Pectoral fascia (fascia pectoralis)
This fascial system covers the anterior chest wall. It plays a crucial role in biomechanics as it creates continuous transitions to the sheaths of the anterior abdominal wall, axillary fossa, and shoulder girdle. Traditionally, two layers are distinguished within it.
Superficial layer (lamina superficialis) Located superficial to the pectoralis major muscle, covering it tightly. It is characterized by extensive attachments to adjacent structures:
- Superiorly, it is securely attached to the clavicle.
- Medially (closer to the midline), it is fixed to the sternum.
- Laterally (towards the side), it thins out and smoothly continues into the fascia of the serratus anterior muscle.
- Inferiorly, it continues into the fascia covering the anterior abdominal wall.
Feature: In the area of the infraclavicular fossa, this layer becomes noticeably thicker. Here, it tightly fuses with the large blood vessels passing beneath it (from the subclavian artery and vein basin, a. et v. subclavia).
Deep layer (lamina profunda) Located deep to the pectoralis major muscle. Its main function is the formation of isolated fascial sheaths for the pectoralis minor and subclavius muscles. This layer attaches to the clavicle and the coracoid process of the scapula.
In the axillary region, the deep layer meets the lower margins of the pectoralis major and latissimus dorsi muscles. At this site, it thickens significantly and forms the axillary fascia (fascia axillaris), which forms the soft connective tissue floor of the axillary fossa.
Clavipectoral fascia (fascia clavipectoralis)
It is a specialized part of the pectoral fascia, tightly stretched between the clavicle and the apex of the axilla.
It not only encloses the pectoralis minor and subclavius muscles but also performs an important skeletal function by strengthening the anterior wall of the axillary cavity. A crucial topographical feature of the clavipectoral fascia is that it is pierced by numerous openings (foramina) through which major vessels and nerve trunks pass.
Pectoral proper and endothoracic fasciae
In addition to the fasciae servicing the shoulder girdle muscles, the chest features membranes directly associated with the ribs and intercostal spaces.
- Parietal thoracic fascia (fascia thoracica) is a fairly thin connective tissue layer. It is located on the outer surface of the chest wall, covering the ribs and external intercostal muscles along their entire length.
- Endothoracic fascia (fascia endothoracica) lines the chest wall from the inside. It is located in the space between the osteomuscular framework of the chest and the parietal pleura. This fascia forms a layer of subpleural adipose tissue. Superiorly, it is firmly connected to the cupula of the pleura, and medially, it continues into the connective tissue of the mediastinal pleura.
Briefly: answers to topical questions
What specific vessels and nerves pass through the openings of the clavipectoral fascia?
- Branches of the thoracoacromial artery (a. thoracoacromialis) pass through the clavipectoral fascia.
- Cephalic vein (v. cephalica) perforates the medial part of the clavipectoral fascia and empties into the axillary vein (v. axillaris).
- Specific nerves passing through the openings of the clavipectoral fascia are not named in the cited sources.
The superficial layer covers the PECTORALIS MAJOR muscle, while the deep layer covers the PECTORALIS MINOR.
Class and exam questions
Which muscles are covered by the lamina profunda of the pectoral fascia?
The deep layer encloses the pectoralis minor and subclavius muscles.
How is the floor of the axillary fossa formed?
It is formed by the axillary fascia (fascia axillaris). It is formed due to the thickening of the deep layer of the pectoral fascia between the lower margin of the pectoralis major muscle and the latissimus dorsi muscle.
Where is the endothoracic fascia located and what is it connected to?
It lines the inner surface of the chest wall (between the ribs and the pleura), forms the subpleural tissue, and is connected to the cupula of the pleura and the mediastinal pleura.
What else to study on this topic
- Topography of vessels and nerves in the region of the fascia clavipectoralis
- Structure and boundaries of the axillary cavity
- Anatomy of the intercostal muscles and the fascia thoracica covering them
- Transition of the pectoral fascia to the anterior abdominal wall
- Subpleural tissue and its connection to the cupula of the pleura
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