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.
Lymphatic anatomy: lymphatics of the breast and axilla
Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman in Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
The axillary sheath extends from the neck to the axilla and is surrounded by a layer of fascia. This sheath contains the great vessels and nerves of the upper extremities. The axillary artery is divided into three parts. The first segment, located medial to the pectoralis minor muscle, has the supreme thoracic branch. This segment supplies the first and second inter-costal spaces. The second segment, located posterior to the pectoralis minor muscle, contains the thoracoacromial trunk and the lateral thoracic artery branches. Located lateral to the pectoralis minor muscle is the third segment of the axillary artery. It has three branches, which are the anterior and posterior humoral circumflex arteries and the subscapular artery. The largest of the axillary branches is this subscapular artery. This artery branches into the subscapular circumflex and the thoracodorsal arteries, which are associated with the central and subscapular lymph nodes, which are described in more detail later in this chapter.
Surgical Anatomy of the Neck
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
The lateral prevertebral muscles, also known as the scalene muscles, are of more significance in head and neck surgery than the anterior group, due to the many important relations of the anterior scalene muscle. The phrenic nerve runs on the superficial surface of the anterior scalene muscle and the second part of the subclavian artery passes posterior to the scalenus anterior, where it gives off the costo-cervical trunk. The transverse cervical, ascending cervical and suprascapular arteries lie superficial to the muscle. The roots of the brachial plexus arise between the scalenus anterior and scalenus medius and emerge on the lateral border of scalenus anterior. The branches of the brachial plexus carry with them a layer of prevertebral fascia, which also encases the subclavian artery and becomes the axillary sheath.
Effect of hyaluronidases added to different concentrations of bupivacaine on quality of ultrasound-guided supraclavicular brachial plexus block
Published in Egyptian Journal of Anaesthesia, 2021
Tarek Abdel Hay Mostafa, Alaa Mohammed Abo Hagar, Amany Faheem Abdel Salam Omara
De Jong [19] stressed the importance of adequate volume for the first time then Winnie [20] suggested that 0.5 ml per 2.54 cm of height was adequate volume to fill the axillary sheath. So, the present study evaluated the efficacy of hyaluronidase as an adjuvant to small volumes of bupivacaine in chronic renal failure patients scheduled for arteriovenous shunt creation surgery under ultrasound-guided supraclavicular brachial plexus block.