PRAVEEN’S ANATOMY WORLD

Origin (proximal attachment) Sternocostal head • Has manubrial, sternal, and aponeurotic fibers • Manubrial fibers – from lateral half of anterior surface of manubrium • Sternal fibers –from lateral half of anterior surface of sternum up to 6th costal cartilage • Costal fibers – from 2nd to 6th costal cartilages. • Aponeurotic fibers – from aponeurosis of external oblique muscle of abdomen

Dr. Praveen Kurrey

06-09-2025

Pectoralis Major and Minor

Insertion (distal attachment) • Form U-shaped bilaminar tendon that inserts on the lateral lip of bicipital groove • Bilaminar tendon has two laminae as follows: – Anterior lamina – shorter than posterior lamina, formed by clavicular fibers of the muscle – Posterior lamina –formed by sternocostal fibers

Dr. Praveen Kurrey

06-09-2025

Muscles of Pectoral Region- Pectoralis major

Actions 1. As a whole muscle: Adduction and medial rotation of arm Draws the scapula forward along with serratus anterior 2. Clavicular head: Flexion of arm. 3. Sternocostal head: Extension of flexed arm against resistance.

Dr. Praveen Kurrey

06-09-2025

Clavipectoral Fascia

Structures piercing 1. Lateral pectoral nerve 2. Cephalic vein 3. Thoracoacromial trunk 4. Lymphatic vessels from breast to apical axillary group of lymph nodes

Dr. Praveen Kurrey

06-09-2025

Clavipectoral Fascia

It encloses the subclavius and pectoralis minor muscles and forms the suspensory ligament of the axilla, which supports the armpit's floor. The fascia also acts as a barrier, with several structures piercing through it, including the cephalic vein, the thoracoacromial artery, the lateral pectoral nerve, and lymphatic vessels

Dr. Praveen Kurrey

13-11-2025

Pectoralis Major Muscle

In Poland syndrome, the anatomy of the pectoralis major is affected by the unilateral absence or underdevelopment of its sternocostal head

Dr. Praveen Kurrey

13-11-2025

Attachment of Pectoralis Major

Insertion: Both heads converge to form a tendon that inserts onto the lateral lip of the intertubercular groove (or bicipital groove) of the humerus. Its lowest fibers are attached on highest position.-PKK

Dr. Praveen Kurrey

13-11-2025

Fascia- Clavipectoral

Thickened upper portion: The portion from the first rib to the coracoid process is called the costocoracoid ligament-pkk

Dr. Praveen Kurrey

13-11-2025

Pectoralis Minor

A triangular muscle located beneath the pectoralis major, originating from the third to fifth ribs and inserting onto the coracoid process of the scapula

Dr. Praveen Kurrey

13-11-2025

Pectoralis Minor

The muscle originates from the anterior surfaces of the third, fourth, and fifth ribs near their costal cartilages. It inserts on the medial border and superior surface of the coracoid process of the scapula.

Dr. Praveen Kurrey

14-11-2025

Pectoralis Minor 3

Medial and Lateral pectoral nerves (from spinal nerves C8 and T1). It Stabilizes the scapula: Pulls the scapula inferiorly and anteriorly, pressing it against the thoracic wall.

Dr. Praveen Kurrey

14-11-2025

P. Minor

The pectoralis minor muscle creates a passage between the ribs for the transit of the brachial plexus and both the subclavian artery and vein. If the muscle is shortened/tight this abnormal tension: negatively affecting the Scapulohumeral Rhythm; can also cause thoracic outlet syndrome

Dr. Praveen Kurrey

14-11-2025

Clavipectoral Fascia 3

At most superficial part, where it is attached to the coracoid process laterally and blends with the upper two external intercostal membranes medially, it is referred to as the Costocoracoid membrane-PKK

Dr. Praveen Kurrey

14-11-2025

Subclavius Muscle

Origin: The junction of the first rib and its costal cartilage. Insertion: The inferior surface of the middle third of the clavicle.

