Injury to the Nerve to Serratus Anterior

Winging of the scapula.

Axilla
INTRODUCTION
The axilla (Latin armpit) is a pyramidal space situated
between the upper part of the arm and the chest wall.
It has the following parts:
• An apex
• A base
• Four walls:
– Anterior
– Posterior
– Medial
– Lateral
The axilla is disposed obliquely
BOUNDARIES
Apex
It is truncated bounded
• Anteriorly: by the posterior surface of clavicle.
• Posteriorly: by the superior border of the scapula and
medial aspect of coracoid process.
• Medially: It is bounded by the outer border of the first
rib.
Base or Floor
• Skin
• Superficial fascia
• Axillary fascia
Anterior Wall
• The pectoralis major in front
• The clavipectoral fascia
• Pectoralis minor
Posterior Wall
• Subscapularis above,
• Teres major and
• Latissimus dorsi below.
Medial Wall
• Upper four ribs with their intercostal muscles.
• Upper part of the serratus anterior muscle.
Lateral Wall
• Upper part of the shaft of the humerus
• Coracobrachialis and short head of the biceps
brachii.
(a) Boundaries of the apex of the axilla, (b) walls of the axilla, and
(c) opened up axilla
Anterior and posterior walls of the axilla with the axillary artery
Muscles forming the posterior wall of axilla with their nerve
Walls and contents of axilla
Contents of Axilla
1. Axillary artery and its branches.
2. Axillary vein and its tributaries.
3. Infraclavicular part of the brachial plexus.
4. Five groups of axillary lymph nodes and the
associated lymphatics.
5. The long thoracic and intercostobrachial nerves.
6. Axillary fat and areolar tissue in which the other
contents are embedded.
Axillary Artery
• Is the continuation of the subclavian artery.
• It extends from the outer border of the first rib to
the lower border of the teres major muscle where
it continues as the brachial artery.
• The pectoralis minor muscle crosses the artery
and divides it into three parts.
i. First part, superior (proximal) to the muscle.
ii. Second part, posterior (deep) to the muscle.
iii. Third part, inferior (distal) to the muscle.
The extent and parts of the axillary artery
Relations of axillary artery
Relations of First Part

Relations of first part of axillary artery

Relations of Second Part

Relations of second part of axillary artery

Relations of Third Part (Upper-
Part)

Relations of third part of axillary artery (upper part)

Relations of Third Part (Lower
Part)

Relations of third part of axillary artery (lower part)

The branches of the axillary artery
Axillary Vein
• The axillary vein is the continuation of the basilic
vein.
• At the outer border of the first rib, it becomes the
subclavian vein.
CLINICAL ANATOMY
• Axilla has abundant axillary hair. Infection of the
hair follicles and sebaceous glands gives rise to
boils.
• An axillary abscess should be incised through the
floor of the axilla, midway between the anterior
and posterior axillary folds, and nearer to the
medial wall