Axillary nerve

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Axillary nerve
Brachial plexus 2.svg
Brachial plexus. (Axillary nerve is visible in gray near center.)
Gray818.png
The suprascapular, axillary, and radial nerves. (Axillary labeled at upper right.)
Details
From posterior cord (C5, C6)
Innervates deltoid, teres minor
Identifiers
Latin nervus axillaris
TA98 A14.2.03.059
TA2 6440
FMA 37072
Anatomical terms of neuroanatomy

The axillary nerve or the circumflex nerve is a nerve of the human body, that originates from the brachial plexus (upper trunk, posterior division, posterior cord) at the level of the axilla (armpit) and carries nerve fibers from C5 and C6. [1] [2] [3] The axillary nerve travels through the quadrangular space with the posterior circumflex humeral artery and vein to innervate the deltoid and teres minor.

Contents

Structure

The nerve lies at first behind the axillary artery, [4] and in front of the subscapularis, [1] and passes downward to the lower border of that muscle.

It then winds from anterior to posterior around the neck of the humerus, in company with the posterior humeral circumflex artery, [2] through the quadrangular space (bounded above by the teres minor, below by the teres major, medially by the long head of the triceps brachii, and laterally by the surgical neck of the humerus), [1] and divides into an anterior, a posterior, and a collateral branch to the long head of the triceps brachii branch.

Variation

Traditionally, the axillary nerve is thought to only supply the deltoid and teres minor. However, several studies on cadavers pointed out that the long head of triceps brachii is innervated by a branch of the axillary nerve. [7] [6] [8]

Function

The axillary nerve supplies two muscles in the arm: deltoid (a muscle of the shoulder) and teres minor (one of the rotator cuff muscles).

The axillary nerve also carries sensory information from the shoulder joint. It also innervates the skin covering the inferior region of the deltoid muscle, known as the regimental badge area. [9] This is innervated by the superior lateral cutaneous nerve branch of the axillary nerve.

The posterior cord of the brachial plexus splits inferiorly to the glenohumeral joint giving rise to the axillary nerve which wraps around the surgical neck of the humerus, and the radial nerve which wraps around the humerus anteriorly and descends along its lateral border.

Clinical significance

The axillary nerve may be injured in anterior-inferior dislocations of the shoulder joint, compression of the axilla with a crutch or fracture of the surgical neck of the humerus. An example of injury to the axillary nerve includes axillary nerve palsy. Injury to the nerve results in:

Direct trauma to the nerve can also lead to paralysis and loss of sensation. [10]

Additional images

See also

Related Research Articles

Arm Proximal part of the free upper limb between the shoulder and the elbow

In human anatomy, the arm is the part of the upper limb between the glenohumeral joint and the elbow joint. In common usage, the arm extends through the hand. The arm can be divided into the upper arm, which extends from the shoulder to the elbow, the forearm which extends from the elbow to the hand, and the hand. Anatomically the shoulder girdle with bones and corresponding muscles is by definition a part of the arm. The Latin term brachium may refer to either the arm as a whole or to the upper arm on its own.

Humerus Long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

Radial nerve

The radial nerve is a nerve in the human body that supplies the posterior portion of the upper limb. It innervates the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.

Median nerve Nerve of the upper limb

The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus.

Long thoracic nerve Large nerve

The long thoracic nerve innervates the serratus anterior muscle.

Deltoid muscle Shoulder muscle

The deltoid muscle is the muscle forming the rounded contour of the human shoulder. It is also known as the 'common shoulder muscle', particularly in other animals such as the domestic cat. Anatomically, the deltoid muscle appears to be made up of three distinct sets of muscle fibers, namely the

  1. anterior or clavicular part
  2. posterior or scapular part
  3. intermediate or acromial part
Upper limb

The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulder, elbow, wrist and knuckle joints. In humans, each upper limb is divided into the arm, forearm and hand, and is primarily used for climbing, lifting and manipulating objects.

Cervical plexus

The cervical plexus is a plexus of the anterior rami of the first four cervical spinal nerves which arise from C1 to C4 cervical segment in the neck. They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral from lateral side. There is anastomosis with accessory nerve, hypoglossal nerve and sympathetic trunk.

Teres minor muscle

The teres minor is a narrow, elongated muscle of the rotator cuff. The muscle originates from the lateral border and adjacent posterior surface of the corresponding right or left scapula and inserts at both the greater tubercle of the humerus and the posterior surface of the joint capsule.

Triceps Muscle on the back of the upper arm

The triceps, or triceps brachii, is a large muscle on the back of the upper limb of many vertebrates. It consists of 3 parts: the medial, lateral, and long head. It is the muscle principally responsible for extension of the elbow joint.

Shoulder joint Synovial ball and socket joint in the shoulder

The shoulder joint is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint. It involves an articulation between the glenoid fossa of the scapula and the head of the humerus. Due to the very loose joint capsule that gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.

Teres major muscle Muscle of the upper limb

The teres major muscle is a muscle of the upper limb. It attaches to the scapula and the humerus and is one of the seven scapulohumeral muscles. It is a thick but somewhat flattened muscle.

Intercostal nerves

The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.

Medial pectoral nerve

The medial pectoral nerve arises from the medial cord of the brachial plexus, and through it from the eighth cervical and first thoracic roots (C8/T1).

Lower subscapular nerve

The lower subscapular nerve, also known as the inferior subscapular nerve, is the third branch of the posterior cord of the brachial plexus. It innervates the inferior portion of the subscapularis muscle and the teres major muscle.

Deep artery of arm

The deep artery of arm is a large vessel which arises from the lateral and posterior part of the brachial artery, just below the lower border of the teres major.

Posterior humeral circumflex artery

The posterior humeral circumflex artery arises from the third part of axillary artery at the lower border of the subscapularis, and runs posteriorly with the axillary nerve through the quadrangular space.

Fascial compartments of arm Anatomical compartments

The fascial compartments of arm refers to the specific anatomical term of the compartments within the upper segment of the upper limb of the body. The upper limb is divided into two segments, the arm and the forearm. Each of these segments is further divided into two compartments which are formed by deep fascia – tough connective tissue septa (walls). Each compartment encloses specific muscles and nerves.

Quadrangular space

The quadrangular space, also known as the quadrilateral space [of Velpeau] and the foramen humerotricipitale, is one of the three spaces in the axillary space. The other two spaces are: triangular space and triangular interval.

Axillary space

The axillary spaces are anatomic spaces. through which axillary contents leave the axilla. They consist of the quadrangular space, triangular space, and triangular interval. It is bounded by teres major, teres minor, medial border of the humerus, and long head of triceps brachii.

References

PD-icon.svgThis article incorporates text in the public domain from page 934 of the 20th edition of Gray's Anatomy (1918)

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