PECTORAL REGION n 



division into sternal and clavicular parts clearly made out. The muscular 

 fibres are rendered tense by abducting the arm from the side. On the 

 right side the dissector begins at the inferior border of the muscle, whilst 

 on the left side he commences at the superior border. He must also clean 

 the anterior margin of the deltoid. In the interval between the deltoid 

 and the clavicular portion of the pectoralis major the cephalic vein and, 

 subjacent to it, the deltoid branches of the thoraco-acromial artery, and 

 the infraclavicular lymph glands will be found. 



.The "cleaning" of a muscle means the removal of the whole of the 

 deep fascia from its surface. To do this successfully the dissector must 



Chain of glands related to the axillary vessels 

 Cephalic vein 

 [. pectoralis major \ 



M. serratus anterior 



M. pectoralis minor 

 Pectoral glands 



M. latissimus dorsi 



M. pectoralis major 



Lymphatic vessels 

 to sternal glands 



FIG. 4. The Lymph Glands and Vessels of the Axilla and Mamma. 

 (From Poirier and Cuneo modified.) 



follow three rules, (i) He must cut boldly down through the deep fascia 

 till he exposes the red fibres of the muscle. (2) As he removes the fascia 

 he must keep the knife edge playing against the fibres of the muscle. 

 (3) As he makes his cuts he must carry the knife blade in the direction 

 of the fibres of the muscle. If he follows rules I and 2 he will not leave 

 a thin film of fascia on the muscle, and as he follows rule 3 he will find 

 that the direction of his incisions change as the course of the fibres of the 

 muscle changes. If the work is well done the deep fascia should be 

 removed from the muscle as a continuous unperforated layer of fibrous 

 tissue, and the surface of the muscle will be clean. 



Lymphoglandulse Infraclaviculares (Infraclavicular Lymph 

 Glands). In the interval between the adjacent margins of 



