PECTORAL REGION 



near its sternal end, and one near its acromial end descending in 

 the fascia over the anterior part of the deltoid muscle. Follow 

 the nerves downwards through the superficial fascia as far as 

 possible ; they descend to the level of the second or third rib, 

 and are sometimes accompanied by small branches of the trans- 

 verse scapular artery which pierce the deep fascia above the 

 clavicle. Near the sternal end of the clavicle small twigs of 

 the clavicular branch of the thoraco - acromial artery may be 

 seen. Near the acromion twigs of the acromial branch of the 

 same artery may be found ; and in the delto -pectoral triangle 

 twigs of the deltoid branch are occasionally visible. 



After the supraclavicular nerves have been found and 

 followed to their terminations cut through the superficial fascia 

 along the line of the anterior fold of the axilla and the lower 

 margin of the pectoralis major. As soon as the level of the 

 deep fascia is reached turn the anterior part of the superficial 

 fascia towards the median plane, and look for the anterior 

 branches of the lateral cutaneous nerves, as they turn round the 

 border of the pectoralis major, pierce the deep fascia, and run 

 medially in the superficial fascia. 



Accessory nerve.- 



' Levator scapulae,^ 



Middle supraclavicula 



nerve- 

 Posterior supraclavicular 

 nerve 



Scalenus niediu 



Nervus cutaneus 

 colli 



FIG. 6. The Supraclavicular Branches of the Cervical Plexus. 



Nervi supraclaviculares. The supraclavicular nerves arise 

 in the neck, from the third and fourth cervical nerves. They 

 spread out as they descend, pierce the deep fascia of the neck, 

 and they cross the clavicle under cover of the platysma. 

 They are classified, according to their positions, into the 

 anterior, the middle, and the posterior branches (Fig. 6). The 

 anterior are the smallest of the series ; they cross the medial 

 part of the clavicle to end in the skin immediately below. 

 The middle branches pass over the middle of the clavicle and 

 extend downwards, in the superficial fascia over the pectoralis 

 major, as far as the third rib. The posterior cross the lateral 



