Redalyc.Variations in Branching Pattern of the Axillary Artery: a Study
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Variation of the Origin of the Lateral Thoracic Artery. Case Report
Revista Română de Anatomie funcţională şi clinică, macro- şi microscopică şi de Antropologie Vol. XVII – Nr. 4 – 2018 CLINICAL ANATOMY VARiation OF THE ORIGin OF THE LatERAL THORacic ARTERY. CASE REPORT Tamás-Csaba Sipos2, Lóránd Dénes1*, Klara Brînzaniuc1, Annamária Szántó1, Zoltán Pávai1, Zsuzsánna Pap1 University of Medicine, Pharmacy, Sciences and Technology of Tîrgu-Mureş 1. Department of Anatomy and Embryology 2. Student, GM 6th year VARIATION OF THE ORIGIN OF THE LATERAL THORACIC ARTERY. Case RePORT (Abstract): Introduction: Anatomical variations of the origin of axillary artery branches are quite common. The most frequent variations are common trunks or emergence from a different segment than the classical description. Material and method: A formalin fixed male human cadaver has been dissected during teaching classes for medical students at the Anatomy and Embryology De- partment of UMFST Târgu Mureş. We observed a pattern of origins of the axillary artery branch- es different from the classical description. Results: The second part of the axillary artery provides the superior thoracic artery and the thoraco-acromial artery from its anterior surface, while the subscapular artery separates from its posterior surface. The lateral thoracic artery is a branch of the subscapular artery. The anterior and posterior circumflex humeral arteries come from the third part of the axillary artery, which corresponds to the classical description. Conclusions: Published studies report multiple variations regarding the origin of the axillary artery branches. Most com- monly, the lateral thoracic artery originates from the subscapular artery, which is the case in our study as well. Key-words: LATERAL THORACIC ARTERY, vaRIATION, SUBSCAPULAR ARTERY INTRODUCTION provides six branches, which are grouped ac- Arterial supply to the thoraco-scapulo-hu- cording to its parts: the first part gives off the meral area is provided by the branches of the superior thoracic artery, the second part pro- axillary artery. -
Branches of Axillary Artery for PDF 13.5.11
Diagram of branches Acromial Br lar Br icu of axillary artery Clav rtery mial a oacro Thorac Deltoid Br t 1st Par d 2n Superior thoracic artery Anterior Pectoral Br circumflex t Par Pectoralis minor humeral d artery 3r Sub- scapular artery Lateral thoracic artery Circumflex scapular artery Posterior circumflex humeral artery TheFromFrom axillary 1st2nd3rd part part artery (a)superior .(a) (a) subscapular begins The thoracoacromial thoracic at the runs outer– itdown runs border artery within along the of– a the thestoutlong firstfirst subscapularshort ribintercostal trunk,and ends nerve,which space. at projustthe- lowerjectswithin border forwardthe posterior of over terres theaxillary major inner ,fold. where boarder Near it continuesof the pectoralis lower as angle the minor brachial of theand scapula dividesartery. itinto divides four branches.into two, one (i) side clavicular, goes to runs the sideup over of the subclavius chest, the ; (ii) other pectoral to the is deep large surface and runs of Thedownthe latissimusaxillary between artery with the runsthetwo longacrosspectorals subscapular the withsuperior the nerve. externalaspect Near of anterior theits origin axilla thoracic itand gives is markednerve, off a large and by asuppliesbranch, line drawn thethese circumflexfrom muscles; the middle scapular(iii) acromial, of the artery, clavicle usually which to comes apasses point off backhalf-way a common through between trunk the “triangu withthe two the- condylesdeltoid,lar space” andof tothe runs the humerus, back dorsum beneath when of the the scapula. deltoidarm is raisedtoward(b) The to the anteriora right acromion; angle. circumflex and (iv) humeral deltoid runsartery down which beside is a smallthe cephalic artery thatvein, passes in a groove out across between the frontdeltoid of andthe pectoralishumerus, Itmajor,sending is divided and a branch endsinto threein up these to partsthe muscles. -
Examination of the Shoulder Bruce S
