Corpus: Clavipectoral fascia

The clavipectoral fascia is the fascia located in the deep chest region below the pectoralis major muscle. It surrounds the pectoralis minor muscle and the subclavius muscle.

The clavipectoral fascia is connected cranially to the clavicle and laterally to the coracoid process of the scapula. As a strong fascia, it covers the subclavian vein cranially from the pectoralis minor muscle. The vein wall and fascia are fused together so that the muscle traction via the fascia widens the lumen of the vein.

Laterally, the clavipectoral fascia is connected to the pectoralis fascia. The pectoralis major muscle lies slidingly on the clavipectoral fascia, separated by a movable layer. Medially, it is connected to the first rib. Caudally, the clavipectoral fascia merges into the axillary fascia. Connecting fibres are also referred to as the suspensory axillary ligament (Gerdy ligament).

The clavipectoral fascia divides the infraclavicular fossa (Mohrenheim fossa) into a superficial and a deep layer.

The clavipectoral fascia is perforated by the following anatomical structures:

• Cephalic vein
• Thoracoacromial artery with its branches and the associated vein
• Lateral pectoral nerve
• Medial pectoral nerve

When inserting a central venous catheter (CVC) into the subclavian vein, there is a risk of aspiration of air into the bloodstream. This is due to the fact that the vessel lumen cannot collapse due to the adhesion of the vein to the clavipectoral fascia. In the diastole of the heart, air is then sucked in as if through a snorkel if the vessel is injured.