The lateral pectoral nerve (C5-C7) arises from the lateral cord of the brachial plexus, crosses in front of the axillary artery and pierces the clavipectoral fascia with the thoracoacromial artery to supply the clavicular and upper sternocostal parts of pectoralis major. Its name reflects its origin from the lateral cord, not its position: it actually lies more medial than the medial pectoral nerve. A loop to the medial pectoral nerve also carries fibres to pectoralis minor.
| Origin | Lateral cord of the brachial plexus (C5, C6, C7) |
|---|---|
| Course | Passes anterior to the axillary artery, pierces the clavipectoral fascia with the thoracoacromial artery and enters the deep surface of pectoralis major, sending a communicating loop (ansa pectoralis) to the medial pectoral nerve |
| Motor | |
| Sensory |
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The lateral pectoral nerve can be compromised during cephalic vein-deltopectoral groove dissection and during lymph node dissection for apical axillary disease. Its preservation is emphasised in prepectoral breast reconstruction where implants are placed in front of the muscle and nerve damage could produce the visible abnormality of clavicular head pectoralis atrophy.
Weakness of the clavicular pectoralis major from nerve damage during axillary or shoulder surgery, producing visible clavicular head atrophy and weak shoulder adduction from the front.
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