Anatomy clinical correlates: Axilla

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Anatomy clinical correlates: Axilla

Prerequisite basic sciences

Prerequisite basic sciences

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Other abdominal organs

Anatomy clinical correlates: Peritoneum and diaphragm

Anatomy clinical correlates: Viscera of the gastrointestinal tract

Appendicitis: Pathology review

Diverticular disease: Pathology review

Gallbladder disorders: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Inflammatory bowel disease: Pathology review

Pancreatitis: Pathology review

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Cerebellum and brainstem

Anatomy clinical correlates: Cerebral hemispheres

Anatomy clinical correlates: Posterior blood supply to the brain

Amnesia, dissociative disorders and delirium: Pathology review

Central nervous system infections: Pathology review

Cerebral vascular disease: Pathology review

Dementia: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Drug misuse, intoxication and withdrawal: Other depressants: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Mood disorders: Pathology review

Seizures: Pathology review

Traumatic brain injury: Pathology review

Anatomy clinical correlates: Breast

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

Aortic dissections and aneurysms: Pathology review

Coronary artery disease: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Anatomy clinical correlates: Viscera of the gastrointestinal tract

Gastrointestinal bleeding: Pathology review

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Skull, face and scalp

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Anatomy clinical correlates: Trigeminal nerve (CN V)

Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck

Headaches: Pathology review

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Cerebellum and brainstem

Anatomy clinical correlates: Cerebral hemispheres

Anatomy clinical correlates: Posterior blood supply to the brain

Cerebral vascular disease: Pathology review

Anatomy clinical correlates: Female pelvis and perineum

Cervical cancer: Pathology review

Complications during pregnancy: Pathology review

Ovarian cysts and tumors: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Urinary tract infections: Pathology review

Uterine disorders: Pathology review

Vaginal and vulvar disorders: Pathology review

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

Apnea, hypoventilation and pulmonary hypertension: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Heart failure: Pathology review

Lung cancer and mesothelioma: Pathology review

Obstructive lung diseases: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Pneumonia: Pathology review

Restrictive lung diseases: Pathology review

Tuberculosis: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Drug misuse, intoxication and withdrawal: Other depressants: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Environmental and chemical toxicities: Pathology review

Medication overdoses and toxicities: Pathology review

Prerequisite basic sciences

Shock: Pathology review

Assessments

Anatomy clinical correlates: Axilla

USMLE® Step 1 questions

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USMLE® Step 2 questions

0 / 1 complete

Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 46-year-old woman presents to her primary care physician to evaluate left-sided shoulder pain and weakness for two weeks. The patient had a recent axillary lymph node dissection for breast cancer surveillance. Vital signs are within normal limits. The patient has normal sensation in the upper extremities on physical exam with 5/5 strength bilaterally. When asked to cross her arms, a notable physical examination finding is demonstrated in the image below. Which of the following anatomic structures is responsible for this patient’s symptoms?  


Image credit: wikipedia  

Transcript

The axilla, also known as the armpit, is first and foremost, incredibly ticklish. But from an anatomical standpoint, it’s a key location that contains many important structures that may be damaged, causing significant functional deficits. The axilla is like a train station, where a number of vascular, nervous and lymphatic structures pass between the trunk and the upper limb.

One very important structure is the brachial plexus, which can be divided into five roots, three trunks, six divisions, three anterior and three posterior cords, and five terminal branches. The order can be remembered using the mnemonic “Remember To Drink Cold Beer.” But you may want to wait until the end of the video before you act on that!

Now, an upper brachial plexus injury affects the superior roots, namely spinal nerves C5 and C6, and a classic example of an upper brachial plexus injury is Erb palsy, which can happen in adults as a shoulder trauma that results in an increase in the angle between the neck and the shoulder, or in newborns, when excessive stretching of the neck occurs during childbirth.

The clinical consequences reflect the affected nerves, which are the ones that are derived solely from C5 and C6 roots, namely, the musculocutaneous, axillary, and suprascapular nerves. This causes paralysis of muscles like the biceps brachii, which normally allows forearm flexion and supination, and the infraspinatus and teres minor, so lateral rotation of the arm is affected, as well as the deltoid and supraspinatus muscles, which would usually cause arm abduction but would also be affected. So with superior brachial plexus injuries, the classic finding is a “waiter’s tip position”, which reflects arm adduction and medial rotation, and forearm extension and pronation.

Sources

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  10. "Regional anatomy" Galen (undefined)
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