upper limb, pectoral region

8/13/2019 Upper limb, Pectoral Region

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Upper Limb

Pecto ral Reg ion

Dr. Gamal Taha

Lecturer of Anatomy


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Surface Anatomy


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Pecto ral reg ionBony Landmarks

Sternum:Jugular

notch (body of T2)Sternal angle of Louise

(T4-5)

Xiphosternal joint (T9)

In addition to

Ribs & costal cartilage

till the Anterior Axillary

Fold

Surface Anatomy


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Surface Anatomy

Superf ic ial

s t ructure

- Skin & derivative ofskin (breast)

Breast : nipple,areolar, mammary

gland (F)

Surface Anatomy(posi t ion ) :

Nipple4-5 inches

from the midline, 4th

intercostal space


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Superf ic ial Struc tures


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Superf ic ial Struc tures

Cutaneous Nerves: Supraclavicular nerves

Anterior cutaneous

nerves of the intercostalnerves (ventral rami ofT2-T6)

Lateral cutaneous

nerves of the intercostalnerves (ventral rami ofT3-T6)

Intercostobrachial Nerve

(Lateral cutaneousnerve of T2


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Superf ic ial Struc tu res -

Nerves


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Arter ies

Cutaneous arter ies

Perforating

branches of theIn ternal tho racic

artery.

Lateral branches of

the Posterior

intercostal arteries.


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Arter ies

Cutaneous arter ies

Superior thoracic

Thoracoacromialarterty

Lateral thoracic

arteries(All from Axillary

artery).


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Pec to ral Fasc iaAttachments:

Superior ly: to theclavicle.

Infer ior ly: Till the

fibrous sheath ofthe RectusAbdominis.

Medial ly: to the

front of thesternum.

Lateral ly:continuous with

fascia that covers


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Muscles Pecto ral is Majo r

Origin : 2 heads;

Clavicular head: From medial of

the front of the

clavicle.

Sternocostal head:From;

Sternum. Upper 6 costal

cartilages. Aponeurosis of

external oblique


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Insert ion:

Lateral lip ofbicipital grooveformingAnterior

Axillary foldon itsway.

Nerve supply :

Medial & lateralpectoral nerves.


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Clavicular

Sternocostal

Pec toral is Major:- Both Parts (Adduction, Medial Rotation)-Clavicular head (Flexion)

-Sternocostal head (Extension)



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Origen:

3rd, 4th& 5thribs(just lateral to

costalcartilages).

Insert ion:

Upper surfaceand

medial borderof

Musc les - Pec to ral is Mino r


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Act ion:

Protraction and

depression of

scapula and aguide to the axilla

Nerve Supply:

Medial Pectoral

Nerve & Lateral

Pectoral nerve.

Muscles Pecto ral is Minor


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Muscles Subclavius

Muscle

Nerve supply:

Nerve to

subclavius fromupper trunk ofbrachial plexus.

Action:

Fixes the clavicleduring movementof shoulder joint.


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Clav ipecto ral Fascia


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Attachments:

Superior ly: It splits toenclose the subclaviusgroove.

Infer ior ly: It splits toenclose the pectoralisminor muscle. Thencontinue as thesuspensory ligament ofthe.

Medially: It blends withfascia over the first twointercostal spaces and isattached to the 1st rib

Laterally: it is thick anddense and is attached tothe coracoid process.


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It is a thickenedmembrane ofDeep Fasc iabetween thesubclavius and

pectoralis minor.

It is p ierced by :Lateral pectoral

nerve.Thoraco-

acromial arteryCephalic vein.Few lymph

vessels.


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Serratus Anter ior Muscle

Origin:

Upper eight

ribs.

Insertion:

Anterior aspect

of the medialborder and

inferior angle of

scapula.

87

5

6

4

3

21


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Nerve supply: Long thoracic

nerve.

Action: Draws the

scapula forward(protrusion, as inboxing).

Rotates scapulaoutwards inraising the armabove 90 degree.


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Thank You

upper limb, pectoral region

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