of which supplies some muscles and skin of the forearm and handthe forearm and hand

Branches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusBranches of the Brachial plexusFrom the posterior cordFrom the posterior cord::

1.1. Upper subscapular nerveUpper subscapular nerve (C5,6) supplies (C5,6) supplies the upper part of the subscapularis muscle.the upper part of the subscapularis muscle.

2.2. Lower subscapular nerveLower subscapular nerve (C5,6) supplies (C5,6) supplies the lower part of the subscapularis and the the lower part of the subscapularis and the teres major muscles.teres major muscles.

3.3. Thoracodorsal nerveThoracodorsal nerve (C6,7,8) supplies the (C6,7,8) supplies the latissimus dorsi muscle.latissimus dorsi muscle.

4.4. Axillary nerveAxillary nerve (C5,6) and. (C5,6) and.5.5. Radial nerveRadial nerve (C5,6,7,8, T1) are the two (C5,6,7,8, T1) are the two

terminal branches of the posterior cord.terminal branches of the posterior cord.

From the posterior cordFrom the posterior cord:: 1.1. Upper subscapular nerveUpper subscapular nerve (C5,6) supplies (C5,6) supplies

the upper part of the subscapularis muscle.the upper part of the subscapularis muscle.2.2. Lower subscapular nerveLower subscapular nerve (C5,6) supplies (C5,6) supplies

the lower part of the subscapularis and the the lower part of the subscapularis and the teres major muscles.teres major muscles.

3.3. Thoracodorsal nerveThoracodorsal nerve (C6,7,8) supplies the (C6,7,8) supplies the latissimus dorsi muscle.latissimus dorsi muscle.

4.4. Axillary nerveAxillary nerve (C5,6) and. (C5,6) and.5.5. Radial nerveRadial nerve (C5,6,7,8, T1) are the two (C5,6,7,8, T1) are the two

terminal branches of the posterior cord.terminal branches of the posterior cord.

4. Axillary Lymph 4. Axillary Lymph NodesNodes

4. Axillary Lymph 4. Axillary Lymph NodesNodes

They about 20-30 small nodes arranged into 6 They about 20-30 small nodes arranged into 6 groups that drain the lymph from:groups that drain the lymph from:

1.1.The upper limb.The upper limb.

2.2.Anterior thoracic and abdominal wall till the Anterior thoracic and abdominal wall till the level of the umbilicus.level of the umbilicus.

3.3.Posterior thoracic and abdominal wall till the Posterior thoracic and abdominal wall till the level of the iliac crest.level of the iliac crest.

4.4.Lateral quadrants of the mammary gland.Lateral quadrants of the mammary gland.

They are grouped into (1) They are grouped into (1) AnteriorAnterior (pectoral), (pectoral), (2) (2) PosteriorPosterior (subscapular), (3) (subscapular), (3) Lateral Lateral (humeral), (4) (humeral), (4) CentralCentral, (5) , (5) InfraclavicularInfraclavicular (deltopectoral) and (6) (deltopectoral) and (6) Apical groupsApical groups..

They about 20-30 small nodes arranged into 6 They about 20-30 small nodes arranged into 6 groups that drain the lymph from:groups that drain the lymph from:

1.1.The upper limb.The upper limb.

2.2.Anterior thoracic and abdominal wall till the Anterior thoracic and abdominal wall till the level of the umbilicus.level of the umbilicus.

3.3.Posterior thoracic and abdominal wall till the Posterior thoracic and abdominal wall till the level of the iliac crest.level of the iliac crest.

4.4.Lateral quadrants of the mammary gland.Lateral quadrants of the mammary gland.

They are grouped into (1) They are grouped into (1) AnteriorAnterior (pectoral), (pectoral), (2) (2) PosteriorPosterior (subscapular), (3) (subscapular), (3) Lateral Lateral (humeral), (4) (humeral), (4) CentralCentral, (5) , (5) InfraclavicularInfraclavicular (deltopectoral) and (6) (deltopectoral) and (6) Apical groupsApical groups..

Axillary Lymph NodesAxillary Lymph NodesAxillary Lymph NodesAxillary Lymph Nodes1.1. Anterior (pectoral) group:Anterior (pectoral) group:

Site:Site: Behind the pectoralis major, Behind the pectoralis major, along the lower border of the pectoralis along the lower border of the pectoralis minor.minor.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the lateral quadrants of the from the lateral quadrants of the mammary gland and from the mammary gland and from the anterolateral aspect of the trunk wall till anterolateral aspect of the trunk wall till the level of the umbilicus.the level of the umbilicus.Efferent:Efferent: It sends to the central and It sends to the central and apical groups.apical groups.

