Axilla

Anatomy of Axilla
Professor
Asmaa Ibrahim Ahmed
Ilos
By the end of this lecture, each
student should be able to:
1. List the boundaries of the axilla.

2. Enumerate the contents of the
axilla.
3. Describe the beginning,
termination, course, branches/
tributaries and surface anatomy
of the axillary vessels.
Definition of Axilla
4 sided pyramidal
space between:
1.Upper part of
thoracic wall
and
2. The medial
side of upper
arm
Boundaries of Axilla
{arm pit}
has :
Apex
Base
4 walls:
1. Anterior wall
2. Posterior wall
3. Medial wall
4. Lateral wall
Boundaries of the
Axilla
Apex:
1
C
L
A R
I
 Is directed B
V
upwards & I
C L
medially to the E
root of the neck.

 Gives passage to
nerves & vessels
to pass between
neck & upper limb
Axilla has
Role of
3
Apex 3 Cervico axillary canal.
It is bounded, by 3
bones:
• Clavicle anteriorly.
• Upper border of the
scapula posteriorly.
• Outer border of the
first rib medially.
Base (floor)3
Formed of :
1. Skin
2. superficial fascia
3. deep axillary fascia
*Lower part of
clavipectoral fascia fuses
with axillary fascia
leading to retraction of
skin of axilla inwards
when arm is abducted
Skin
Superficial fascia
Axillary fascia
Clavipectoral fascia
Anterior wall =3
1. Pectoralis major
2. Pectoralis minor
3. Subclavius muscles+
Clavipectoral fascia
2
4
1
Anterior Fold Of Axilla
Twisted fibers of lower
border of pectoralis major
Posterior wall = 3
Is formed by:
1. Subscapulari
s.
2. Latissimus
dorsi.
3. Teres major
muscles.
**The Posterior Fold Of
Axilla
Tendon of latissimus
dorsi winds around
the lower border of
teres major
The posterior fold of axilla
reaches a lower level than the anterior fold
The lower border of teres major forms the

limitation between the axilla and upper arm
Medial wall=3
It is wide and

formed by:
1. Serratus anterior.
2. Upper 4-5 ribs .
3. Intercostal
muscles .
Prof Azza Kamal

The lateral wall =3:
It is narrow and formed
by:
1. Coracobrachialis.
2. Biceps brachii.
3. Bicepital groove of
the humerus
1. Upper part of shaft
of humerus
2. coracobrachialis
3. Short head
of biceps
Lateral wall of axilla

Prof Azza Kamal
Contents of axilla
1. Axillary artery & its
branches
2. Axillary vein & its
tributaries
3. Cords of brachial
plexus & their brs
4. Axillary L.N.
5. Axillary tail of breast
6. Lateral cutaneous brs
of upper intercostal
nerves & long thoracic
nerve
7. Axillary fat
Prof Azza Kamal

1. The axillary artery
2. axillary vein
3. Cords of brachial plexus
are enclosed by
the axillary sheath,
which is derived from the
fascia of the neck.
Brachial plexus
musclocutanus
Axillary
radial
median
ulnar
26
Subclavian
1-Axillary artery artery
Is the main source of

arterial blood supply
to the upper limb. Axillary
Begins: as the artery
continuation of the
subclavian artery at
the outer border of the
1st rib.
Ends: at the lower
border of teres
major by forming Axillary
artery
the brachial
artery.
Course: It passes
through apex of Teres
axilla & then along major
its lateral wall till
its termination.
** It is divided by
pectoralis minor
into 3 parts: 1
2
- 1st part: before 3
pectoralis minor.
- 2nd part: behind
pectoralis minor.
- 3rd part: below
pectoralis minor.
Branches:
1. 1st part: Gives 1 branch:
Superior thoracic artery
2nd part: Gives 2 branches:
a. acromio thoracic artery.
b. Lateral thoracic artery.
3rd part: 3 branches:

A. Subscapular artery
B. Anterior circumflex
humeral artery
c. Posterior circumflex humeral artery:
First part:
Gives ONE
branch:
Superior thoracic
artery.
supplies
serratus anterior
Second part: Gives TWO
branches:
clavicular
a. Thoracoacromial artery: This is
a short trunk which pierces theAcromial
clavipectoral fascia & then divides Deltoid
into 4 branches (A, P, C, D);
acromial, pectoral
pectoral, clavicular & deltoid
branches.
A. Acromial branch: shares in
acromial anastomosis.
B. Pectoral branch: supplies pectoral
muscles and breast.
C. Clavicular branch: gives articular branches
D. Deltoid branch: runs in deltopectoral groove
to supply both muscles.
b. Lateral thoracic
artery:
1. supply serratus
anterior muscle.
2. -In female it is
enlarged & gives
which supply the
breast Lateral thoracic
artery
Third part: Gives THREE branches:
a. Subscapular artery:
This is the largest branch of the axillary
artery. Anterior
Share in the anastomosis around the circumflex
scapulaGives the circumflex scapular artery artery
b. Anterior circumflex humeral
artery:
It passes in front of the surgical
neck of the humerus Anterior
circumflex
c. Posterior circumflex humeral artery
artery: Subscapular
It runs backwards and artery
Circumflex scapular
anastomoses with the anterior
artery
circumflex humeral artery to Form
A Circular Anastomosis Around
The Surgical Neck Of The
Axillary Vein
Begins: As the continuation of
the basilic vein at the lower border
of teres major.
Ends: At the outer border of the
1st rib by forming the
subclavian vein.
It runs medial to the axillary artery.
Tributaries:
a. Tributaries corresponding to the
branches of
the axillary artery.
b. Cephalic vein at its upper part.
c. The two venae comitantes of the
Axillary Lymph Nodes
These form a group of
lymph nodes that range
from 20-30 in number and
are distributed in the axilla. Central
They are arranged into 5 Apical

groups: Lateral
.anterior (pectoral) group /1 Anterior
posterior (subscapular) /2
.group Posterior
.lateral group /3
.central group /4
apical (Infra clavicular) group /5
Surface anatomy of axillary artery
With the arm

abducted 90 degree and
laterally rotated,
the axillary artery is represented
by
a line joining the mid-clavicular
point with a point at (opposthe
middle of
the medial side of the arm
***Applied Anatomy:
Accumulation of pus inside the axilla due to an
infected lymph node may
extend upwards to the root of the neck through the
apex of the axilla or downwards towards the
base where it can be drained.
***N.B.: Most of the axillary
contents are nearer to its lateral wall.

Axilla

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Anatomy of Axilla

1. List the boundaries of the axilla.

root of the neck.

The lower border of teres major forms the

It is wide and

Prof Azza Kamal

Lateral wall of axilla

Prof Azza Kamal

Is the main source of

3rd part: 3 branches:

They are arranged into 5 Apical

With the arm

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