The clavipectoral fascia arises from the edges of the groove in two layers that cover the front and back sides of this muscle. The clavipectoral fascia is a sheet of loose connective tissue which is the deep layer of fascia in the pectoral region. The fascia converges in the axilla, where it acts as a protective structure over the neurovascular structure of the axilla. The clavipectoral fascia it splits above to enclose subclavius and is attached to the edges of the subclavian groove on the undersurface of the clavicle. Anatomical considerations for creating the pacemaker. Clavipectoral fascia an overview sciencedirect topics. Pectoral fascia axillary fascia clavipectoral fascia deltoid fascia infraspinous fascia supraspinous fascia. If you would like a large, unwatermarked image for your web page or.
The clavipectoral fascia extends superiorly from the clavicle, medially from the costochondral joints, and superolaterally from the coracoid process the fascia converges in the axilla, where it acts as a protective structure over the neurovascular structure of the axilla components. Breast surgery is one of the most frequently performed surgeries in hospitals and can be associated with significant postoperative pain. Anatomy video lectures, questions and doubt clearing by indias top anatomy professor, dr. The clavipectoral fascia is a strong fascial sheet deep to the clavicular head of the pectoralis major muscle, filling the space between the clavicle and the pectoralis minor muscle. It contains the cephalic vein, and deltopectoral fascia, which is a layer of deep fascia that invests the three structures that make up the border of the triangle. It includes the muscular fascia that envelops the subclavius and pectoralis minor muscles and the strong membrane costocoracoid membrane formed in the interval between them, and the suspensory ligament of the axilla. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Passing outwards are the acromiothoracic axis artery which is a branch of the axillary artery and the lateral pectoral nerve lateral pectoral.
The clavipectoral fascia is a strong sheet of connective tissue that is attached above to the clavicle. The upper fascicle emerged from the anterior wall of the thorax as a thin muscular extension of the pectoral fascia and the anterior sheet of the clavipectoral fascia. The clavipectoral fascia lies below the clavicular head of the pectoralis major. Pdf right sided costocoracoid ligament a case report. Now trace the terminal part of the cephalic vein to the clavipectoral fascia. It occupies the interval between the pectoralis minor and subclavius, and protects the axillary vein and artery, and axillary nerve. Assigning the correct current procedural terminology cpt code for procedures and services is an important aspect of surgical practice. Medial and lateral tissue planes are developed to expose the clavipectoral fascia. A fascia is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Ta a fascia that extends between the coracoid process, the clavicle, and the thoracic wall. Pectoralis major tear repair, fixation help restore.
The clavipectoral fascia is a strong fascia situated under cover of the clavicular portion of the pectoralis major. Had we assumed that the patient had occult breast cancer with lymph node metastasis, she would have received neoadjuvant chemotherapy that would have altered her stage and prognosis. Clavipectoral fascia fascia clavipectoralis imaios. Pectoralis major tear repair, fixation help restore anatomy, biomechanics. Below the subclavius, the two layers of the clavipectoral fascia come together to form a single sheet of tissue. The pectoralis minor muscle was transected at its origin to reveal. Ueshoulderpectoral region questions and study guide. The relationship of the subclavius muscle with relevance. The clavipectoral fascia is a sheet of membrane filling in the space between clavicle and pectoralis minor, limited laterally by the coracoid process and passing medially to fuse with the external intercostal membrane of the upper two spaces.
The pectoralis major muscle is enclosed by a fascia known as pectoral fascia while the pectoralis minor and subclavius muscles are enclosed by a deep fascia known as clavipectoral fascia. The deltopectoral triangle is the region that is bounded by deltoid, pectoralis major and superiorly by the small bare length of clavicle that does not provide an origin for either of these muscles. This column responds to several frequently asked questions posed to the american college of surgeons coding hotline. Clavipectoral fascia the reason behind the naming that it extends from the subclavius to pectoralis minor clavipectoral fascia. With the arm abducted, considerable fat will be noted in the axilla. The clavipectoral fascia is a sheet of strong connective tissue. A spontaneous loss of its normal elasticity may end in a contracture of this structure, causing limitation of elevation of the arm. Although it is a single continuous fibrous sheath, the clavipectoral fascia has been subdivided into. Clavipectoral fascia wikimili, the free encyclopedia.
