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# Shoulder fasciae

The shoulder fasciae are sheets covering the deltoid and chest muscles; the cephalic vein passes through one of them, the clavipectoral fascia.

Official name: Deltoid, pectoral and clavipectoral fasciae

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## What it is

Thin sheets over the deltoid and chest muscles.

## What it does

Cover the shoulder and chest muscles; the cephalic vein pierces the clavipectoral fascia.

## Key points

- Clavipectoral fascia: from the clavicle around the subclavius, down to wrap the pectoralis minor, then on to the axillary fascia; its upper thick part is the costocoracoid membrane
- Besides the cephalic vein, thoracoacromial artery and lateral pectoral nerve, lymph vessels from the breast and [chest](https://durgical.com/en/anatomy/region/chest/) wall pass through it to the apical nodes
- The pectoral fascia lies behind the breast with the retromammary space in between; tumour fixed to it or to the pectoralis major changes surgical planning

## Key facts

**Where**
Deltoid, pectoral and clavipectoral fasciae

**Function**
Cover the shoulder and chest muscles; the clavipectoral fascia is pierced by the cephalic vein, thoracoacromial artery and lateral pectoral nerve

## Relations

**Superficial**
[Pectoral fascia](https://durgical.com/en/anatomy/pectoral-fascia/) on the [pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/) with the breast in front; deltoid fascia over the deltoid, attached to [clavicle](https://durgical.com/en/anatomy/clavicle/), acromion and scapular [spine](https://durgical.com/en/anatomy/region/spine/)

**Deep**
Clavipectoral fascia deep to the pectoralis major, around the [subclavius](https://durgical.com/en/anatomy/subclavius/) and [pectoralis minor](https://durgical.com/en/anatomy/pectoralis-minor-muscle/); behind it, the [axillary artery](https://durgical.com/en/anatomy/axillary-artery/), [axillary vein](https://durgical.com/en/anatomy/axillary-vein/) and the cords of the [brachial plexus](https://durgical.com/en/anatomy/roots-of-brachial-plexus/)

**Contents**
Structures piercing the clavipectoral fascia: [cephalic vein](https://durgical.com/en/anatomy/cephalic-vein/), [thoracoacromial artery](https://durgical.com/en/anatomy/thoracoacromial-artery/), lateral pectoral nerve and lymphatics

**Below**
Below the pectoralis minor it continues as the suspensory ligament of the axilla to the axillary fascia, the floor of the armpit

**Lateral**
The deltoid fascia continues into the [brachial fascia](https://durgical.com/en/anatomy/brachial-fascia/)

## How to find it

The deltopectoral groove is felt as a dip between the deltoid and pectoralis major below the lateral third of the clavicle, widening above into the infraclavicular fossa; the clavipectoral fascia lies deep to that fossa.

## On imaging

On ultrasound and MRI the pectoral and clavipectoral fasciae are thin lines over pectoralis major and around pectoralis minor. In breast cancer, loss of the fat plane behind the tumour is not enough: on MRI, enhancement of the pectoralis muscle itself is the sign of invasion. On ultrasound, the thoracoacromial vessels between the two pectorals mark the PECS block plane.

## Clinical notes

- Deltopectoral approach: the cephalic vein is kept, usually with the deltoid, and the clavipectoral fascia is opened lateral to the conjoint tendon to reach the joint
- Infraclavicular brachial plexus block places local anaesthetic around the cords deep to the pectoralis minor and clavipectoral fascia
- In mastectomy the pectoral fascia is generally removed with the breast

## Memory aid

What pierces the clavipectoral fascia: CALL (Cephalic vein, thoracoAcromial artery, Lateral pectoral nerve, Lymphatics).

## Test yourself

Think of the answer, then tap the question to see it.

## Which structures pierce the clavipectoral fascia?

The cephalic vein, the thoracoacromial artery, the lateral pectoral nerve and lymphatics.

## Which muscles does the clavipectoral fascia enclose, and what is its upper thick part called?

Subclavius and pectoralis minor; its upper thick part is the costocoracoid membrane.

## What lies between the breast and the pectoral fascia, and why does fixation matter?

The retromammary space; a tumour fixed to the pectoral fascia or pectoralis major changes surgical planning.

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## Its names

**Official Latin (TA2)**
fascia deltoidea TA2 2540

**Official Spanish (DeCS)**
Fascias deltoidea, pectoral y clavipectoral

**English (TA2)**
Deltoid, pectoral and clavipectoral fasciae

## Related

- [Clavicle](https://durgical.com/en/anatomy/clavicle/)
- [Humerus](https://durgical.com/en/anatomy/humerus/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Shoulder](https://www.ncbi.nlm.nih.gov/books/NBK536933/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/deltoid-pectoral-and-clavipectoral-fasciae/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/deltoid-pectoral-and-clavipectoral-fasciae/