Anatomy and supply

The pectoralis minor is a fan-shaped muscle of the shoulder girdle. It originates from the third to fifth ribs, and inserts on the coracoid process of the scapula. It is innervated by the medial and lateral pectoral nerves (C6-Th1), branches of the brachial plexus. The pectoralis minor is located under the pectoralis major, and both form the anterior wall of the axilla. The contracted muscle can be easily palpated there. It is also located close in relation to the brachial plexus and both the subclavian artery and vein, which all run between the muscle and the ribcage.

Function

The pectoralis minor has two main functions. On one hand, it pulls the scapula anteriorly and inferiorly toward the ribs (abduction and depression respectively). This leads to a dorsomedial movement of the inferior angle of the scapula. This movement is both helpful when retracting the elevated arm and as well as moving the arm posteriorly behind the back. On the other hand, the pectoralis minor elevates the third to fifth ribs (given a fixed scapula) and expands the ribcage. By those means, it can also serve as an accessory muscle during inspiration.

Pathology

Both the axillary artery and vein, as well as some nerves of the brachial plexus run between the pectoralis minor and the coracoid process (coracopectoral space). In cases of hypertrophy or stiffening (e.g. when permanently leaning your upper body over the table while sitting) a compression of the neurovascular bundle can often occur. This is referred to as pectoralis minor syndrome (PMS), one form of thoracic outlet syndrome (TOS). Common complaints are tingling, numbness up to pain in the affected arm (especially in the ring and small finger) and a stiff shoulder.

In plastic surgery, the pectoralis minor is regarded as one of the best choices for reanimation of a paralyzed face. That is true due to the fact that this muscle is flat, triangular shaped and has double innervation. Those characteristics enable one transplant to replace two or more paralyzed facial muscles at the same time.

References:

  • M. Schünke/E. Schulte/U. Schumacher: Prometheus – LernAtlas der Anatomie – Allgemeine Anatomie und Bewegungssystem, 2.Auflage, Thieme Verlag (2007), S.294-295
  • J. E. Muscolino: The muscular system manual – The skeletal muscles of the human body, 2.Auflage, Elsevier Mosby (2005), S.263-265
  • B. Strauch [et al.]: Grabb's Encyclopedia of Flaps – Head and Neck, 3.Auflage, Lippincott Williams & Wilkins (2009), S.443-444
  • G. Fors: Why We Hurt: A Complete Physical & Spiritual Guide to Healing Your Chronic Pain, Llewellyn Pub (2007), S.193-195

Author: Achudhan Karunaharamoorthy

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