Clavipectoral Fascia

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY The clavipectoral fascia is a layer of connective tissue located in the upper chest region, which plays an important role in providing support and stability to the shoulder girdle. It is a complex structure that is composed of several layers of fascia, including the clavipectoral fascia proper, the costocoracoid membrane, and the coracoclavicular ligament.

The clavipectoral fascia proper is the most superficial layer of the clavipectoral fascia and extends from the clavicle to the pectoralis major muscle. It is a dense, fibrous layer that helps to anchor the pectoralis major muscle to the clavicle and provides a protective covering for the axillary vessels and nerves.

The costocoracoid membrane is a thin, fibrous layer of the clavipectoral fascia that extends from the first rib to the coracoid process of the scapula. It helps to stabilize the scapula and forms a protective tunnel for the subclavius muscle and the neurovascular structures that pass through it.

The coracoclavicular ligament is a strong, fibrous band that extends from the coracoid process to the inferior surface of the clavicle. It helps to support and stabilize the acromioclavicular joint and is an important structure in preventing dislocation of the clavicle.

The clavipectoral fascia is an important anatomical structure that is involved in several clinical conditions, including thoracic outlet syndrome, breast cancer, and axillary lymph node dissection. Understanding the anatomy and function of the clavipectoral fascia is essential for clinicians in the diagnosis and treatment of these conditions.

Several structures pierce the clavipectoral fascia, including nerves, blood vessels, and muscles. The clavipectoral fascia provides a protective covering for these structures as they pass through the upper chest region.

The structures that pierce the clavipectoral fascia include:

Cephalic vein: The cephalic vein is a superficial vein that originates in the hand and forearm and passes through the upper arm to enter the shoulder region. It pierces the clavipectoral fascia and empties into the axillary vein.

Thoracoacromial artery: The thoracoacromial artery is a branch of the axillary artery that supplies blood to the pectoral region. It pierces the clavipectoral fascia and divides into several branches that supply the pectoralis major muscle and the overlying skin.

Lateral pectoral nerve: The lateral pectoral nerve is a branch of the brachial plexus that supplies the pectoralis major muscle. It pierces the clavipectoral fascia and enters the muscle.

Clavipectoral lymphatics: The clavipectoral lymph nodes are a group of lymph nodes that drain lymph from the upper limb and the pectoral region. They pierce the clavipectoral fascia and are located between the clavicle and the pectoralis minor muscle.

References

Gray H. Anatomy of the Human Body. 20th edition. Philadelphia: Lea & Febiger; 1918. Available from: https://www.bartleby.com/107/

Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st edition. Elsevier; 2016.

Tubbs RS, Salter EG, Oakes WJ. Surgical anatomy of the clavipectoral fascia and its relevance. Clin Anat. 2006 Jan;19(1):28-34. doi: 10.1002/ca.20181. PMID: 16331611.