Functional Anatomy of Axilla

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Presentation Transcript

Functional Anatomy of Axilla : 

Functional Anatomy of Axilla Prof. Dr. M. Saeed Shafi AMDC

Kamal Azfar 35-year laborer : 

Kamal Azfar 35-year laborer an expert in lifting heavy weights in “Akbari Mandi” One day he lifted a heavy cartoon on right shoulder and in the evening he was unable to raise his right arm above the level of the shoulder. Moreover, he noticed loss of pushing and punching action of right upper limb. His wife noticed an excessive prominence of medial border of right scapula while he was trying to push the bed. ?????????

Slide 4: 

Noor Fatima 40-year High school teacher experienced similar symptoms & signs two weeks after right axillary lymph node biopsy

Objectives? : 

Objectives?

Axilla : 

Axilla Pyramidal space Apex Base Anterior wall Posterior wall Medial wall Lateral wall

Slide 9: 

AXILLA LOCATION AND BOUNDRIES CROSS SECTION SAGITAL SECTION

Slide 11: 

2/14/2009 malik 11

Slide 13: 

AXILLA LOCATION AND BOUNDRIES CROSS SECTION SAGITAL SECTION

Contents : 

Contents Fat Brachial plexus Axillary blood vessels Lymph nodes / Lymphatics

Slide 18: 

AXILLARY ARTERY

Slide 20: 

VEINS OF AXILLA

Axillary Lymph nodes : 

Axillary Lymph nodes Anerior (pectoral) group Posterior(subscapular) group Lateral group Central group Infraclavicular(deltopectoral) group Apical group

Slide 23: 

BRACHIAL PLEXUS Network of nerves supplying the upper limb. Composed of ventral rami of lower four(C5-C8) cervical and first thoracic spinal nerves(T1). Divided by the clavicle into supraclavicular and infraclavicular parts. Prefixed & Postfixed Brachial Plexus

Brachial Plexus : 

Brachial Plexus

Slide 33: 

How Brachial Plexus Gets Damaged Physical Injury Neurological disorders Excessive stretching of the neck/arm.

Slide 34: 

AXILLA CONTENTS

Clinical Outcomes : 

Clinical Outcomes Axillary sheath nerve block Enlargement of axillary lymph nodes Examination of lymph nodes Iatrogenic Injury to: long thoracic nerve thoracodorsal nerve

Slide 36: 

AXILLARY NERVE INJURY AREA OF ANAESTHESIA

Slide 37: 

Signs and symptoms of Erb’s Paralysis Paralysis of the shoulder and arm (deltoid, biceps, brachials and brachioradials) results in an abducted shoulder, medially rotated arm, and extended elbow (waiter’s tip position) Adduction and lateral rotation of the arm not possible. Flexion and supination of the forearm not possible. Sensation lost over a small area over lower part of deltoid.

Slide 38: 

Signs and Symptoms Paralysis of the Intrinsic muscles of the hand and ulnar flexors of the wrist and fingers resulting in claw hand. Cutanious anesthesia and analgesia in narrow zone along ulnar border of the forearm and hand. Skin with sensory fibres loss are warmer and drier due to arteriolar dilation and absence of sweating as sympathetic fibres are also damaged.

SUMMARY? : 

SUMMARY? What is axilla? Boundaries & contents? Why so much fat in axilla? Axillary sheath? Axillary lymph nodes / staging biopsysy? Injuries to Brachial plexus?