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Axillary nerve: want to learn more about it?

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Axillary nerve

The axillary nerve is one of the terminal branches brachial plexus, derived from its posterior cord (C5-6). It travels through the quadrangular space together with the posterior circumflex artery and vein.

It is a mixed nerve, meaning that it has both motor and sensory fibers which innervate important muscles of the upper limb and parts of the skin within the axillary region.

It also innervates glenohumeral joint, and due to their close spacial relation, the nerve is often injured whenever the joint is injured. The injuries of the axillary nerve lead to decreasing or complete loss of function within the structures that it innervates.

This article will talk about the anatomy and function of the axillary nerve, followed by any clinical pathology related to this nerve.

Key facts about the axillary nerve
Origin Posterior cord of brachial plexus (C5-C6)
Branches Anterior, posterior, articular branches
Innervation Motor - deltoid muscle, teres minor muscle, lateral head of the triceps brachii muscle
Sensory - glenohumeral joint, skin of the deltoid region/upper arm 
Clinical relations Neuropathy, quadrangular space syndrome

Origin and course

The axillary nerve originates as a terminal branch of the posterior cord of the brachial plexus. The brachial plexus is formed by the ventral rami (roots) of the fifth to eighth cervical nerves (C5-8), along with the ventral ramus of the first thoracic nerve (T1). These five roots merge to form three trunks, the superior (C5-6), middle (C7) and inferior (C8-T1).

These three trunks then divide into anterior and posterior divisions which then reform to result in three cords. There are five terminal branches of the brachial plexus derived from these cords. One of these terminal branches is the axillary nerve.

The axillary nerve branches from the posterior cord (C5 - T1) and descends in the axilla posterior to the axillary artery and anterior to the subscapularis. It emerges from the axilla at the level of the lower border of the subscapularis, by traversing the quadrangular space. This is a space in the posterior scapular region, which is bounded by the superior margin of the teres major inferiorly, the inferior margin of the teres minor superiorly, the lateral margin of the long head of the triceps brachii medially and the surgical neck of the humerus laterally. Here, it supplies a branch to the shoulder joint. The posterior circumflex humeral artery and vein also run posterior to this nerve in this space.

Have you wondered whether you should be using 3D anatomy to learn about the axillary nerve? Here's why you should think again.

The axillary nerve then passes medial to the surgical neck of the humerus before dividing into three terminal branches:

  • The anterior branch
  • The posterior branch
  • The articular branch

The anterior branch winds around the surgical neck of the humerus, posteriorly, with the posterior circumflex humeral vessels and supplies the anterior aspect of the deltoid muscle.

The posterior branch supplies the posterior aspect of the deltoid muscle as well as the teres minor. Following this, it passes around the lower border of the deltoid and is then referred to as the superior/upper lateral cutaneous nerve of the arm. This nerve supplies the skin over the lower part of the deltoid and over the upper part of the long head of triceps both anteriorly and posteriorly.

The articular branch supplies the glenohumeral joint.

Function

The axillary nerve has both a motor and a sensory distribution of innervation.

  • It has motor fibres that innervate the deltoid muscle, acting as an abductor, flexor and extensor at the shoulder joint, as well as the teres minor muscle, allowing lateral rotation of the glenohumeral joint.
  • As mentioned above, it has sensory innervation to the skin of the arm superficial to lower part of the the deltoid muscle and superficial the upper part of the long head of the triceps, as the superior/upper lateral cutaneous nerve of the arm. 

Axillary nerve: want to learn more about it?

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