Upper Limb
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
The axillary vein is located within the axillary sheath, a connective tissue sleeve that also surrounds the axillary artery and the brachial plexus. The axillary artery (Figure 4.4) is the continuation of the subclavian artery; it begins at the lateral border of the first rib, and ends at the inferior border of the teres major where its name changes to brachial artery (”artery of the arm”). The easiest way to learn the branches of the axillary artery is to divide it into three parts: The first, second, and third parts lie medially, posteriorly, and laterally to the pectoralis minor muscle, respectively (Plate 4.9). Details about the specific muscles that the branches of the axillary artery supply are given in Tables 4.1 and 4.2. The first part of the axillary artery has one branch: the superior thoracic artery, which makes sense because this is the most medial—and thus superior—branch of the axillary artery and lies in the thoracic region, supplying mainly the first and second intercostal spaces.
Angiographie Anatomy of the Peripheral Vasculature and the Non-invasive Assessment of Peripheral Vascular Disease
Richard R Heuser, Giancarlo Biamino in Peripheral Vascular Stenting, 1999
After the vertebral artery, the subclavian artery gives rise to four major branches: internal mammary, thyrocervical trunk, dorsal scapular artery, and suprascapular artery (Fig. 2.4). Next, the subclavian artery heads inferiorly and crosses the first rib. At this landmark, it becomes the axillary artery and gives rise to the following branches: superior thoracic artery, thoracoacromial artery, lateral thoracic artery, subscapular artery, and the circumflex humeral branches (Fig. 2.5). Next the axillary artery crosses the lower border of the tendon of the teres major where it becomes the brachial artery. The main branches of the brachial artery are the profunda brachial and the superior ulnar collateral arteries, both of which form a collateralization network around the brachial artery. The brachial artery bifurcates into the ulnar and radial arteries below the elbow.
Dislocations around the shoulder
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
Although uncommon, an injury to the axillary artery can lead to devastating complications, particularly if there is a delay in diagnosis. A review of the literature demonstrates that of the axillary artery injuries reported following a dislocation of the shoulder, 86% are found in patients over 50 years of age18. Most injuries occur in the third part of the artery distal to the pectoralis minor, with 68% presenting with an axillary mass. Distal pulses may rarely be present due to collateral vessel flow and should not rule out an arterial injury. Any patient presenting with an axillary mass and diminished pulses after a shoulder dislocation should be investigated with an arteriogram for possible axillary artery injury and early vascular input is required. Atherosclerotic changes in the artery associated with tenting of the artery over the pectoralis minor may be responsible for the increased incidence of this injury in the elderly patient.18
Superficial location of the brachial plexus and axillary artery in relation to pectoralis minor: a case report
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
K Keet, G Louw
The axillary artery is a continuation of the subclavian artery once it has passed over the first rib. The pectoralis minor muscle is located superficial to the axillary artery and it is this relationship that is used to divide the artery into three parts. The first part of the axillary artery is situated between the first rib and the superior border of pectoralis minor, the second part is deep to pectoralis minor, and the third part is located between the inferior borders of pectoralis minor and teres major muscles, after which it is known as the brachial artery.5 The axillary artery is accompanied by the axillary vein, a continuation of the brachial vein at the inferior border of teres major. The axillary vein is superficial to the axillary artery and becomes the subclavian vein as it crosses over the outer border of rib one.6
Alternative Access for Mechanical Circulatory Support
Published in Structural Heart, 2020
Mir B. Basir, Marvin H. Eng, Pedro Villablanca, Mark B. Anderson, Mohammad Zaidan, Dee Dee Wang, Khaldoon Alaswad, William W. O’Neill, Mohammad Alqarqaz
Individual case series have targeted different segments of the axillary artery for percutaneous access. Some have accessed the AxA in the first segment27,30; while others have accessed the AxA in the third segment of the vessel.32,35 Both locations have reported high procedural success and low complications rates. Based on the proximity to the brachial plexus we typically aim, similar to other groups,34 to access the AxA within the distal portion of the first segment or within the second segment, i.e. through the pectoralis minor muscle. This part of the artery has less side branches when compared to the distal vessel; is located lateral to the rib cage (extra-thoracic) thus potentially decreasing the risk of pneumothorax; and if manual compression is required the artery can be compressed against the rib cage at this location. Avoiding the distal segment may also decrease risk of brachial plexus injury which is located anterior to the AxA in its distal segment.36 This first portion of the axillary artery is also larger than the distal segment.
Congenital Large Cutaneous Hemangioma with Arteriovenous and Arterioarterial Malformations: A Novel Association
Published in Fetal and Pediatric Pathology, 2019
Sihem Darouich, Houda Bellamine, Lasaad Mkaouar, Amira Ayachi, Mechaal Mourali
Internal examination showed massive effusions of all serous cavities, thymic hypoplasia (1.35 g; normal ranges 2.25–2.5), lung hypoplasia (5.5 g/4.25 g; normal ranges 10.2–10.6/9.2–9.6) and myocardial hypertrophy without structural abnormalities (13.8 g; normal ranges 5.5–6). There were no visceral petechiae. The right axillary mass was consistent with a large arteriovenous fistula of aneurysmal aspect, which was predominately fed by one vessel arising from the axillary artery, and emptied into a larger vessel tributary of the axillary vein. The right subclavian and axillary arteries were large. Other abnormal vascular shunts were observed, consisting of bilateral anastomosis between the common carotid artery and the subclavian artery (Fig. 1c). Cut sections showed tumor extension into dermal and subcutaneous layers with characteristic spongious architecture without involving the muscle (Fig. 2a).