This section is from the book "Anatomy Of The Arteries Of The Human Body", by John Hatch Power. Also available from Amazon: Anatomy of the Arteries of the Human Body, with the Descriptive Anatomy of the Heart.
The artery may be reached either by cutting through the anterior wall of the axilla, or through its base. If we prefer the former plan, we make our incision about three inches long, over the areolar interval between the deltoid and great pectoral muscles, taking care not to injure the cephalic vein. After scraping through some areolar tissue, the pectoralis minor muscle is exposed; and beneath it (i.e. nearer to the base of the axilla) we can feel the common cord formed by the vessels and nerves. The distended vein is then drawn inwards, and the artery which lies between the roots of the median nerve must be insulated carefully and tied.
The operations through the base of the axilla may be thus performed:—the patient being placed on a table, and the arm abducted and supinated, an incision about two inches and a half in length should be cautiously made through the integuments and fascia of the axilla, in the direction of the head of the humerus. The coraco-brachialis muscle will then form a good guide to the artery: by carefully scraping through the areolar tissue, the axillary vein will be exposed: the median nerve will also present itself, and may be drawn outwards while the vein is pressed inwards, and the aneurism-needle carried cautiously round the artery from within outwards.
* Chirurg. Clinique, vol. i. 17.
The axillary artery has been torn both by the attempts made to reduce a luxation of the humerus, and by the head of the bone itself in the very act of being dislocated into the axilla: these occurrences are exceedingly rare. M. Floubert, of Rouen, relates a case of the former, and the following very interesting example of the latter is related by Mr. Adams, one of the surgeons to the Richmond Hospital, in the 35th number of Todd's Cyclopaedia of Anatomy and Physiology. The laceration of the axillary artery was recognized a few minutes after dislocation had occurred, and before any effort whatever had been made to restore the humerus to its place.