‫‪Pectoral region‬‬

‫‪and Axilla‬‬
‫‪Lecture 8‬‬

‫‪Please check our Editing File.‬‬

‫هذا العمل ال يغني عن المصدر األساسي للمذاكرة‬ ‫ُُ‬

‫ه{‬
‫ْ‬ ‫َسب‬
‫َ ح‬
‫هْ‬
‫و‬ ‫َُ‬
‫ف‬ ‫َى َّ‬
‫اّلله ْ‬
‫ْ‬ ‫َل‬ ‫َّْ‬
‫ل ع‬ ‫َك‬‫َو‬
‫يت‬‫ْ َ‬
‫َن‬‫َم‬
‫}و‬
 Objectives
● Identify and describe the muscles of the pectoral region:
- Pectoralis major
- Pectoralis minor
- Subclavius
- Serratus anterior
● Describe and demonstrate the boundaries and contents of the axilla.
● Describe the formation of the brachial plexus and its branches.

● Text in BLUE was found only in the boys’ slides

● Text in PINK was found only in the girls’ slides
● Text in RED is considered important
● Text in GREY is considered extra notes
 Muscles of the pectoral region
Pectoralis Major

(1) Clavicular head: Medial ½ of the front of

the clavicle.
origin (2) Sternocostal head: Sternum - Upper 6
costal cartilages* - Aponeurosis** of the
external oblique muscle.

insertion Lateral lip of bicipital groove (Humerus).

Nerve supply Medial & lateral pectoral nerves.

(1) Adduction of the arm. Extra picture

(2) medial rotation of the arm.
Action
(3) flexion shoulder (helps by clavicular
head).
(4) Also it helps in climbing.

*Costal cartilage (hyaline cartilage that **Aponeurosis: a sheet of fibrous tissue which takes the place of a Recall what we took in foundation: Muscles are
connects the ribs to the sternum) . tendon in sheet-like muscles having a wide area of attachment. attached to bones / ligaments / cartilage by
1) tendons 2) aponeurosis 3) raphe. **Team436
 Muscles of the pectoral region
Pectoralis Minor
It locate deep to Pectoralis Major

3rd ,4th, & 5th ribs close to their costal

origin cartilages.(on the bone itself)

insertion Coracoid process (scapula).

Nerve supply Medial pectoral nerve.

(1)Depression of the shoulder."Pectoralis Major

it helps but the main is Pectoralis Minor"

Extra picture

Action

(2) Draw the ribs upward and outwards

during deep inspiration. " ‫شهيق "لما تأخذ نفس عميق‬
‫" ترتفع لفوق وتبرز لبرا‬ribs ‫الـ‬
 Muscles of the pectoral region
Subclavius

1st rib and its costal cartilage

origin
(1st costochondral junction).

Subclavian groove in the middle 1/3 of the

insertion
inferior surface of clavicle.

Nerve to subclavius from upper trunk of

Nerve supply
brachial plexus.

Action Fixes"‫ "يثبت‬the clavicle during movement of

shoulder joint.
 pectoral region
Clavipectoral Fascia ‫هي األخضر اللي دار ما دار‬

fascia = dense fibrous connective tissue

For better understand watch it!

Definition:
It is a thickened
membrane of deep fascia
between the subclavius
above and pectoralis
minor below.

It’s pierced by "‫ "يمر من خالله‬:

“CALL”
1- C :Cephalic vein.
2- A :Thoraco-Acromial artery.
3- L : Lateral pectoral nerve.
4- L : Few Lymph vessels.
 Muscles of the pectoral region
Serratus anterior

origin Upper eight ribs.

anterior aspect of the medial border and

insertion
inferior angle of scapula.

Long thoracic nerve (from roots of brachial

Nerve supply
plexus,C5,6,7) “ nerve of Serratus anterior”

(1) Draws the scapula forward in boxing,

(protrusion or protraction*)"boxer's muscle"
Action (2) Rotates scapula outwards in raising the
arm above 90 degree (Abduction above 90)
with trapezius muscle.

*Team 436:
Don’t confuse protraction and retraction. for better understand of Serratus anterior
Retraction: (when you wake up and are yawning). action (2:18 to 2:48)
Protraction: (when you extend your arm like when
punching someone or boxing hence the name boxer's muscle).
 Applied Anatomy
Winging of scapula
Lesion “suffered damage” of long thoracic nerve
(C5,6,7) causes : backward projection of medial
border of scapula.

This deformity is (Paralysis of Serratus anterior

muscle)
 Axilla
• A 4 sided pyramidal-shaped space between the upper
part of the arm and the side of the chest.
• It’s the space through which major neurovascular
structures pass between neck & thorax and upper
limbs.

The Axilla has:

A. Apex
B. Base
C. Four Walls:
1. Anterior wall
2. Posterior wall
3. Medial wall
4. Lateral wall

Extra picture
for understanding
 Axilla
• Is directed upwards & medially to the root of
the neck.
• It is called Cervicoaxillary canal (which
neurovascular structures pass through) .
APEX
• It is bounded, by 3 bones:
- Clavicle anteriorly.
- Upper border of the scapula posteriorly.
- Outer border of the first rib medially.

• Formed by skin stretching between the

anterior and posterior walls.