Dr. Praveen Kurrey

14-11-2025

Subclavius 2

Nerve to subclavius: A branch from Upper trunk of the brachial plexus, specifically from the C5 and C6 nerves. Stabilization: It actively stabilizes the clavicle at the sternoclavicular joint, which is important for movements of the upper limb. Depression: It helps depress the clavicle, moving it downwards and forwards

Dr. Praveen Kurrey

14-11-2025

Subclavius 4

The vessels and nerves running behind the subclavius muscle can sometimes become entrapped between the clavicle and the first rib, inside the costoclavicular space. This is referred to as costoclavicular syndrome and marks one of the three types of thoracic outlet syndromes (TOS)

Dr. Praveen Kurrey

14-11-2025

Mammary Gland Anatomy

Tissue: The breast is primarily composed of glandular (milk-producing) and fatty tissue, the ratio of which can vary with age and hormonal status. Glands: It contains lobes, which are clusters of smaller sacs called lobules that can produce milk. Ducts: Thin tubes called ducts carry milk from the lobules to the nipple.

Dr. Praveen Kurrey

14-11-2025

Breast Location and Bed

Breasts also have nerves, blood vessels, and a system of lymph vessels and lymph nodes, which can be affected by breast cancer. Location: The base of the breast is formed by the pectoralis major muscle, which lies over the ribs.

Dr. Praveen Kurrey

14-11-2025

Structure of Breast

The breast is an apocrine gland. The breasts are about 80 to 90% stromal tissue (fat and connective tissue), while epithelial or glandular tissue only accounts for about 10 to 20% of the volume of the breasts.

Dr. Praveen Kurrey

14-11-2025

Mammary Gland Structure

The nipple of the breast is surrounded by the areola (nipple-areola complex). The areola has many sebaceous glands, and the skin color varies from pink to dark brown. The basic units of the breast are the terminal duct lobular units (TDLUs), which produce the fatty breast milk. breast is also composed of connective tissues (collagen, elastin), white fat, and the suspensory Cooper's ligaments.

Dr. Praveen Kurrey

14-11-2025

Anatomy of Breast

Nipples have hundreds of nerve endings, which makes them extremely sensitive to touch. Each breast has between 15 to 20 lobes, or sections. These lobes surround your nipple like spokes on a wheel.

Dr. Praveen Kurrey

14-11-2025

Male Breast

During puberty, the hormone testosterone usually stops breasts from developing. On the outside, there are nipples and areolae. Internally, they have undeveloped milk ducts and no glandular tissue. Male breast problems can include gynecomastia, a benign condition that causes the breasts to enlarge, and very rarely, breast cancer.

Dr. Praveen Kurrey

14-11-2025

Mammary Bed

The muscles that form the mammary bed (the deep surface upon which the breast rests) are the pectoralis major, the serratus anterior, and the external oblique muscle

Dr. Praveen Kurrey

14-11-2025

Cutaneous Innervation Mammary Gland

supraclavicular nerves (\(C_{3}\) and \(C_{4}\)) from the cervical plexus, anterior and lateral cutaneous branches of the intercostal nerves (T2to (T6. The intercostobrachial nerve (T2 also contributes, supplying the skin of the upper medial arm and the floor of the axilla.

Dr. Praveen Kurrey

14-11-2025

Arterial Supply Breast

Lateral thoracic and thoracoacromial branches. Lateral mammary branches – originate from the posterior intercostal arteries (derived from the aorta). Mammary branch – originates from the anterior intercostal artery.

Dr. Praveen Kurrey

14-11-2025

Arteries of Breast

Axillary artery via several branches: superior thoracic, thoracoacromial, lateral thoracic and subscapular arteries Internal thoracic artery via the medial mammary arteries Perforating branches of second, third and fourth intercostal arteries

Dr. Praveen Kurrey

14-11-2025

Blood Supply of Breast

Venous- Axillary, internal thoracic and second to fourth intercostal veins.

