Pectoral Region & Shoulder Flashcards
Deltopectoral groove
Surface of pectoral and shoulder
Furrow between deltoid and pectorals major muscles
Carries cephalic vein (towards axillary vein) -
Drains entire upper limb
Cephalic vein
Drains entire upper limb
Runs along deltopectoral groove
Anterior axillary fold
On pectorales major muscle
Interdigitations of serratus anterior
Seen anterolaterally at origin, ribs 1-8 or 9
Heart beat is clearest at 5th intercostal space
Sternal angle
At level of intervertebral disc between T4-T5
At level of second costal cartilage
Mammary gland
Modified sweat glands
Have numerous ducts
Found in hypodermic superficial to pec major
Involved in lympatic drainage to axillary and parasternal nodes
Lympathic drainage
From mammary glands to axillary lymph nodes and parasternal nodes
Axillary lymph nodes
Main lymphatic drainage path
Cancer cells can lodge here and produces metasteses
These nodes communicate head and neck
Parasternal nodes
Lymphatic drainage
Communicate with other breast, liver, heart, and lungs
Cancer cells may spread to cranial cavity and brain via communication between:
intercostal venous vein and
vertebral venous plexus
Cutaneous innervation for pectoral and shoulder region
Ventral rami of thoracic spinal nerves
Supraclavicular nerves
Ventral rami of thoracic spinal nerves
Mixed nerves (sensory & motor) Starting with T1 Lateral cutaneous branches and Anterior cutaneous branches Supply thoracic wall (continues to become intercostal nerve as it passes into ribs)
Supraclavicular nerves
C3 and C4 from cervical plexus
Supply skin over clavicular region, shoulder, and thoracic wall above T2
Pectoral region fasciae
Pectoral fascia
Clavipectoral fascia
Costocoracoid membrane
Pectoral fascia
Envelopes pec major and attaches to clavicle and sternum
Continuous with axillary & abdominal fascia, which becomes superficial back fascia
Clavipectoral fascia
Deep to pec major
Envelopes subclavius muscle and pec minor muscle
Attaches laterally to coracoid process
Attaches superiorly to the clavicle
Medially known as “costcoracoid membrane”
Costocoracoid membrane
Medial specialization of the clavipectoral fascia
Attaches laterally to coracoid process
Attaches medially to clavicle and first rib
Pectoral region muscles
Pec major
Pec minor
Subclavius
Shoulder region muscles
Deltoid Supraspinatus Infraspinatus Teres major Teres minor Subscapularis
What sits deep to pec minor muscle?
Axillary artery and brachial plexus cords
Cutaneous innervation of shoulder region
Superior shoulder:
supraclavicular nerves from cervical plexus
Inferior Deltoid:
branch from axillary nerve supplies skin
Which muscles are part of the rotator cuff?
Supraspinatus Infraspinatus Teres minor Subscapularis Teres major
Spaces of pectoral/shoulder region
Triangular space
Quadrangular space
Triangular space
Borders: Teres minor (superior) Teres major (inferior) Long head of Triceps Brachii (lateral) Contains: Scapular circumflex artery
Quadrangular space
Borders: Teres minor (superior) Teres major (inferior) Long head of Triceps Brachii (medial) Diaphysis of the humerus (lateral) Contains: Posterior humeral circumflex artery and axillary nerve
Arteries supplying pectoral/shoulder region
Suprascapular artery
Posterior humeral circumflex artery
Scapular circumflex artery
Scapular anastomosis