A 67 year old man is brought into the ED following a road traffic collision. You are performing a secondary survey. You note he is tender over the distal left pectoralis muscle. The pectoralis major muscle inserts into which of the following structures:
The pectoralis major is the largest and most superficial muscle of the anterior wall. Its inferior margin underlies the anterior axillary fold, which marks the anteroinferior border of the axilla.
Muscle | Pectoralis Major |
---|---|
Origin | Clavicular head: Medial half of clavicle
Sternocostal head: Medial part of anterior thoracic wall (anterior surface of sternum, first seven costal cartilages, sternal end of sixth rib, aponeurosis of external oblique) |
Insertion | Lateral lip of intertubercular sulcus of humerus |
Function | Flexion, adduction and medial rotation of arm at glenohumeral joint |
Innervation | Medial and lateral pectoral nerves |
The muscle has two heads:
The muscle inserts into the lateral lip of the intertubercular sulcus of the humerus.
Acting together, the two heads of the pectoralis major flex, adduct and medially rotate the arm at the glenohumeral joint.
The pectoralis major is innervated by the medial and lateral pectoral nerves which originate from the brachial plexus in the axilla.
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Biochemistry | Normal Value |
---|---|
Sodium | 135 – 145 mmol/l |
Potassium | 3.0 – 4.5 mmol/l |
Urea | 2.5 – 7.5 mmol/l |
Glucose | 3.5 – 5.0 mmol/l |
Creatinine | 35 – 135 μmol/l |
Alanine Aminotransferase (ALT) | 5 – 35 U/l |
Gamma-glutamyl Transferase (GGT) | < 65 U/l |
Alkaline Phosphatase (ALP) | 30 – 135 U/l |
Aspartate Aminotransferase (AST) | < 40 U/l |
Total Protein | 60 – 80 g/l |
Albumin | 35 – 50 g/l |
Globulin | 2.4 – 3.5 g/dl |
Amylase | < 70 U/l |
Total Bilirubin | 3 – 17 μmol/l |
Calcium | 2.1 – 2.5 mmol/l |
Chloride | 95 – 105 mmol/l |
Phosphate | 0.8 – 1.4 mmol/l |
Haematology | Normal Value |
---|---|
Haemoglobin | 11.5 – 16.6 g/dl |
White Blood Cells | 4.0 – 11.0 x 109/l |
Platelets | 150 – 450 x 109/l |
MCV | 80 – 96 fl |
MCHC | 32 – 36 g/dl |
Neutrophils | 2.0 – 7.5 x 109/l |
Lymphocytes | 1.5 – 4.0 x 109/l |
Monocytes | 0.3 – 1.0 x 109/l |
Eosinophils | 0.1 – 0.5 x 109/l |
Basophils | < 0.2 x 109/l |
Reticulocytes | < 2% |
Haematocrit | 0.35 – 0.49 |
Red Cell Distribution Width | 11 – 15% |
Blood Gases | Normal Value |
---|---|
pH | 7.35 – 7.45 |
pO2 | 11 – 14 kPa |
pCO2 | 4.5 – 6.0 kPa |
Base Excess | -2 – +2 mmol/l |
Bicarbonate | 24 – 30 mmol/l |
Lactate | < 2 mmol/l |
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