Dr. Praveen Kurrey

14-11-2025

Breast Arteries

Dr. Praveen Kurrey

14-11-2025

Mammary Gland Arteries

Dr. Praveen Kurrey

14-11-2025

Breast Arterial Supply

Dr. Praveen Kurrey

14-11-2025

Nerve Supply Breast

Anterior and lateral cutaneous branches of the second to sixth intercostal nerves Fourth intercostal nerve (nipple)

Dr. Praveen Kurrey

14-11-2025

Lymph Nodes of Breast

Subareolar lymphatic plexus -> pectoral lymph nodes -> axillary lymph nodes -> subclavian lymphatic trunks (75%) Subareolar lymphatic plexus -> parasternal lymph nodes -> bronchomediastinal lymphatic trunks (25%)

Dr. Praveen Kurrey

14-11-2025

Breast Parts and Lymph Nodes

Dr. Praveen Kurrey

14-11-2025

Breast Lymphatics

There are three groups of lymph nodes that receive lymph from breast tissue – the axillary nodes (75%), parasternal nodes (20%) and posterior intercostal nodes (5%). The skin of the breast also receives lymphatic drainage: Skin – drains to the axillary, inferior deep cervical and infraclavicular nodes. Nipple and areola – drains to the subareolar lymphatic plexus.

Dr. Praveen Kurrey

14-11-2025

Lymphatics of Mammary Gland

The axillary (underarm) nodes, the parasternal (chest) nodes, and the intercostal nodes

Dr. Praveen Kurrey

14-11-2025

L.N. of Breast

75% of drainage. Lymph is collected in the subareolar plexus (Sappey's plexus) and then travels along the inferior border of the pectoralis major muscle to the axillary node

Dr. Praveen Kurrey

14-11-2025

Breast L.Nodes

Dr. Praveen Kurrey

14-11-2025

Mammary Gland Lymphatics

Dr. Praveen Kurrey

14-11-2025

Breast cancer

Common presentations associated with breast cancer are due to blockages of the lymphatic drainage. Excess lymph builds up in the subcutaneous tissue, resulting in clinical features such as nipple deviation and retraction, and prominent skin between small dimpled pores (peau d’orange). Larger dimples are generally caused by cancerous invasions and fibrosis. This causes traction of the suspensory ligaments, causing them to shorten.

Dr. Praveen Kurrey

14-11-2025

Breast cancer - Symptoms

Dr. Praveen Kurrey

14-11-2025

Carcinoma Breast

Dr. Praveen Kurrey

14-11-2025

Breast Cancer

Metastasis commonly occurs through the lymph nodes. It is most likely to be the axillary lymph nodes that are involved. They become stony hard and fixed. Following this, the cancer can spread to distant places such as the liver, lungs, bones and ovary.

Dr. Praveen Kurrey

14-11-2025

Peau'd Orange- Breast Cancer

Peau d'orange" is a medical term for skin that has a dimpled or pitted, orange-peel-like appearance, which can be a sign of inflammatory breast cancer. It happens when cancer cells block the lymph vessels in the breast, causing fluid buildup and a thickened, leathery skin texture. If you notice this on your breast, it is important to see a doctor right away for an accurate diagnosis.

Dr. Praveen Kurrey

14-11-2025

Breast Feeding

Dr. Praveen Kurrey

15-11-2025

Anatomy of Breast

Structures and Lymph nodes.

Dr. Praveen Kurrey

15-11-2025

Axilla Boundaries

A Pyramid-shaped space bounded by anterior, posterior, medial, lateral, superior, and inferior walls. The anterior wall is formed by the pectoral muscles, the posterior wall by the subscapularis, teres major, and latissimus dorsi muscles, and the lateral wall by the humerus. The medial wall consists of the serratus anterior and thoracic wall, while the base is the skin and fascia of the armpit. The apex is the open, superior part, defined by the first rib, clavicle, and scapula.

Dr. Praveen Kurrey

15-11-2025

Axilla Boundary and Content

Anterior wall Muscles: Lateral part of the pectoralis major, pectoralis minor, and subclavius Fascia: Clavipectoral fascia Posterior wall Muscles: Subscapularis, teres major, and latissimus dorsi

Dr. Praveen Kurrey

15-11-2025

Axilla Inlet Apex

Axillary apex, is the triangular opening at the top of the armpit (axilla) that connects the neck to the axilla. It is bounded by the lateral border of the first rib, the posterior surface of the clavicle, and the superior border of the scapula, and serves as the passage for major nerves and blood vessels, like the brachial plexus and subclavian vessels, to enter the axilla from the neck.