1.1. Anterior (pectoral) group:Anterior (pectoral) group:Site:Site: Behind the pectoralis major, Behind the pectoralis major, along the lower border of the pectoralis along the lower border of the pectoralis minor.minor.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the lateral quadrants of the from the lateral quadrants of the mammary gland and from the mammary gland and from the anterolateral aspect of the trunk wall till anterolateral aspect of the trunk wall till the level of the umbilicus.the level of the umbilicus.Efferent:Efferent: It sends to the central and It sends to the central and apical groups.apical groups.

Axillary Lymph NodesAxillary Lymph NodesAxillary Lymph NodesAxillary Lymph Nodes2.2. Posterior (subscapular) group:Posterior (subscapular) group:

Site:Site: on the subscapular muscle on the subscapular muscle along the course of the along the course of the subscapular vessels.subscapular vessels.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the posterior aspect of the from the posterior aspect of the trunk wall till the level of the iliac trunk wall till the level of the iliac crest.crest.Efferent:Efferent: It sends to the central It sends to the central and apical groups.and apical groups.

2.2. Posterior (subscapular) group:Posterior (subscapular) group:Site:Site: on the subscapular muscle on the subscapular muscle along the course of the along the course of the subscapular vessels.subscapular vessels.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the posterior aspect of the from the posterior aspect of the trunk wall till the level of the iliac trunk wall till the level of the iliac crest.crest.Efferent:Efferent: It sends to the central It sends to the central and apical groups.and apical groups.

Axillary Lymph NodesAxillary Lymph NodesAxillary Lymph NodesAxillary Lymph Nodes

3.3. Lateral (humeral) group:Lateral (humeral) group:Site:Site: along the medial side of the along the medial side of the axillary vein.axillary vein.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the whole upper limb, except from the whole upper limb, except the lateral superficial part.the lateral superficial part.Efferent:Efferent: It sends to the central It sends to the central and apical groups.and apical groups.

3.3. Lateral (humeral) group:Lateral (humeral) group:Site:Site: along the medial side of the along the medial side of the axillary vein.axillary vein.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the whole upper limb, except from the whole upper limb, except the lateral superficial part.the lateral superficial part.Efferent:Efferent: It sends to the central It sends to the central and apical groups.and apical groups.


4.4. Central group:Central group:Site:Site: in the center of the axilla in the center of the axilla within the axillary fat.within the axillary fat.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the anterior, posterior and from the anterior, posterior and lateral groups.lateral groups.Efferent:Efferent: It sends to the apical It sends to the apical group.group.

4.4. Central group:Central group:Site:Site: in the center of the axilla in the center of the axilla within the axillary fat.within the axillary fat.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the anterior, posterior and from the anterior, posterior and lateral groups.lateral groups.Efferent:Efferent: It sends to the apical It sends to the apical group.group.


5.5. Infraclavicular (deltopectoral) Infraclavicular (deltopectoral) group:group:

Site:Site: in the deltopectoral groove. in the deltopectoral groove.Afferent:Afferent: It receives superficial It receives superficial lymph vessels from the lateral side lymph vessels from the lateral side of the hand, forearm and arm.of the hand, forearm and arm.Efferent:Efferent: It sends to the apical It sends to the apical group.group.

5.5. Infraclavicular (deltopectoral) Infraclavicular (deltopectoral) group:group:

Site:Site: in the deltopectoral groove. in the deltopectoral groove.Afferent:Afferent: It receives superficial It receives superficial lymph vessels from the lateral side lymph vessels from the lateral side of the hand, forearm and arm.of the hand, forearm and arm.Efferent:Efferent: It sends to the apical It sends to the apical group.group.


6.6. Apical group:Apical group:Site:Site: in the apex of the axilla at the in the apex of the axilla at the lateral border of the first rib.lateral border of the first rib.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the above mentioned groups.from the above mentioned groups.Efferent:Efferent: It forms the subclavian It forms the subclavian lymph trunk, which drains into:lymph trunk, which drains into:

On the On the right sideright side: right lymph trunk.: right lymph trunk. On the On the left sideleft side: thoracic duct.: thoracic duct.

6.6. Apical group:Apical group:Site:Site: in the apex of the axilla at the in the apex of the axilla at the lateral border of the first rib.lateral border of the first rib.Afferent:Afferent: It receives lymph vessels It receives lymph vessels from the above mentioned groups.from the above mentioned groups.Efferent:Efferent: It forms the subclavian It forms the subclavian lymph trunk, which drains into:lymph trunk, which drains into:

On the On the right sideright side: right lymph trunk.: right lymph trunk. On the On the left sideleft side: thoracic duct.: thoracic duct.

THANK THANK YOUYOU

THANK THANK YOUYOU

Contents of the Axilla 1.Axillary artery and its branches. 2.Axillary vein and its tributaries. 3.Cords of the brachial plexus and their branches. 4.Axillary.

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