Identification and protection of the Axillary nerve
- it is essential to locate axillary nerve when performing any anterior shoulder reconstruction;
- to facilitate nerve identification, place arm in adduction & in neutral rotation;
- pass a finger along lower aspect of subscapularis, inorder to palpate nerve as it passes medially along subscapularis to palpate axillary nerve coursing inferolaterally;
- volar aspect of the index finger palpates the nerve proximal to the quadrangular space.
- note that external rotation and adduction of the arm moves the nerve away from subscapularis tendon and offers further protection;
- anterior circumflex humeral vessels mark inferior border of subscapularis;
- incise upper 2 cm of pectoralis tendon to better palpate and visualize nerve;
- proximally the nerve courses back to the brachial plexus;
- distally the nerve course to the quadrangular space
The axillary nerve in its relationship to common sports medicine shoulder procedures.
Traumatic brachial plexus injuries in the adult: Retro and inferior clavicular lesions.
Anatomy of the axillary nerve and its relation to inferior capsular shift.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Monday, July 2, 2012 7:36 pm