Examination of the Shoulder Bruce S. Wolock, MD Towson Orthopaedic Associates 3 Joints, 1 Articulation 1. Sternoclavicular 2. Acromioclavicular 3. Glenohumeral 4. Scapulothoracic AC Separation Bony Landmarks 1. Suprasternal notch 2. Sternoclavicular joint 3. Coracoid 4. Acromioclavicular joint 5. Acromion 6. Greater tuberosity of the humerus 7. Bicipital groove 8. Scapular spine 9. Scapular borders-vertebral and lateral Sternoclavicular Dislocation Soft Tissues 1. Rotator Cuff 2. Subacromial bursa 3. Axilla 4. Muscles: a. Sternocleidomastoid b. Pectoralis major c. Biceps d. Deltoid Congenital Absence of Pectoralis Major Pectoralis Major Rupture Soft Tissues (con’t) e. Trapezius f. Rhomboid major and minor g. Latissimus dorsi h. Serratus anterior Range of Motion: Active and Passive 1. Abduction - 90 degrees 2. Adduction - 45 degrees 3. Extension - 45 degrees 4. Flexion - 180 degrees 5. Internal rotation – 90 degrees 6. External rotation – 45 degrees Muscle Testing 1. Flexion a. Primary - Anterior deltoid (axillary nerve, C5) - Coracobrachialis (musculocutaneous nerve, C5/6 b. Secondary - Pectoralis major - Biceps Biceps Rupture- Longhead Muscle Testing 2. Extension a. Primary - Latissimus dorsi (thoracodorsal nerve, C6/8) - Teres major (lower subscapular nerve, C5/6) - Posterior deltoid (axillary nerve, C5/6) b. Secondary - Teres minor - Triceps Abduction Primary a. Middle deltoid (axillary nerve, C5/6) b. Supraspinatus (suprascapular nerve, C5/6) Secondary a. Anterior and posterior deltoid b. Serratus anterior Deltoid Ruputure Axillary Nerve Palsy Adduction Primary a. Pectoralis major (medial and lateral pectoral nerves, C5-T1 b. Latissimus dorsi (thoracodorsal nerve, C6/8) Secondary a. Teres major b. Anterior deltoid External Rotation Primary a. Infraspinatus (suprascapular nerve, C5/6) b. Teres minor (axillary nerve, C5) Secondary a. -
Blood Vessels and Lymphatics of the Upper Limb Axillary Artery • Course: – It Starts at the Outer Border of the 1St Rib As a Continuation of the Subclavian Artery
Blood vessels and lymphatics of the upper limb Axillary artery • Course: – It starts at the outer border of the 1st rib as a continuation of the subclavian artery. – It is divided by the covering pectoralis minor muscle into 3 parts: • 1st part, is proximal to pectoralis minor. • 2nd part, is under cover the pectoralis minor. • 3rd part, is distal to the pectoralis minor. • It ends at the lower border of the teres major muscle which it continues as the brachial artery. • Relations: • Anterior: muscles of the pectoral muscles and clavipectoral fascia. • Posterior: muscles of the posterior wall of axilla and posterior cord of the brachial plexus. • Medially: the axillary vein and the medial cord of the brachial plexus. • Laterally: the lateral cord of the brachial plexus. • Branches: – 1st part: (one branch): • The superior thoracic artery: which supplies the upper part of the chest wall. – 2nd part: (two branches): • Thoraco-acromial artery: on the upper border of the pectoralis minor, which supplies the pectoral and shoulder regions. It gives off: Acromial, pectoral, clavicular & deltoid branches. • Lateral thoracic artery: on the lower border of the pectoralis minor, which supplies the pectoral region and the breast. – 3rd part: (three branches): • Subscapular artery: it descends on the lateral border of the scapula and it gives off circumflex scapular artery. It supplies the back of shoulder. • Posterior circumflex humeral artery: it accompanies the axillary nerve on the back of the surgical neck of the humerus. • Anterior circumflex humeral artery: in front of the surgical neck of the humerus. • Anastmosis related to the axillary artey: – Anastmosis around the scapula: formed by: • Suprascapular artery, form the thyrocervical trunk. -
Anatomical Evaluation of Lateral Thoracic Artery in Cadavers in North Indian Population
International Journal of Medical and Health Research Original Research Article International Journal of Medical and Health Research ISSN: 2454-9142 Received: 20-08-2018; Accepted: 22-09-2018 www.medicalsciencejournal.com Volume 4; Issue 10; October 2018; Page No. 178-180 Anatomical evaluation of lateral thoracic artery in cadavers in North Indian population Dr. Rekha Sinha1, Dr. Mundrika PD Sudhanshu2* 1 Assistant Professor, Department of Anatomy, Patna Medical College, Patna, Bihar, India 2 Professor and Head, Department of Anatomy, Patna Medical Callege, Patna, Bihar, India *Corresponding author: Dr. Mundrika Pd Sudhanshu Abstract The lateral thoracic artery follows the lower border of the Pectoralis minor to the side of the chest, supplying the Serratus anterior and the Pectoralis, and sending branches across the axilla to the axillary glands and Subscapularis; it anastomoses with the internal mammary, subscapular, and intercostal arteries, and with the pectoral branch of the thoracoacromial. Based on the literature findings the present