► Pectoral Region

► Learning Objectives

► At the end of this lecture the student should be able to:

• Know the role of muscles of pectoral region in stabilizing the pectoral girdle.

• Enumerate the muscle of pectoral girdle .

• Describe the attachments of muscle of pectoral girdle, nerve supply and actions ( Pectoralis Major
and minor,

• Subclavius,Trapezius,Latissimus Dorsi,Rhomboid major and minor,Levator Scapulae and Serratus

anterior).

• Discuss the clavi-pectoral fascia.

• Know the triangle of auscultation.

• Mention the nerves and blood vessels of this region.

► PECTORAL GIRDLE

► The pectoral girdle or shoulder girdle is the set of bones which connects the upper limb to the
axial skeleton on each side.

► Consists of the clavicle and scapula

► PECTORAL GIRDLE

► The only joints between the shoulder girdle and axial skeleton are the sternoclavicular joints
on each side.

► No joint exists between each scapula and the rib cage; instead the muscular connection
between the two permits relatively great mobility of the shoulder girdle in relation to the
pelvic girdle.

► Superficial Fascia

► It contains the moderate amount of fat—continuous with the fascia of surrounding region.

► Contents: cutaneous nerves—cervical plexus.

► Cutaneous branches from the thoracic and posterior intercostal arteries.

► Platysma .

► Breast
► Cutaneous Vessel

► The anterior cutaneous nerve are accompanied by perforating branches of internal thoracic
artery.

► The 2nd, 3rd and 4th branches enlarges in female—supply the breast.

► Lateral cutaneuos nerves accompanied the lateral cutaneous branches of posterior intercostal
arteries.

► Breast

► Most important structure present in the pectoral region.

► It is a modified sweat gland and ectodermal in origin.

► Deep Fasica (Pectoral Fasica)

► The deep fasica covering the pectoralis major muscle is called pectoral fascia .

► Thin and closely attached to the muscle by the numerous septa passing b/w the faciculi of the
muscle.

► It attached superiorly—clavicle & anteriorly to the sternum.

► Superiorlaterally—passes over the infraclavicular fossa and deltopectoral groove

► Inferiolaterally –facsia curve round the inferolateral border of the pectoralis major– cont. with
the axillary fascia.

► Inferiorly—cont. with the fascia of thorax and rectus sheath.

► PERCTORAL GIRDLE MUSCLES

► Muscles of the pectoral girdle broadly are divided into

► • Anterior axioappendicular group

► • Posterior axioappendicular group

► ANTERIOR AXIOAPPENDICULAR MUSCLES

► Also called

► Thoracoappendicular or

► pectoral muscles

► • Four muscles
 ► – Pectoralis major

► – Pectoralis minor

► – Subclavius

► Serratus anterior

► PECTORALIS MAJOR

• Large fan shaped

• Covers superior part of thorax

• Has clavicular and sternocostal heads

• Its inferior border forms Ant. Axillary fold

• Pectoralis major and adjacent deltoid forms the narrow

deltopectoral groove in which cephalic vein runs

• Pectoralis major along with clavicle forms clavipectoral or deltopectoral triangle

► PECTORALIS MINOR

• Lies beneath Pectoralis major

• An imp.landmark for structures in axilla

• With coracoid process makes a bridge beneath which vessels and nerves pass

► SUBCLAVIUS

► • Lies almost horizontally when the arm is in anatomical position

► • Located inferior to clavicle and affords some protection to the

► subclavian vessels and the superior trunk of brachial plexus if

► clavicle fractures

► SERRATUS ANTERIOR

► Saw toothed appearance, also called boxer’s muscle

► • Overlies lateral part of thorax and forms medial wall of axilla

► • Holds scapula against thoracic wall while doing push-ups

► Posterior Axioappendicular Muscles

► Also called scapulohumeral muscles

► • Divided into 3 groups

► • Superficial posterior Appendicular (extrinsic shoulder) muscles

► – Trapezius

► – Latissimus dorsi

► • Deep posterior Appendicular (extrinsic shoulder) muscles

► – Levator scapulae or rhomboids

► Scapulohumeral (intrinsicshoulder) muscles;

► – Deltoid

► – Teres major

► – 4 rotator cuff muscles (supraspinatus, infraspinatus, teres minor and subscapularis)