Dr. Praveen Kurrey

15-11-2025

Walls of Axilla

Posterior wall is made of the subscapularis, latissimus dorsi, and teres major muscles. The medial wall is the serratus anterior muscle and the first four ribs, and the lateral wall is the humerus, coracobrachialis, and short head of the biceps brachii.

Dr. Praveen Kurrey

15-11-2025

Inlet of Axilla

Dr. Praveen Kurrey

15-11-2025

Axilla Limits

Dr. Praveen Kurrey

15-11-2025

Axilla Dissected

Dr. Praveen Kurrey

15-11-2025

Axilla - Lymph Nodes

Dr. Praveen Kurrey

15-11-2025

Axillary Vein

It begins at the lower border of the teres major muscle where the basilic vein and brachial veins merge and ends at the outer border of the first rib, where it becomes the subclavian vein. It is a clinically significant vessel used for venous access for medical devices like pacemakers and defibrillators

Dr. Praveen Kurrey

15-11-2025

Axillary Lymph Nodes

Divided into groups based on their relationship to the pectoralis minor muscle: Level I (lateral), Level II (deep), and Level III (medial).

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 1

Formed by nerve roots C5 through T1, it is structured in five parts: roots, trunks, divisions, cords, and branches.

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 2- Formation

Roots: The network begins with five nerve roots from the spinal cord (C5–T1). Trunks: The roots combine to form three trunks: superior (C5-C6), middle (C7), and inferior (C8-T1

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 3- Branches

Divisions: Each trunk splits into an anterior and a posterior division. Cords: The divisions then regroup into three cords, named for their position relative to the axillary artery: the lateral, posterior, and medial cords. Branches: Finally, the cords form the terminal branches, which are the major nerves that extend into the shoulder, arm, and hand.

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 4- Location

The roots of the brachial plexus emerge from the spinal cord and travel between the anterior and middle scalene muscles in the posterior triangle of the neck.

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 5 - Formation

The ‘roots’ refer the anterior rami of the spinal nerves that comprise the brachial plexus. These are the anterior rami of spinal nerves C5, C6, C7, C8, and T1.

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus- Branches of Root

1. Dorsal scapular nerve C4, C5 rhomboid muscles and levator scapulae - 2. long thoracic nerve C5, C6, C7 serratus anterior - 3. branch to phrenic nerve C3, C4, C5 Diaphragm 4. Branch to Longus Coli and Scalene Muscles

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 7- Branches From Trunk

Only Upper Trunk Gives Branches- 1. Suprascapular Nerve- Supraspinatus and Infraspinatus 2. Nerve to Subclavius- Subclavius

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 8- Branches of Lateral Cord

(LML) 1. Lateral Pectoral Neve 2. Musculocutaneous Nerve 3. Lateral Root of Median Nerve

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 9- Branches From Medial Cord

(M4 U) 1. Medial Pectoral Nerve 2. Medial Root of Median Nerve 3. Medial Cutaneous nerve of Arm 4. Medial Cutaneous nerve of Forearm 5. Ulnar Nerve

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 10- Branches From Posterior Cord

(ULNAR) 1. Upper Subscapular Nerve 2. Lower Subscapular nerve 3. Nerve to Lattissimus Dorsi (Thoracodorsal neve) ( Middle Subscapular Nerve) 4. Axillary Nerve 5. Radial Nerve

Dr. Praveen Kurrey

18-11-2025

Long Thoracic Nerve of Bell

Roots Long thoracic nerve C5, C6, C7 serratus anterior- Winging of Scapula

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus 11- Branches

Dr. Praveen Kurrey

18-11-2025

Erb's Palsy- Brachial Plexus Injury

Erb’s palsy refers to an injury to the upper roots of the brachial plexus (typically C5-6). It most commonly occurs as a result of a stretching injury during a difficult vaginal delivery. Nerves affected – the peripheral nerves derived from C5-6 roots are most affected. This includes the musculocutaneous, axillary, suprascapular, and nerve to subclavius. Muscles affected – supraspinatus, infraspinatus, subclavius, biceps brachii, brachialis, coracobrachialis, deltoid and teres minor.