study was planned to evaluate the arterial pattern of lateral thoracic artery in human cadavers. As this study is helpful to know the type and frequency of vascular variations. The present study was planned in Department of Anatomy in Patna Medical College to assess the arterial pattern of lateral thoracic artery in human cadavers. The study was planned on 30 cadaveric subjects. The axillae from embalmed cadavers allotted for dissection in the Department of Anatomy used for the study. The knowledge of these variations is necessary for the surgeons considering the frequency of procedures performed in this region. The absence of branches from the second and third parts of axillary artery may be responsible for compromised collateral circulation between the branches. -
Variations in the Branching Pattern of the Radial Nerve Branches to Triceps Brachii
Review Article Clinician’s corner Images in Medicine Experimental Research Case Report Miscellaneous Letter to Editor DOI: 10.7860/JCDR/2019/39912.12533 Original Article Postgraduate Education Variations in the Branching Pattern Case Series of the Radial Nerve Branches to Anatomy Section Triceps Brachii Muscle Short Communication MYTHRAEYEE PRASAD1, BINA ISAAC2 ABSTRACT Results: The branching patterns seen were types A 1 (3.6%), Introduction: The axillary nerve arises from the posterior cord B1 (1st pattern) 1 (3.6%), B2 (2nd pattern) 1 (3.6%), and C3 of the brachial plexus and supplies the deltoid and teres minor 22 (78.6%). Two new patterns observed were: type B2 muscles. Axillary nerve injuries lead to abduction and external (6th pattern) 1 (3.6%) and type D (2nd pattern) 2 (7.1%). The long rotation weakness. In such cases, branches to the heads of head had single innervation in 89.3% cases and the lateral and triceps brachii muscle have been transferred to the axillary nerve medial heads had dual innervation in 10.7% and 7.1% cases to establish reinnervation of the deltoid muscle. In addition, the respectively. triceps nerve branches can be nerve recipients to reinstitute Conclusion: The knowledge of the different branching patterns elbow extension. that are present will help surgeons to identify the most suitable Aim: To study the different branching patterns of the radial radial nerve branch to triceps brachii that can be used for nerve nerve branches to triceps brachii muscle. transfer to restore the motor function of the deltoid muscle or to reanimate the triceps brachii muscle. -
Pectoral Region and Axilla Doctors Notes Notes/Extra Explanation Editing File Objectives
Color Code Important Pectoral Region and Axilla Doctors Notes Notes/Extra explanation Editing File Objectives By the end of the lecture the students should be able to : Identify and describe the muscles of the pectoral region. I. Pectoralis major. II. Pectoralis minor. III. Subclavius. IV. Serratus anterior. Describe and demonstrate the boundaries and contents of the axilla. Describe the formation of the brachial plexus and its branches. The movements of the upper limb Note: differentiate between the different regions Flexion & extension of Flexion & extension of Flexion & extension of wrist = hand elbow = forearm shoulder = arm = humerus I. Pectoralis Major Origin 2 heads Clavicular head: From Medial ½ of the front of the clavicle. Sternocostal head: From; Sternum. Upper 6 costal cartilages. Aponeurosis of the external oblique muscle. Insertion Lateral lip of bicipital groove (humerus)* Costal cartilage (hyaline Nerve Supply Medial & lateral pectoral nerves. cartilage that connects the ribs to the sternum) Action Adduction and medial rotation of the arm. Recall what we took in foundation: Only the clavicular head helps in flexion of arm Muscles are attached to bones / (shoulder). ligaments / cartilage by 1) tendons * 3 muscles are attached at the bicipital groove: 2) aponeurosis Latissimus dorsi, pectoral major, teres major 3) raphe Extra Extra picture for understanding II. Pectoralis Minor Origin From 3rd ,4th, & 5th ribs close to their costal cartilages. Insertion Coracoid process (scapula)* 3 Nerve Supply Medial pectoral nerve. 4 Action 1. Depression of the shoulder. 5 2. Draw the ribs upward and outwards during deep inspiration. *Don’t confuse the coracoid process on the scapula with the coronoid process on the ulna Extra III. -
A Comprehensive Review of Anatomy and Regional Anesthesia Techniques of Clavicle Surgeries
