2. بسم الله الرحمن الرحيم ” و فى أنفسكم أفلا تبصرون“

3. The Upper limb

4. 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

5. Axilla Contents of Axilla: 1.Axillary Artery. 2.Axillary Vein. 3.Brachial Plexus (cords + branches). 4.Axillary Lymph nodes. 5.Fat. 6.Axillary tail of Breast.

6. 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

7. 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 1 st rib, medially Apex

8. Axilla Definition: Pyramidal space between the upper part of the arm and chest. It has the following boundaries:  Base: Skin & fascia

9. 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

10. Axilla Pectoralis major:

11. Axilla Pectoralis major:

12. Axilla Pectoralis major:

13. Axilla Pectoralis major:

14. 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.

15. 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.

16. Axilla Pectoralis major:

17. Axilla Pectoralis minor: Origin:The 3 rd, 4 th and 5 th ribs Insertion: Medial border and upper surface of coracoid process of scapula Nerve supply:Medial pectoral nerve Action (Girdle): Depression and protraction of scapula.

18. Axilla Pectoralis minor: Origin:The 3 rd, 4 th and 5 th ribs Insertion: Medial border and upper surface of coracoid process of scapula Nerve supply:Medial pectoral nerve Action (Girdle): Depression and protraction of scapula.

19. Axilla Pectoralis minor: Origin:The 3 rd, 4 th and 5 th ribs Insertion: Medial border and upper surface of coracoid process of scapula Nerve supply:Medial pectoral nerve Action: Depression and protraction of scapula.

20. Axilla Pectoralis minor: Origin:The 3 rd, 4 th and 5 th ribs Insertion: Medial border and upper surface of coracoid process of scapula Nerve supply:Medial pectoral nerve Action: Depression and protraction of scapula.

21. Axilla Pectoralis minor:

22. Axilla Subclavius: Origin: 1 st costal cartilage and 1 st rib. Insertion: groove on inferior surface of clavicle Nerve supply: Nerve to subclavius Action:  Depress the clavicle.  Steadies clavicle during movements of shoulder joint.

23. Axilla Subclavius: Origin: 1 st costal cartilage and 1 st rib. Insertion: groove on inferior surface of clavicle Nerve supply: Nerve to subclavius Action:  Depress the clavicle.  Steadies clavicle during movements of shoulder joint.

24. Axilla Subclavius: Origin: 1 st costal cartilage and 1 st rib. Insertion: groove on inferior surface of clavicle Nerve supply: Nerve to subclavius Action:  Depress the clavicle.  Steadies clavicle during movements of shoulder joint.

25. Axilla Subclavius:

26. 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 costo- coracoid ligament that extends from anterior end of 1st rib and contenues downward as the Suspensory ligament of axilla.

27. Axilla Clavipectoral fascia: Structures piercing it:  Cepalic vein, ends in axillary vein  Acromio-thoracic artery, branch of 2 nd part of axillary artery  Lateral pectoral nerve, supplies pectoralis major  Lymph vessels.

28. 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.

29. 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.

30. 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.

31. 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.

32. 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.