The axillary arch (arch of Langer) is an anomalous musculofascial slip crossing the axilla between pectoralis major and latissimus dorsi. Present in 7% of individuals, it may compress the axillary neurovascular bundle.
| Origin | Pectoralis major lateral border — lower fibres |
|---|---|
| Insertion | Latissimus dorsi tendon and coracobrachialis |
| Nerve Supply | Medial pectoral nerve or thoracodorsal nerve — variable |
| Blood Supply | Lateral thoracic artery |
| Actions | Adducts the arm; Tenses the axillary fascia |
|---|
The axillary arch is clinically significant as a cause of axillary vein thrombosis, brachial plexus compression, or axillary lymphoedema when hypertrophied. In axillary lymph node dissection, an unrecognised axillary arch can be mistaken for the axillary vein. Division is required to clear the axillary contents adequately.
Not palpable from outside. Identified as a muscular band crossing the axilla during dissection.
Hypertrophied arch of Langer compressing the axillary vein or brachial plexus producing effort thrombosis or neuropathy, managed by surgical division.
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