vv ISSN: 2641-3116 DOI: https://dx.doi.org/10.17352/ojor CLINICAL GROUP Received: 31 March, 2021 Research Article Accepted: 07 April, 2021 Published: 10 April, 2021 *Corresponding author: Dr. Kartik Sonawane, Uncovering secrets of the Junior Consultant, Department of Anesthesiol- ogy, Ganga Medical Centre & Hospitals, Pvt. Ltd. Coimbatore, Tamil Nadu, India, E-mail: beauty bone: A comprehensive Keywords: Clavicle fractures; Floating shoulder sur- gery; Clavicle surgery; Clavicle anesthesia; Procedure review of anatomy and specific anesthesia; Clavicular block regional anesthesia techniques https://www.peertechzpublications.com of clavicle surgeries Kartik Sonawane1*, Hrudini Dixit2, J.Balavenkatasubramanian3 and Palanichamy Gurumoorthi4 1Junior Consultant, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India 2Fellow in Regional Anesthesia, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India 3Senior Consultant, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India 4Consultant, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India Abstract The clavicle is the most frequently fractured bone in humans. General anesthesia with or without Regional Anesthesia (RA) is most frequently used for clavicle surgeries due to its complex innervation. Many RA techniques, alone or in combination, have been used for clavicle surgeries. These include interscalene block, cervical plexus (superficial and deep) blocks, SCUT (supraclavicular nerve + selective upper trunk) block, and pectoral nerve blocks (PEC I and PEC II). The clavipectoral fascial plane block is also a safe and simple option and replaces most other RA techniques due to its lack of side effects like phrenic nerve palsy or motor block of the upper limb. -
Axillary Nerve Injury Associated with Sports
Neurosurg Focus 31 (5):E10, 2011 Axillary nerve injury associated with sports SANGKOOK LEE, M.D.,1 KRIANGSAK SAETIA, M.D.,2 SUPARNA SAHA, M.D.,1 DAVID G. KLINE, M.D.,3 AND DANIEL H. KIM, M.D.1 1Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; 2Division of Neurosurgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; and 3Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana Object. The aim of this retrospective study was to present and investigate axillary nerve injuries associated with sports. Methods. This study retrospectively reviewed 26 axillary nerve injuries associated with sports between the years 1985 and 2010. Preoperative status of the axillary nerve was evaluated by using the Louisiana State University Health Science Center (LSUHSC) grading system published by the senior authors. Intraoperative nerve action potential recordings were performed to check nerve conduction and assess the possibility of resection. Neurolysis, suture, and nerve grafts were used for the surgical repair of the injured nerves. In 9 patients with partial loss of function and 3 with complete loss, neurolysis based on nerve action potential recordings was the primary treatment. Two patients with complete loss of function were treated with resection and suturing and 12 with resection and nerve grafting. The minimum follow-up period was 16 months (mean 20 months). Results. The injuries were associated with the following sports: skiing (12 cases), football (5), rugby (2), base- ball (2), ice hockey (2), soccer (1), weightlifting (1), and wrestling (1). Functional recovery was excellent. Neurolysis was performed in 9 cases, resulting in an average functional recovery of LSUHSC Grade 4.2. -
Electrodiagnosis of Brachial Plexopathies and Proximal Upper Extremity Neuropathies
Electrodiagnosis of Brachial Plexopathies and Proximal Upper Extremity Neuropathies Zachary Simmons, MD* KEYWORDS Brachial plexus Brachial plexopathy Axillary nerve Musculocutaneous nerve Suprascapular nerve Nerve conduction studies Electromyography KEY POINTS The brachial plexus provides all motor and sensory innervation of the upper extremity. The plexus is usually derived from the C5 through T1 anterior primary rami, which divide in various ways to form the upper, middle, and lower trunks; the lateral, posterior, and medial cords; and multiple terminal branches. Traction is the most common cause of brachial plexopathy, although compression, lacer- ations, ischemia, neoplasms, radiation, thoracic outlet syndrome, and neuralgic amyotro- phy may all produce brachial plexus lesions. Upper extremity mononeuropathies affecting the musculocutaneous, axillary, and supra- scapular motor nerves and the medial and lateral antebrachial cutaneous sensory nerves often occur in the context of more widespread brachial plexus damage, often from trauma or neuralgic amyotrophy but may occur in isolation. Extensive electrodiagnostic testing often is needed to properly localize lesions