AXILLA

• Site: It is an
intermuscular space lying
between the upper part
of the side of the chest
and the upper part of the
medial side of the arm.
• Boundaries: It is a four
sided pyramid having :
• An apex, a base (or floor)
and four walls (anterior,
posterior, lateral and
medial).
• Apex (cervico-axillary canal)
Directed upwards towards the root of
the neck.
• A triangular interval bounded by:
- Outer border of the first rib,
medially.
- Superior border of scapula,
posteriorly.
- Posterior surface of the clavicle,
anteriorly.
• It communicates the axilla with the
root of neck, through it the axillary
vessels and nerves enter the axilla
from the neck.
• Lateral (humeral) wall: is the
narrowest wall.
• It is formed by bicipital groove
of humerus hidden by biceps
and coraco-brachialis.
• Medial (costal) wall:
• It is formed by the upper four
ribs and their intercostals
muscles.
• It is covered by the upper part
of serratus anterior muscle.
• Anterior (pectoral) wall: Formed
of two layers:
1. Superficial layer:
• formed by pectoralis major muscle
covered by deep (pectoral fascia).
2. Deep layer (the axillary septum)
:formed by
• Subclavius muscle
• Clavi-pectoral fascia
• Pectoralis minor muscle
• Suspensory ligament of the axilla,
attached below to the axillary
fascia
• N.B. Anterior fold of axilla: Is the
lower border of the anterior wall
and is formed by the lower border
of pectoralis major.
• Posterior (subscapular) wall:
Formed from above downwards and
medially by:
• 1. Subscapularis (its lateral part)
• 2. Teres major
• 3. Latissimus dorsi muscle
• N.B. Posterior fold of axilla: Is the
lower border of the posterior wall
and is formed by teres major and
latissimus dorsi muscles.
• Base (floor): Looks
downwards and is formed
by:
• 1. Skin (rich in hairs, sweat
and sebaceous glands).
• 2. Superficial fascia.
• 3. Deep (axillary) fascia:
Receives the attachment
of suspensory ligament of
the axilla.
• Contents of axilla:
• Vessels:
• Axillary artery and its branches.
• Axillary vein and its tributaries.
• Nerves: Infra-clavicular part of
brachial plexus (cords and their
branches).
• Lymph Nodes: Five groups of axillary
lymph nodes (anterior, posterior,
lateral, central and apical).
• Special content:
- Tail of mammary gland.
- Axillary sheath: around the subclavian
vessels and the brachial plexus from
the prevertebral fascia in the neck.