The effects of the pectoral fascia can clearly be seen in the hollow of the armpit, which is caused by the fascia attachment in this area. Pulls the skin of the axilla superiorly with shoulder abduction. The clavipectoral triangle also known as the deltopectoral triangle is an anatomical region found in humans and other animals. Pectoralis major muscle an overview sciencedirect topics. Muscles of pectoral region platysma lies in sf subcutaneous muscle, not included in the pectoral region origin deep fascia over the p. The pectoralis major, pectoralis minor and subclavius muscle. Pectoralis major repair with unicortical button fixation. Or its a thick, bilateral connective tissue structure deep to pectoralis major.
The clavipectoral fascia is then excised in line with the skin incision, and both pectoralis major tendon heads are. Pectoral region it is composed of muscles of the pectoral region which include. We report a novel technique of intraoperative lateral pectoral nerve block under direct vision for analgesia post subpectoral implant placement for breast reconstruction. Anatomy lecture for medical students by medical students studying for the usmle step 1 or nclex. Pdf clavipectoral fascia plane block for analgesia after. The lateral pectoral nerve pierces the clavipectoral fascia just medial to the pectoralis minor in order to reach the pectoralis major. So, the network of fascia accounts for how all aspects of the body interrelate beyond the origin and insertion points where muscles start and stop. It fills in the space between the clavicle and the pectoralis minor.
It occupies the interval between the pectoralis minor and subclavius, and protects the axillary vessels and nerves. Trace the lateral pectoral nerve, medial pectoral nerve, and branches of the thoracoacromial artery. A as observed in sagittal section of anterior axillary wall. Bulk of the fascia is actually deep to behind the muscle and its principle role is to give support to the structures of the axilla by enclosing the neurovascular structures that exit and enter the thoracic inlet. From its origin, this fascicle was directed to the axillary fossa, joining in this trajectory with the middle fascicle emerging from the latissimus dorsi muscle, although clearly separated from it. Comprising of 11 units, over 50 hours video and topic wise tests, this app will ensure that you master anatomy for exams such as neet pg, nimhans pg and others. Clavipectoral fascia definition of clavipectoral fascia. Traced upward, it splits to enclose the subclavius, and its two layers are attached to the clavicle. The clavipectoral fascia encloses the subclavius muscle located. The deltopectoral groove is an indentation in the muscular structure between the deltoid muscle and pectoralis major. The fascia is then excised with metzenbaum scissors to allow for lateral retraction of the deltoid and, ultimately, expose the insertion site of the pectoralis major tendon fig 1. The medial pectoral nerve pierces the pectoralis minor and the clavipectoral fascia.
The clavipectoral fascia also known as the costocoracoid membrane or coracoclavicular fascia, which covers the area between the pectoralis minor muscle and the subclavius muscle, was then identified. The costocoracoid fascia is that part of the clavipectoral fascia which is situated superomedial to the pectoralis minor muscle. Understand your pectoralis minor for deeper backbends. The pectoralis major muscle is covered by a thin but strong fascial layer the clavipectoral fascia. Slit the clavipectoral fascia at a point close to the clavicle and expose the subclavius muscle 689n183, which is encased by the tough fascial layer. Its function is to wrap the two muscles and allow them to glide smoothly when contracting.
The pectoral fascia is a thin layer of tissue that covers the pectoralis major and minor muscles. The deltopectoral triangle clavipectoral fascia and the. The artery cuts through the clavipectoral fascia also known as coracoclavicular fascia and costocoracoid membrane, which is where it then splits up into a handful of branches. In attaching to the coracoid process, the pectoralis minor forms a bridge structures passing into the upper limb from the thorax will pass directly underneath. Below, it splits to enclose the pectoralis minor muscle and then continues downward as the suspensory ligament of the axilla and joins the fascial floor of the armpit.
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