For medical, nursing and physiotherapy undergraduates, and postgraduates

1. INTRODUCTION TO
UPPER LIMB
AND PECTORAL REGION

2. SURFACE LANDMARKS
1. Clavicle
2. Jugular notch
3. Sternal angle
4. Epigastric fossa
5. Nipple
6. Mid-clavicular line
7. Infra –clavicular fossa
8. Tip of Coracoid process
9. Acromion
10.Deltoid
11.Axilla
12.Mid-axillary line

5. SUPERFICIAL FASCIA
1. Cutaneous nerves
2. Cutaneous vessels
3. Platysma
4. Breast
5. Fat

6. CUTANEOUS NERVES
1. Medial supraclavicular nerves (Cervical plexus- C3,4)
2. Intermediate supraclavicular nerves (Cervical plexus- C3,4)
3. Lateral supra clavicular nerves (Cervical plexus- C3,4)
4. Anterior cutaneous branches of 2nd to 6th Inter-costal nerves
5. Lateral cutaneous branches of 2nd to 6th Inter-costal nerves

8. CUTANEOUS VESSELS
• They are very small
• Anterior cutaneous nerves are accompanied by the
perforating branches of Internal thoracic artery
• Lateral cutaneous branches are accompanied by lateral
cutaneous branches of posterior intercostal arteries.

9. PLATYSMA
• Thin, broad sheet of subcutaneous muscle.
• It extends from
• It is supplied by cervical branch of Facial nerve

10. DEEP PECTORAL FASCIA
• The deep fascia covering the pectoralis major muscles is called
Pectoral fascia.
• It is thin and closely attached to the muscle by numerous septa.

11. DEEP PECTORAL FASCIA
• Extent :
• Superiorly : Clavicle
• Inferiorly : continuous with fascia over thorax and rectus sheath
• Anteriorly : Sternum
• Supero-laterally : continuous with fascia covering deltoid
• Infero-laterally : continuous with Axillary fascia