腋窝解剖

null腋窝解剖腋窝解剖AxillanullThe axilla is the region between the arm and the thorax. It contains a number of important structures running to the arm and is also one of the main areas for drainage of lymph from the breast. 'Armpit' or 'underarm' refer to the inferior skin (floor) of the axilla, or the hollow formed by that skin (the axillary fossa). The axilla is a pyramidal space located inferior to the shoulder joint, at the junction of the upper limb and thorax. It provides a space through which many of the important vessels and nerves pass from the trunk to the upper limb. The space is almost obliterated in full abduction of the shoulder, a position in which the contents become vulnerable. nullnullshapeshapeAnterior wall Pectoralis major Pectoralis minor Subclavius plexus（锁骨下丛） The anterior axillary fold is the inferior border of pectoralis major covered by fascia and skin. nullnullnullSubclavius visible at upper left, above first rib.nullPosterior wall Subscapularis （肩胛下肌） Teres major （大圆肌） Teres minor Latissimus dorsi （背阔肌） The posterior axillary fold is formed by latissimus dorsi, teres major and skin. nullSubscapularis visible near center top.) nullMuscles on the dorsum of the scapula, and the Triceps brachii muscle: #3 is Latissimus dorsi muscle #5 is Teres major muscle #6 is Teres minor muscle #7 is Supraspinatus muscle #8 is Infraspinatus muscle #13 is long head of Triceps brachii muscle nullnullLateral wall Coracobrachialis （喙肱肌） Short head of biceps brachii （二头肌） Humerus （肱骨）null喙肱肌nullMedial wall Serratus anterior （前锯肌） Thoracic wall nullnullApex The cervoaxillary canal: Outer border of first rib Superior border of scapula （肩胛骨） Posterior border of clavicle （锁骨）nullFloor Adipose tissue （脂肪组织） Skin Fascia （筋膜，肌膜）contentscontentsAxillary artery Axillary artery and its branches – anterior view of right upper limb and thorax. Upper and lower limits labeled. 肩胛下动脉subscapular artery较粗大，发自腋动脉第三段，沿肩胛下肌下缘向后下方行下，随即分出旋肩胛动脉，经三边孔到冈下窝，本干延续为胸背动脉，与同名神经伴行，分布于背阔肌等结构。nullnullnullAxillary vein Anterior view of right upper limb and thorax – axillary vein and the distal part of the basilic vein（贵要V） and cephalic vein.（头V） brachial（上肢，肱） nullBrachial plexusBrachial plexusnullBrachial plexus 胸长神经longthoracic nerve经臂丛后方入腋腔，沿前锯肌面下行，约在胸外侧动脉后方2横指处，分支支配前锯肌 胸背神经thoracodorsal nerve与肩胛下动脉和胸背动脉伴行，支配背阔肌 肩胛下神经subscapular nerves The right brachial plexus with its short branches, viewed from in front. null肋间臂神经肋间臂神经nullAxillary lymph nodes 前anter-前锯肌的表面 后poster-肩胛下血管周围 外later-沿腋静脉远侧段排列 中央centra-腋腔底部中央的结缔组织中，收纳上述三群淋巴结的输出管。 腋尖apica-胸小肌上部，锁胸筋膜深面，沿腋动脉近侧段排列.行乳腺癌根治手术清扫淋巴结时，需注意保护前群附近的胸长神经和与后群相邻的胸背神经。 nullAdipose tissue An axillary sheath（鞘） surrounds the vessels and nerves proximally,a continuation of the cervical fascia. Clinical relevanceClinical relevanceMetastasis from breast cancer to the axillary lymph nodes Brachial plexus injury Brachial plexus injury 短神经： 胸长神经longthoracicnerve(C5～7)发自臂丛根部，经臂丛后方入腋腔，沿前锯肌表面下行，约在胸外侧动脉后方2横指处，分支支配前锯肌。该神经损伤后，由于前锯肌瘫痪，导致肩胛骨脊柱缘起，叫做翼状肩，患者的上肢不能高举过头。 胸背神经thoracodorsalnerve(C5～7)起于后束，与肩胛下动脉和胸背动脉伴行，支配背阔肌。 胸外侧神经和胸内侧神经 臂丛长神经从各束发出后，行向自由上肢，支配各该部的肌肉和皮肤。由外侧束发出的有肌皮神经和正中神经外侧根 nullTHANK YOU!