The base is bounded by:

• In front by the anterior axillary fold (formed by
BASE the lower border of Pectoralis major).
• Behind by the posterior axillary fold (formed
by tendons of latissimus dorsi and teres major).
• Medially by upper 4 to 5 ribs & the chest wall.
-Laterally by part of the shaft of humerus and
it’s muscles.
 Axilla
Is formed by :
1- Pectoralis major (it forms the anterior fold)
Anterior wall 2- Pectoralis minor
3- Subclavius
4- Clavipectoral fascia

Is formed by:
1- Subscapularis
2- Latissimus dorsi Anterior wall Posterior wall
Posterior wall 3- Teres major muscles
(Latissimus dorsi and Teres major muscles
form the posterior fold)

It is WIDE and formed by:

Medial wall 1- Serratus anterior
2- Upper 4-5 ribs & Intercostal muscles
Upper
It is NARROW and formed by: 4-5 ribs
1- Coracobrachialis 2- Biceps brachii
Lateral wall Anterior wall Medial & lateral wall
3- Bicipital (intertubercular) groove of the
humerus
 Axilla
Contents of axilla
brachial plexus
• Cords and braches of the brachial plexus.
Axillary artery
• Axillary artery and its branches.
• Axillary vein and its tributaries.
• Axillary lymph nodes.
• Axillary fat.
• Loose connective tissue.
Axillary vein
 Brachial Plexus
Watch this video for a better
understanding of Brachial Plexus.

The posterior triangle

consists of: 1) clavicle
2) sternocleidomastoid
muscle 3) trapezius

Definition: Location: Formation:

Brachial plexus it is present in the it is formed by the
is a network of posterior union of the
triangle of the anterior Rami of
nerves that is
neck and axilla. the C5th, 6th, 7th,
formed at the
8th (cervical spinal
root of the neck nerves) and the
to enter the 1st thoracic spinal Extra picture
upper limb. nerve.
 Brachial Plexus
The plexus can be divided into 5 stages:
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❖ Roots from C5 and C6

unite to form upper
trunk.
❖ Roots of c7
continuous as the
middle trunk.
❖ Roots from C8 and T1
unite to form lower
trunk.

Divisions: behind Trunks: in the Roots: in the

Branches: Cords: in
the clavicle (in posterior posterior
in the axilla. the axilla.
cervicoaxillary canal) triangle. triangle.

❖ The first 2 stages lie in posterior triangle.

❖ The last 2 stages lie in the axilla.
 Brachial Plexus
*Each Trunk have Posterior and Anterior divisions.

The anterior divisions of the The anterior division of the All the posterior divisions of
upper and middle trunks lower trunk continues as the three trunks join to form the
unite to form the Lateral cord. Medial cord. Posterior cord.
 Roots Upper trunk
Dorsal scapular nerve (C5) Suprascapular nerve (C5,C6)

Long thoracic nerve (C5,C6,C7) Nerve to subclavius (C5,C6)

Lateral cord-3 Medial cord-5 Posterior cord-5

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Lateral pectoral nerve. Medial pectoral nerve. Upper & lower

Subscapular nerves.

Median nerve (Lateral Median nerve (medial Thoracodorsal (N.

root). root). to latissimus dorsi).

Musculocutaneous Axillary nerve

nerve. Ulnar Nerve

Medial cutaneous nerve of Radial nerve

arm & forearm.
Team 436
Summary for Muscles of the pectoral region
 MCQs
(1) Insertion of pectoralis major (muscle of
pectoral region) is ___________ :
A- coracoid process (scapula)
B- lateral lip of bicipital groove (humerus) (4) Which one of these sentences about the axillary
C- subclavian groove of clavicle walls is/are correct :
A- the medial wall is wide, the lateral wall is narrow
(2) Clavipectoral Fascia is a thickened B- the anterior wall is narrow, the posterior wall is
membrane of deep fascia between ___________ : wide
A- subclavius and pectoralis minor C- both A and B
B- subclavius and pectoralis major
C- subclavius and Serratus anterior (5) In brachial plexus the roots of C8 & T1 unite to
form ___________ :
(3) Apex of axilla is is bounded by ___________ : A- Upper trunk
A- 4 bones B- Middle trunk
B- 2 bones C- Lower trunk
C- 3 bones
Answers
1-B
2-A
3-C
4-A
5-C
Lamia Abdullah Alkuwaiz (Team
Team Members
Leader) Faisal Fahad Alsaif (Team Leader)
Rawan Mohammad Alharbi Abdulaziz Al dukhayel
Abeer Alabduljabbar Maha Barakah Fahad Alfaiz Abdulmajeed Alwardi
Afnan Abdulaziz Almustafa Majd Khalid AlBarrak Akram Alfandi Abdulrahman Alageel
Ahad Algrain Norah Alharbi Saad Aloqile Rayyan Almousa
Alanoud Almansour Nouf Alotaibi Saleh Almoaiqel Sultan Alfuhaid
Albandari Alshaye Noura Mohammed Alothaim Abdulaziz Alabdulkareem Ali Alammari
AlFhadah abdullah alsaleem Rahaf Turki Alshammari Abdullah Almeaither Fahad alshughaithry
Arwa Alzahrani Reham Alhalabi Yazeed Aldossari Fayez Ghiyath Aldarsouni
Dana Abdulaziz Alrasheed Rinad Musaed Alghoraiby Muath Alhumood Mohammed Alquwayfili
Dimah Khalid Alaraifi Sara Alsultan Abdulrahman Almotairi
Ghada Alhaidari Shahad Alzahrani Abduljabbar Al-yamani
Ghada Almuhanna Wafa Alotaibi Abdulelah Aldossari Sultan Al-nasser
Ghaida Alsanad Wejdan Fahad Albadrani Abdulrahman Alduhayyim Majed Aljohani
Hadeel Khalid Awartani Wjdan AlShamry Hamdan Aldossari Zeyad Al-khenaizan
Haifa Alessa Mohammed Alomar Mohammed Nouri
Khulood Alwehabi Abdulrahman Aldawood Abdulaziz Al-drgam
Layan Hassan Alwatban Saud Alghufaily Fahad Aldhowaihy
Lojain Azizalrahman Hassan Aloraini Omar alyabis
Lujain Tariq AlZaid Khalid Almutairi