chap, xi.2 REGION OF THE SHOULDER. 189 



with displacement, by many axillary growths, and by 

 some inflammations of the upper part of the thoracic 

 wall. In subclavicular, or intracoracoid dislocation, 

 the fossa is replaced by an eminence. In this region, 

 at a spot to the inner side of the coracoid process, 

 and corresponding nearly to the middle of the clavicle, 

 the pulsations of the axillary artery can be felt on 

 deep pressure, and the vessel be compressed against the 

 second rib. Just below the clavicle the interspace 

 between the sternal and clavicular portions of the 

 pectoralis major can often be made out. 



The anterior and posterior borders of the axilla 

 are very distinct. The anterior border formed by the 

 lower edge of the pectoralis major follows the line of 

 the fifth rib. The depression of the armpit varies, 

 other things being equal, with the position of the 

 upper limb. It is most deep when the arm is raised 

 from the side at about an angle of 45, and when the 

 muscles forming the borders of the space are in a 

 state of contraction. As the arm is raised above the 

 horizontal line the depression becomes shallower, the 

 head of the bone projects into the space and more 

 or less obliterates it, while the width of the fossa is 

 encroached upon by the approximation of the anterior 

 and posterior folds. The coraco-brachialis muscle 

 itself forms a distinct projection along the humeral 

 side of the axilla when the arm is raised to a right 

 angle with the body. If the arm be brought nearly 

 close to the side, the surgeon's hand can be thrust 

 well up into the axilla, and the thoracic wall explored 

 as high up as the third rib. 



The axillary glands cannot be felt when they are 

 in a normal condition. 



The direction of the axillary artery, when the arm 

 is raised from the side, is represented by a line drawn 

 from about the middle of the clavicle to the humerus 

 at the inner side of the coraco-brachialis. A line 



