The dissection of the pectoral region
When starting to dissect the pectoral region, the cadaver should be in the supine position. The dissection starts by reflection of the skin and fascia. Make a vertical incision into the lateral surface of the arm and then a horizontal incision parallel to the clavicle. Commence separating the skin and fascia and reflect it to expose the chest wall, the upper part of the arm and the axilla. In the female, the mammary gland lies in the superficial fascia of the chest wall; it should also be removed. Identify pectoralis major with its origin from the clavicle, sternum and costal cartilages. Then abduct the arm observing that it forms the anterior fold of the axilla. Cut through the middle of pectoralis major and reflect each half; branches of the lateral pectoral nerve can be observed in the upper part of the deep surface. The pectoralis minor appears as a small triangular muscle which lies under the deep surface of pectoralis major; the medial pectoral nerve lies superficial to it. The clavipectoral fascia lies between the two muscles and extends superiorly to the inferior surface of the clavicle after cover of subclavius. The clavipectoral fascia, between the clavicle and pectoralis minor, is pierced by the thoracoacromial artery, cephalic vein and the lateral pectoral nerve. The cephalic vein ascends on the lateral surface of the arm and finally pierces the clavipectoral fascia to drain into the axillary vein. Next, clear the area around pectoralis minor by cleaning the fascia carefully. Most of the structures passing through the axilla will appear passing under pectoralis minor.
When starting to dissect the pectoral region, the cadaver should be in the supine position. The dissection starts by reflection of the skin and fascia. Make a vertical incision into the lateral surface of the arm and then a horizontal incision parallel to the clavicle. Commence separating the skin and fascia and reflect it to expose the chest wall, the upper part of the arm and the axilla. In the female, the mammary gland lies in the superficial fascia of the chest wall; it should also be removed. Identify pectoralis major with its origin from the clavicle, sternum and costal cartilages. Then abduct the arm observing that it forms the anterior fold of the axilla. Cut through the middle of pectoralis major and reflect each half; branches of the lateral pectoral nerve can be observed in the upper part of the deep surface. The pectoralis minor appears as a small triangular muscle which lies under the deep surface of pectoralis major; the medial pectoral nerve lies superficial to it. The clavipectoral fascia lies between the two muscles and extends superiorly to the inferior surface of the clavicle after cover of subclavius. The clavipectoral fascia, between the clavicle and pectoralis minor, is pierced by the thoracoacromial artery, cephalic vein and the lateral pectoral nerve. The cephalic vein ascends on the lateral surface of the arm and finally pierces the clavipectoral fascia to drain into the axillary vein. Next, clear the area around pectoralis minor by cleaning the fascia carefully. Most of the structures passing through the axilla will appear passing under pectoralis minor.