of the brachial plexus, frequently requiring testing of sensory nerves, which are not commonly used in the assessment of other types of lesions. INTRODUCTION Few anatomic structures are as daunting to medical students, residents, and prac- ticing physicians as the brachial plexus. Yet, detailed understanding of brachial plexus anatomy is central to electrodiagnosis because of the plexus’ role in supplying all motor and sensory innervation of the upper extremity and shoulder girdle. There also are several proximal upper extremity nerves, derived from the brachial plexus, Conflicts of Interest: None. Neuromuscular Program and ALS Center, Penn State Hershey Medical Center, Penn State College of Medicine, PA, USA * Department of Neurology, Penn State Hershey Medical Center, EC 037 30 Hope Drive, PO Box 859, Hershey, PA 17033. -
Radial Medial Head Triceps Branch Transfer to Axillary Nerve by Axillary Approach Acesso Ao Nervo Axilar Por Via Axilar Anterior
THIEME 134 Review Article | Artigo de Revisão Radial Medial Head Triceps Branch Transfer to Axillary Nerve by Axillary Approach Acesso ao nervo axilar por via axilar anterior José Marcos Pondé 1 Lazaro Santos 2 João Pedro Magalhaes 2 Ana Flavia D ’Álmeida 2 1 Department of Neurosciences and Mental Health, Universidade Address for correspondence José Marcos Pondé, MD, PhD, Av. Paulo Federal da Bahia (UFBA), Salvador, Bahia, Brazil VI, 111, Pituba, Salvador, BA, Brazil 41810-000 2 Bahian School of Medicine and Public Health, Salvador, Bahia, Brazil (e-mail: [email protected]). Arq Bras Neurocir 2015;34:134 –138. - Abstract Objective To describe axillary approach for axillary nerve transfer with radial nerve branch in brachial plexus lesions. Methods Six patients aged 24 to 54 (mean 30) years with traumatic superior trunk brachial plexus injury underwent axillary approach between October 2011 and April 2012. On physical examination prior to surgery, they could not perform shoulder abduction, external rotation, or elbow flexion. Surgical approach was made through axillary pathway without any muscular section. The transfer was done with the radial branch to the medial head of triceps. In addition to transfer to axillary nerve, each Keywords patient had spinal accessory nerve transferred to suprascapular nerve and ulnar nerve ► axillary nerve fascicle transferred to musculocutaneous nerve. ► brachial plexus Conclusion Theaxillary approach allowseasyaccesstoaxillarynerveand, therefore, is ► transfer a feasible pathway to transferences involving this nerve. Resumo Objetivo Apresentar via axilar por transferência de nervo axilar com ramo de nervo radial em lesões do plexus braquial. Métodos Seis pacientes com idade entre 24 e 54 anos (média de 30) com lesão braquial traumática do plexus no tronco superior submetidos a via axilar entre outubro de 2011 e abril de 2012. -
Arteries of The
This document was created by Alex Yartsev ([email protected]); if I have used your data or images and forgot to reference you, please email me. Arteries of the Arm st The AXILLARY ARTERY begins at the border of the 1 rib as a continuation of the subclavian artery Subclavian artery The FIRST PART stretches between the 1st rib and the medial border of pectoralis minor. First rib It has only one branch – the superior thoracic artery Superior thoracic artery The SECOND PART lies under the pectoralis Thoracoacromial artery minor; it has 2 branches: Which pierces the - The Thoracoacromial artery costocoracoid membrane - The Lateral Thoracic artery deep to the clavicular head The THIRD PART stretches from the lateral border of pectoralis major of pectoralis minor to the inferior border of Teres Major; it has 3 branches: Pectoralis major - The Anterior circumflex humeral artery - The Posteror circumflex humeral artery Pectoralis minor - The Subscapular artery Axillary nerve Posterior circumflex humeral artery Lateral Thoracic artery Travels through the quadrangular space together Which follows the lateral with the axillary nerve. It’s the larger of the two. border of pectoralis minor onto the chest wall Anterior circumflex humeral artery Passes laterally deep to the coracobrachialis and Circumflex scapular artery the biceps brachii Teres Major Passes dorsally between subscapularis and teres major to supply the dorsum of the scapula Profunda Brachii- deep artery of the arm Thoracodorsal artery Passes through the lateral triangular space (with Goes to the inferior angle of the scapula, the radial nerve) into the posterior compartment Triceps brachii supplies mainly the latissimus dorsi of the arm.