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus Injury

Erb’s palsy- Motor functions affected – abduction at shoulder, lateral rotation of arm, supination of forearm, and flexion at shoulder. Sensory functions affected – sensation over the lateral aspect of upper limb (C5-6 dermatomes).

Dr. Praveen Kurrey

18-11-2025

BP Injury

Klumpke’s palsy is an injury of the lower roots of the brachial plexus (C8-T1). It is also most commonly associated with a difficult vaginal delivery but has a much lower incidence than Erb’s palsy. Nerves affected – the peripheral nerves derived from T1 root are most affected; the ulnar and median nerves Muscles affected – the intrinsic hand muscles Sensory functions affected – sensation along medial side of upper limb (C8-T1 dermatomes).

Dr. Praveen Kurrey

18-11-2025

Brachial Plexus Injury 3

Erbs Palsy- ‘waiter’s tip Hand", Policeman Tip hand, Porter Tip Hand-PKK

Dr. Praveen Kurrey

18-11-2025

Branches of Brachial Plexus

Dr. Praveen Kurrey

18-11-2025

Axillary artery Location

Dr. Praveen Kurrey

20-11-2025

Axillary Artery - Parts

It is a continuation of the subclavian artery, starting at the lateral border of the first rib and ending at the lower border of the teres major muscle, where it becomes the brachial artery. The pectoralis minor muscle divides the artery into three parts, with one branch arising from the first part, two from the second, and three from the third.

Dr. Praveen Kurrey

20-11-2025

Axillary Artery- Relations

First part (proximal to pectoralis minor) Anterior: Pectoralis major (clavicular part), a nerve loop connecting the medial and lateral pectoral nerves. Posterior: Medial cord of the brachial plexus, the long thoracic nerve, and the first digitations of the serratus anterior muscle. Medial: Axillary vein. Lateral: Lateral and posterior cords of the brachial plexus.

Dr. Praveen Kurrey

20-11-2025

Axillary Artery- Anatomy

Dr. Praveen Kurrey

20-11-2025

Axillary Artery -Relation 2

Second part (behind the pectoralis minor) Anterior: Pectoralis minor. Posterior: Posterior cord of the brachial plexus and the subscapularis muscle. Medial: Medial cord of the brachial plexus and the axillary vein. Lateral: Lateral cord of the brachial plexus.

Dr. Praveen Kurrey

20-11-2025

Axillary Artery -Relation 3

Third part (distal to pectoralis minor) Anterior: Skin, superficial fascia, and deep fascia. Posterior: Radial nerve, axillary nerve (in the upper part), and the subscapularis, latissimus dorsi, and teres major muscles (tendons). Lateral: Coracobrachialis muscle, musculocutaneous nerve, and the lateral root of the median nerve (in the upper part). Medial: Axillary vein and the medial cutaneous nerve of the arm and forearm.

Dr. Praveen Kurrey

20-11-2025

Axillary Artery - Situation

The axillary artery is located in the armpit (axilla), beginning at the outer border of the first rib and ending at the lower border of the teres major muscle. It serves as the main artery for the upper limb, with its path divided into three parts by the pectoralis minor muscle

Dr. Praveen Kurrey

20-11-2025

Axillary Artery - Branches

First part Superior thoracic artery: Supplies blood to the pectoralis minor and major muscles. Second part Thoracoacromial artery: Divides into several branches, including the acromial, pectoral, clavicular, and deltoid arteries. Lateral thoracic artery: Supplies the pectoral muscles, serratus anterior, and the mammary gland.

Dr. Praveen Kurrey

20-11-2025

Axillary artery - Branches 2

Third part Subscapular artery: The largest branch, which gives off the circumflex scapular and thoracodorsal arteries. Anterior circumflex humeral artery: Wraps around the surgical neck of the humerus. Posterior circumflex humeral artery: Also wraps around the surgical neck of the humerus, supplying blood to the shoulder joint and surrounding muscles.

Dr. Praveen Kurrey

20-11-2025

Axillary Artery Dissected

Dr. Praveen Kurrey

20-11-2025

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