Axillary hole

Axillary fossa (axillary hole) - the area limited front of the large pectoral muscle, rear - wide muscle in the back, inside - front teeth, muscle and outside - the inner surface of the shoulder (Fig). Leather axillary fossa thin, mobile, covered with hair, contains a large amount of sweat and sebaceous glands. For subcutaneous fat layer and superficial fascia should own fascia, and then fatty tissue, in which lie the axillary artery Vienna, nerves, lymph nodes.
From inflammatory diseases axillary fossa most frequent gidradenit (see), there are boils. The spread of the inflammatory process in depth, under the pectoralis major muscle, develops spektralnaya cellulitis (see).
When wounded axillary pits can be damaged large vessels, leading to life-threatening blood bleeding, and threatens air embolism (see)if the injured Vienna. The only reliable way of temporary stop bleeding from vessels axillary fossa - to have a hand to failure behind his back and tightly premenovat to the body. From benign tumors in axillary hole observed lipoma, fibroids, from malignant - cancer and sarcoma. When breast cancer metastases usually first formed in axillary lymph nodes fossa.

Axillary fossa (fossa axillaris; synonym axillary the hole) is limited in front of the large pectoral muscle (m. pectoralis major), rear - wide muscles (m. latissimus dorsi), from the inside of the front teeth, muscle (m. serratus anterior), outside - the short head of the biceps shoulder (m. biceps brachii) and the shoulder-beaked muscle (m. coracobrachialis) (Fig.).

axillary hole
Topography armpit:
1 - m. pectoralis major (big breast muscles);
2 - m. serratus ant. (front serratus);
3 - m. latissimus dorsi (latissimus dorsi muscles);
4 - m. teres major (large circular muscle);
5 - m. triceps brachii (caput longum) (long head triceps shoulder);
6 - m. coracobrachialis (kljuvovidno-shoulder muscle);
7 - m. triceps brachii (caput mediale) (internal cylinder, triceps shoulder);
8 - m. biceps brachii. (biceps muscle of the upper arm).

Leather armpit hairy and contains a large amount of sweat and sebaceous glands. In subcutaneous adipose tissue is 5-8 superficial lymph nodes. Superficial fascia is poorly developed; private fascia is more dense on the edges of your armpit and thin in the center. In the depth P. I. is located axillary a cavity filled fatty tissue, which is the main neurovascular bundle and are located deep lymph nodes.
In adipose tissue P. I. there are five main groups of deep axillary lymph nodes: exterior (Inn. ахillares laterales) - on the outside wall of your armpit; breast (Inn. axillares pectorales) - on the inner wall; if (Inn. axillares subscapulares) - on the back wall; Central (Inn. axillares centrales) and upper (Inn. axillares apicales) - in the upper division axillary cavities. Deep lymph nodes linked to the surface and between themselves in a common axillary lymph plexus, lymph from which the left subclavian the trunk in the thoracic duct right subclavian vein (v. subclavia).
The neurovascular bundle armpit consists of axillary artery (a. axillaris), the same vein (v. axillaris) and secondary beams and nerves brachial plexus.
Axillary artery - continuation of the subclavian arteries (see) - in the area of P. I. gives the number of branches: the upper thoracic artery, Grodno-acromial, lateral thoracic, Chuck, front and rear envelopes humerus artery (a. thoracica suprema, a. thoracoacromialis, a. thoracica lat., a. subscapularis, a. circumflexa humeri ant., a. circumflexa humeri post.), continuing further in the brachial artery (A. brachialis). In relation to the artery elements neurovascular bundle P. I. located as follows: outwards from arteries - the median nerve (n. medianus) with lateral leg and musculo-cutaneous nerve (n. rnusculocutaneus), medially from arteries - ulnar nerve (n. agent and the domestic leg of the median nerve, axillary Vienna (v. axillaris), skin internal nerves shoulder and forearm (n. cutaneus brachii med. et n. cutaneus antibrachii med.), behind artery radial nerve (n. radialis) and axillary (n. axillaris).
Damage armpit often accompanied by infringement of an integrity neurovascular bundle. Closed damage blood vessels and nerves are observed at dislocations of the shoulder joint (see) and with closed fractures, surgical or anatomical necks shoulder. Gunshot wounds vessels and nerves armpit in wartime occur relatively frequently.
At infringement of an integrity neurovascular bundle showing surgery: the seam vessels and nerves. Tubal axillary artery gives a high percentage of necrosis limbs (15%).
Purulent processes (phlegmons, abscesses) P. I. can complicate wound process or occur lymphogenous way. The characteristic feature of purulent processes P. I. is the formation of various localization of purulent satekov: on the shoulder (but go neurovascular bundle), if the space under the deltoid muscle, under the pectoralis major muscle. During spreading of inflammatory process in the tissue under the big and small chest muscles are formed deep phlegmonous adenitis (the so-called spektralnaya cellulitis). Diagnostics of these phlegmon sometimes difficult, especially if the input gates of infection are small. Symptoms: asymmetry of the upper section of the chest, the rigidity of the pectoral muscles, the violation of the limbs, pain, fever, leukocytosis. The abscess is opened on the outer edge of the pectoralis major muscle.
Infection of the sweat glands in the armpit can lead to gidradenit (see); frequent in the armpit also boils (see), carbuncles (see).
In malignant breast tumors is metastases in the axillary lymph nodes, which are increasing, are dense, sedentary. Lymph node status, P. I. determined by palpation; recently receives the dissemination of limfoadenopatia (see Lymphography).