Transcript 8a015b85bff8f6a

‫بسم هللا الرحمن الرحيم‬
‫” و فى أنفسكم أفال تبصرون“‬
The Upper limb
Axilla
Definition: Pyramidal space between the
upper part of the arm and chest.
It has the following boundaries:
 Apex
 Base
 Anterior wall
 Posterior wall
 Lateral wall
 Medial wall
Axilla
Contents of Axilla:
1.
2.
3.
4.
5.
6.
Axillary Artery.
Axillary Vein.
Brachial Plexus (cords + branches).
Axillary Lymph nodes.
Fat.
Axillary tail of Breast.
Axilla
Definition: Pyramidal space between the
upper part of the arm and chest.
It has the following boundaries:
 Apex
 Base
 Anterior wall
 Posterior wall
 Lateral wall
 Medial wall
Axilla
Definition: Pyramidal space
between the upper part of
the arm and chest.
It has the following
boundaries:
 Apex (cervicoaxillary
canal).
Triangular.
Bounded by:
1.clavicle, anterior.
2.Upper border od scapula,
posterior.
3.Outer border of 1st rib,
medially
Apex
Axilla
Definition: Pyramidal space between the
upper part of the arm and chest.
It has the following boundaries:
 Base:
Skin & fascia
Axilla
Definition: Pyramidal space between the
upper part of the arm and chest.
It has the following boundaries:
 Anterior wall
 Posterior wall
 Lateral wall
 Medial wall
Axilla
Pectoralis major:
Axilla
Pectoralis major:
Axilla
Pectoralis major:
Axilla
Pectoralis major:
Axilla
Pectoralis major:
Origin:
 Anterior surface of medial half of
clavicle
 Front of sternum, front of upper 6 costal
cartilages.
Insertion:
 Lateral lip of bicipital groove of the
humerus
Nerve supply:
 Medial pectoral nerve
 Lateral pectoral nerve
Action:
 Adduction, flexion and medial rotation of
arm at the shoulder joint.
 The sternocostal fibers can extened the
flexed arm.
Axilla
Pectoralis major:
Origin:
 Anterior surface of medial half of
clavicle
 Front of sternum, front of upper 6 costal
cartilages.
Insertion:
 Lateral lip of bicipital groove of the
humerus by a Bilaminar tendon
Nerve supply:
 Medial pectoral nerve
 Lateral pectoral nerve
Action (Joint):
 Adduction, flexion and medial rotation of
arm at the shoulder joint.
 The sternocostal fibers can extened the
flexed arm.
Axilla
Pectoralis major:
Axilla
Pectoralis minor:
Origin:The 3rd, 4th and 5th ribs
Insertion: Medial border and upper
surface of coracoid process of scapula
Nerve supply:Medial pectoral nerve
Action (Girdle): Depression and
protraction of scapula.
Axilla
Pectoralis minor:
Origin:The 3rd, 4th and 5th ribs
Insertion: Medial border and upper
surface of coracoid process of scapula
Nerve supply:Medial pectoral nerve
Action (Girdle): Depression and
protraction of scapula.
Axilla
Pectoralis minor:
Origin:The 3rd, 4th and 5th ribs
Insertion: Medial border and upper
surface of coracoid process of scapula
Nerve supply:Medial pectoral nerve
Action: Depression and protraction of
scapula.
Axilla
Pectoralis minor:
Origin:The 3rd, 4th and 5th ribs
Insertion: Medial border and upper
surface of coracoid process of scapula
Nerve supply:Medial pectoral nerve
Action: Depression and protraction of
scapula.
Axilla
Pectoralis minor:
Axilla
Subclavius:
Origin: 1st costal cartilage and 1st rib.
Insertion: groove on inferior surface of
clavicle
Nerve supply: Nerve to subclavius
Action:
 Depress the clavicle.
 Steadies clavicle during movements of
shoulder joint.
Axilla
Subclavius:
Origin: 1st costal cartilage and 1st rib.
Insertion: groove on inferior surface of
clavicle
Nerve supply: Nerve to subclavius
Action:
 Depress the clavicle.
 Steadies clavicle during movements of
shoulder joint.
Axilla
Subclavius:
Origin: 1st costal cartilage and 1st rib.
Insertion: groove on inferior surface of
clavicle
Nerve supply: Nerve to subclavius
Action:
 Depress the clavicle.
 Steadies clavicle during movements of
shoulder joint.
Axilla
Subclavius:
Axilla
Clavipectoral fascia:
Definition:A strong fibrous sheet of
connective tissue lies deep to pectoralis
major.
Attachment:
 Its upper border splits to enclose
subclavius to be attached to the clvicle.
 Its lower border splits to enclose the
pectoralis minor , along lower border of
subclavius, thickened to form costocoracoid ligament that extends from
anterior end of 1st rib and contenues
downward as the
Suspensory ligament of axilla.
Axilla
Clavipectoral fascia:
Structures piercing it:
 Cepalic vein, ends in axillary vein
 Acromio-thoracic artery, branch of 2nd
part of axillary artery
 Lateral pectoral nerve, supplies pectoralis
major
 Lymph vessels.
Axilla
Subscapularis:
Origin: Subscapular fossa.
Insertion: Lesser tuberosity of the humerus.
Nerve supply: Upper and lower subscapular
nerves.
Action:
 Adduction and medial rotation of the
arm.
 Stabilizes the shoulder joint.
Axilla
Latissimus dorsi:
Origin:
1. Posterior part of iliac crest.
2. Lumbar fascia.
3. Lower thoracic spines and
supraspinous ligaments.
4. Lower 3 or 4 ribs.
5. Back of inferior angle of scapula.
Insertion:
 Wrap around the teres major (Triple
relation.
 Floor of intertubercular groove of the
humerus
Nerve supply:Thoracodorsal nerve.
Action (joint): Powerful adductor,
extensor and medial rotator of the
arm.
Axilla
Latissimus dorsi:
Origin:
1. Posterior part of iliac crest.
2. Lumbar fascia.
3. Lower thoracic spines and supraspinous
ligaments.
4. Lower 3 or 4 ribs.
5. Back of inferior angle of scapula.
Insertion:
 Wrap around the teres major (Triple
relation.
 Floor of intertubercular groove of the
humerus
Nerve supply:Thoracodorsal nerve.
Action (joint): Powerful adductor, extensor
and medial rotator of the arm.
Axilla
Latissimus dorsi:
Origin:
1. Posterior part of iliac crest.
2. Lumbar fascia.
3. Lower thoracic spines and supraspinous
ligaments.
4. Lower 3 or 4 ribs.
5. Back of inferior angle of scapula.
Insertion:
 Wrap around the teres major (Triple
relation.
 Floor of intertubercular groove of the
humerus
Nerve supply:Thoracodorsal nerve.
Action (joint): Powerful adductor, extensor
and medial rotator of the arm.
Axilla
Teres major:
Origin: Lower 1/3 of back of lateral border
of scapula
Insertion: Medial lip of bicipital groove of
the humerus
Nerve supply: Lower subscapular nerve.
Action: Adduction and medial rotation and
extension of the arm.