Attachment for the upper limb

Attachment to axial skeleton at the sternoclavicular joint

Origins for Pectoralis Major, Deltoid & Subclavius

Anterior attachment for the ribs (costal cartilages) at sternocostal joints

1. Manubrium

2. Body/Gladiolus

3. Xiphoid Process

Jugular notch

Clavicular notch

Sternoclavicular joint

articulates with rib 1 (synchrondrosis)

body of sternum (symphysis)

Junction of manubrium and body

articulation with rib 2

Symphysis type

articulation with rib 7

7 pairs vertebrosternal

3 pairs vertebrochondral

2 pairs vertebral

Head articulates with vertebral bodies (costovertebral joints)

Tubercle with transverse process (costotransverse joint)

Shaft features angle and costal groove

Shortest

Grooves for subclavian a&v

Scalene tubercle

Atypical Rib #11 & 12

No tubercle

Reduced costal cartilage

Single facet on head

Pectoralis Major actions

Pectoralis Major attachments

Clavicle (clavicular head)

Sternum & sixth cartilage (Sternalcostal head)

to the lateral edge of intertubercular sulcus of humerus

Pectoralis Major Innervation

Lateral pectoral nerve C5-C7 (both heads)

Medial pectoral nerve C8-T1 (sternocostal head)

of lateral and medial cords, respectively of brachial plexus

Pectoralis Minor attachments

(Landmarks for parts of axillary artery)

Protraction of scapula

Secures of scapula to thoracic cage

Subclavian Artery

From brachiocephalic artery (right) or arch of aorta (left)

Deep to scalenus anterior

Continues as axillary artery at lateral border of rib 1

1. Thyrocervical trunk

2. Vertebral artery

3.Internal costal artery

4. Costocervical trunk

Axillary Artery (First part)

From lateral border of rib 1 to medial border of pectoralis minor

Only branch is supreme thoracic artery

Axillary Artery (Second Part)

Behind pectoralis minor

thoracoacromial trunk (medially)

lateral thoracic artery (laterally)

From lateral border of pectoralis minor to inferior border of teres major

Produces subscapular artery and 2 circumflex humoral artery

splits into circumflex scapular and thoracosdorsal artery

• beginning at inferior border of teres major
• continuation of axillary artery into upper limb

Lateral superficial vein of upper limb

Traverses deltopectoral triangle

Passes deep to enter axillary vein

Borders of Axilla:

Apex

Bounded anteriorly by clavicle

Bounded posteriorly by superior border of scapula

Bounded medially by rib 1

Borders of Axilla:

Floor

(armpit)

Axillary fascia & skin

Borders of Axilla:

Anterior Wall

Pectoralis Major

Pectoralis Minor

Borders of Axilla:

Posterior Wall

Latissimus Dorsi

Teres Major

Subscapularis

Borders of Axilla:

Medial Wall

Borders of Axilla:

Lateral Wall

Meeting point of anterior and posterior folds at intertubercular sulcus of humerus

fat

axillary artery

axillary vein

lymph nodes

cords of brachial plexus

long head of biceps brachii

short heads of biceps brachii

coracobrachialis

Roots of Brachial Plexus

anterior primary rami of C5-T1

Branches:

Dorsal Scapular Nerve C4-C5 (rhomboids)

Long Thoracic Nerve C5-C7 (serratus anterior)

Trunks of Brachial Plexus

Upper (C5-C6)

Middle (C7)

Lower (C8-T1)

Branches:

suprascapular nerve C4-C6 (upper trunk)

nerve to subclavius C5-C6 (upper trunk)

Lateral Cord of BP

From anterior divisions of upper and middle trunks

Source of lateral pectoral nerve C5-C7

From anterior division of lower trunk

Source of medial pectoral nerve C8-T1

Medial brachial cutaneous & Medial antebrachial cutaneous nerves C8-T1

Posterior Cord of BP

From posterior divisions of all trunks

1. Upper Subscapular Nerve C5-C7

2. Thoracodorsal Nerve C6-C8

3. Lower Subscapular Nerve C5-C7

Musculocutaneous Nerve C5-C7

Median Nerve C5-T1

Ulnar Nerve C8-T1

Axillary Nerve C5-C6

Radial Nerve C5-T1

ends lateral cord

supplies anterior compartment of arm

cutaneous to lateral arm

Receives "head" from lateral and medial cords

main nerve supply to anterior forearm mm.

motory & sensory to hand

Ends medial cord

Motor to anterior forearm and hand

Sensory to hand

From posterior cord of BP to posterior compartments of upper limb

Sensory to wrist and hand