Diagram 2 : Borders of axilla from base

Diagram 1 : Borders + apex + base of axilla

Diagram 3 : Contents of Axilla

Diagram 4 : Content of axilla : Brachial Plexus

Diagram 5 : Axilla passageways : Clavipectoral triangle (Borders)

Diagram 6 :Axilla passageways : Quadrangular Space (Borders)

ANATOMICAL NOTES.
The Axilla
 A named Anatomical pyramid shaped space located at the junction between arm and thorax.
 Lies inferior to Glenohumeral Joint
• Junction between Arm & Thorax.
 Size & shape of the Axilla varies with abduction
• Decreases in size when the arm is fully abducted
• Axillary contents at most risk of injury when upper limb is abducted
 Boundaries:
o Anteriorly: Pectoral Major & Minor, Clavipectoral Fascia, Subclavius.
o Posteriorly: Subscapularis, Teres Major, Latissimus Dorsi.
o Medially: Serratus Anterior, upper 5 ribs, intercostal muscles & their associated intercostal spaces
o Laterally: Intertubercular groove.
o Base: Axillary fascia & skin.
 Apex: Superior border of scapula, 1st rib, clavicle
 Content of Axilla (Diagram 3) :
o 1. Branches of the Brachial Plexus
o 2. Axillary blood vessels – artery, branches, vein, tributaries
o 3. Axillary lymph vessels + nodes
o AXILLARY VEIN
• Axillary vein is a continuation of Basilic Vein
• Lies medial to axillary artery in the axilla
• Cephalic vein passes in Deltopectoral Groove, and drains into axillary vein in the axilla
• Axillary Sheath encloses cords of the brachial plexus, axillary artery & vein
• Vein remains flat if pressed, unlike artery
o Axillary Lymph Nodes
• Filter lymph that has drained from the upper limb & pectoral region.
• Pectoral (anterior) 3-5 nodes in the medial wall of the axilla
• Subscapular (posterior) 6-7 nodes along the posterior axillary fold
• Humeral (lateral) 4-6 nodes located in the lateral wall of the axilla
• Central 3-4 large nodes in fat at base of the axilla
• Apical Located in the apex of the axilla at lateral border of 1st rib
 Act as passageways for neurovascular structures.
o Clavipectoral Triangle in anterior axillary wall. (Diagram 5)
• Bounded by Pectoralis Major, Deltoid & Clavicle
• Pectoral nerves & cephalic vein
o Quadrangular Space in posterior axillary wall. (Diagram 6)
• Bounded by Teres Major & Minor, Triceps, Surgical Neck Humerus that allows passage for :
• Axillary Nerve & Posterior Circumflex Humeral Arteries
• Quadrangular Space Syndrome
• Swelling of the space may compress nerve and cause quadrangular space syndrome
 Clinical Notes:
o Thoracic Outlet Syndrome: compression of the blood vessels or brachial plexus against the clavicle or
first rib.
- Trauma, sports injury, extra rib
- Pain in upper limb, numbness, muscle weakness
o Lymphogenic spread of breast cancer: In patients with breast cancer, the axillary lymph nodes are
often removed, however, in this procedure the long thoracic nerve may become damaged resulting in
the condition of ‘winged scapula’.
o Axillary Intertrigo: rash in the body folds with excessive perspiration. Often bacterial.
o The subclavian vein is often used for central line placement to administer nutritional & medication
fluids.
o An aneurysm of the axillary artery can compress the trunks of the brachial plexus in the axilla.