ANTERIOR ASPECT OF SHOULDER & ARM
INNERVATIONS
1. Supraclavicular n
2. Superior lat cutaneous nerve of arm
3. Intercostobrachial n
4. Inferior lat cutaneous n of arm
5. Medial cutaneous n of arm
6. Medial cutaneous n of forearm
7. Lat cutaneous n of forearm
SHOULDER FASCIAS
Superficial
● Cont w neck, upper limb above & abdomen below
● Contain mammary gland
Pectoral
● Deep → thin
● Cov pec major
● Between pec major’s fasciculi
● Attach medially sternum, above clavicle, cont inferolateral w fascia of shoulder, axilla, thorax
● Thick btwn → pec major & latissimus dorsi; forming floor of axilla
● Axillary fascia divides lat margin of latissimus dorsi into 2; ensheathes m & attach behind to spine of thoracic vertebrae
, Infraclavicular
● Separates upper border of pec major from deltoid
● Contains: cephalic v; deltoid branch of thoracoacromial a
● Lower border of pec major forms axillary fold
Clavipectoral
● Behind clavicular part of pec major
● btwn pec minor & subclavius
● Covers axillary v & n
● Around subclavius, attach to clavicle both ant & post to groove for subclavius
● Btwn 1st rib & coracoid process
● Thickens → costocoracoid lig
● Cephalic v, thoracoacromial a & v, lat pectoral n
ARM FASCIAS
Superficial
● Cutaneous n
● Superficial v
● Cephalic v; drain to axillary v
● Basilic v; forms axillary v at lower border of teres major
● Median cubital v
Brachial
● Deep
● Covering deltoid & pec major
● Med & lat intermuscular septa
● Lateral intermuscular septum
● Medial intermuscular septum
,● Elbow; attach to epicondyles of humerus & ulna olecranon, cont w antebrachial fascia
MUSCULOCUTANEOUS NERVE (C5-6-7)
● Motor innervation to muscles in ant compartment of arm
● Sensory innervation to skin on lateral surf of forearm
BLOOD VESSELS
Axillary artery
● Subclavian → axillary → brachial
● 1st rib - teres major
● Pec minor divides into 3 parts
1. 1st branch
a. Superior thoracic a
2. 2nd branch
a. Thoracoacromial a
b. Lateral thoracic a
3. 3rd branch
a. Subscapular a
i. Thoracodorsal a
ii. Circumflex scapular a
b. Ant circumflex humeral a
c. Post circumflex humeral a
Brachial artery
● Continuation of axillary artery at lower border of teres major m
● Divides into radial & ulnar a
● Profunda brachii
○ Mid collateral a
, ○ Radial collateral a
○ Humeral nutrient a
○ Deltoid branch
● Superior ulnar collateral a
● Inferior ulnar collateral a
● Muscular branch
● Radial a
● Ulnar a
NERVES OF ARM
● Median
● Ulnar
● Musculocutaneous
● Radial axillary
VEINS
Deep veins
● Anterior region of forearm
○ Radial
○ Ulnar
○ Ant interosseous
○ Post interosseous
● Ant region of arm
○ Brachial
○ Axillary
Median cubital v
● Communication btwn basilic & cephalic v
INNERVATIONS
1. Supraclavicular n
2. Superior lat cutaneous nerve of arm
3. Intercostobrachial n
4. Inferior lat cutaneous n of arm
5. Medial cutaneous n of arm
6. Medial cutaneous n of forearm
7. Lat cutaneous n of forearm
SHOULDER FASCIAS
Superficial
● Cont w neck, upper limb above & abdomen below
● Contain mammary gland
Pectoral
● Deep → thin
● Cov pec major
● Between pec major’s fasciculi
● Attach medially sternum, above clavicle, cont inferolateral w fascia of shoulder, axilla, thorax
● Thick btwn → pec major & latissimus dorsi; forming floor of axilla
● Axillary fascia divides lat margin of latissimus dorsi into 2; ensheathes m & attach behind to spine of thoracic vertebrae
, Infraclavicular
● Separates upper border of pec major from deltoid
● Contains: cephalic v; deltoid branch of thoracoacromial a
● Lower border of pec major forms axillary fold
Clavipectoral
● Behind clavicular part of pec major
● btwn pec minor & subclavius
● Covers axillary v & n
● Around subclavius, attach to clavicle both ant & post to groove for subclavius
● Btwn 1st rib & coracoid process
● Thickens → costocoracoid lig
● Cephalic v, thoracoacromial a & v, lat pectoral n
ARM FASCIAS
Superficial
● Cutaneous n
● Superficial v
● Cephalic v; drain to axillary v
● Basilic v; forms axillary v at lower border of teres major
● Median cubital v
Brachial
● Deep
● Covering deltoid & pec major
● Med & lat intermuscular septa
● Lateral intermuscular septum
● Medial intermuscular septum
,● Elbow; attach to epicondyles of humerus & ulna olecranon, cont w antebrachial fascia
MUSCULOCUTANEOUS NERVE (C5-6-7)
● Motor innervation to muscles in ant compartment of arm
● Sensory innervation to skin on lateral surf of forearm
BLOOD VESSELS
Axillary artery
● Subclavian → axillary → brachial
● 1st rib - teres major
● Pec minor divides into 3 parts
1. 1st branch
a. Superior thoracic a
2. 2nd branch
a. Thoracoacromial a
b. Lateral thoracic a
3. 3rd branch
a. Subscapular a
i. Thoracodorsal a
ii. Circumflex scapular a
b. Ant circumflex humeral a
c. Post circumflex humeral a
Brachial artery
● Continuation of axillary artery at lower border of teres major m
● Divides into radial & ulnar a
● Profunda brachii
○ Mid collateral a
, ○ Radial collateral a
○ Humeral nutrient a
○ Deltoid branch
● Superior ulnar collateral a
● Inferior ulnar collateral a
● Muscular branch
● Radial a
● Ulnar a
NERVES OF ARM
● Median
● Ulnar
● Musculocutaneous
● Radial axillary
VEINS
Deep veins
● Anterior region of forearm
○ Radial
○ Ulnar
○ Ant interosseous
○ Post interosseous
● Ant region of arm
○ Brachial
○ Axillary
Median cubital v
● Communication btwn basilic & cephalic v
