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PubMed1984

Perinatal age and sex variations of the triiodothyronine nuclear receptors in the chick pectoralis major muscle.

The ontogenesis of the nuclear triiodothyronine receptors was determined in the pectoralis muscle of male and female chicken at 18 days in ovo and 0, 3, 6, 14 and 35 days ex ovo. Our results show the presence of putative T3 nuclear receptors with equilibrium dissociation constant values (Kd approximately 5.50 X 10(-10) M) in good agreement with these reported in other tissues. The T3 receptor numbers decrease from 18 days incubation to 6-day-old animals, then increase until 35 days of age. Compared to the already reported levels of thyroid hormone in plasma and tissues, the results seem to correspond to a down-regulation of the muscle T3 receptors. The nuclear binding capacity of T3 was higher in females than in males, which could be related to the known effects of various sex steroid hormones on the T4 to T3 tissue conversion.

Age Factors↗

PubMed2005

Chronic rupture of the pectoralis major muscle: report of two cases.

Rupture of the pectoralis major muscle is relatively rare. The authors present two cases of chronic rupture in which direct suturing was not possible; reconstruction was possible using a bone-patellar tendon autograft. They conclude that this surgical technique may be useful in some cases of chronic ruptures of the pectoralis major muscle in which direct tendon suturing is impossible.

Adult↗

PubMed1975

Delayed repair of a ruptured pectoralis major muscle.

A repair of the pectoralis major avulsion injury to the tendinous insertion into the humerus was successfully performed 6 months after the initial injury. The critical clinical observation was the presence of some intact tendon. In order to properly test for the presence of this tendon, it is necessary to abduct the arm so an attenuated band will be under tension. The presence of any remaining tendon is a favorable factor in consideration of delayed repair of this injury because it may have prevented full retraction of the muscle mass.

Adult↗

PubMed1993

Rupture of the pectoralis major muscle in body-builders.

Rupture of the pectoralis major muscle is rarely encountered. However, among body-builders this lesion, commonly called the "pec-tear", is well known. The bench-press exercise is a common cause. In the following report the typical history, symptomatology, and treatment are discussed.

Adult↗

PubMed1975

Modified radical mastectomy with preservation of the pectoralis major muscle.

A new technique of modified radical mastectomy for early breast cancer was devised with an express purpose of preserving pectoralis major muscle but still enabling radical removal of the regional lymphnodes. The pectoralis major muscle was transected at its midportion to expose the thoracic wall for radical dissection of axillar and subclavicular lymphnodes followed by resuturing of the muscle to preserve its continuity. The parasternal nodes can also be dissected if necessary. The pectoralis minor muscle is either resected or preserved. This procedure should be applied mainly in T1N0 and T1N1a (Stage I in the TNM staging system) which seems recently to be increasing rapidly in number and for which the radical mastectomy with resection of pectoralis major muscle is thought to be too excessive. The procedure proposed in the present communication offers advantage not only in functional but also cosmetic aspect by preserving the pectoralis major muscle while the radicality of the operation is retained. Although the number of cases thus treated is limited and the long-term follow up with survival rate is not yet available, the procedure seems to be of considerable value in selected patients.

Adult↗

PubMed1985

The segmental pectoralis major muscle flap: a function-preserving procedure.

A function-sparing pectoralis major muscle flap is presented. The flap is a medially based segmental transfer of a single intercostal portion of the pectoralis major muscle supplied by a single perforating branch of the internal thoracic artery. The segmental terminal nerve distribution of the medial and lateral pectoral nerves permits preservation of the remainder of the muscle in situ. Six cases of this procedure are presented with five successful outcomes. The single exception was in the loss of the distal tip when used to cover an irradiated carotid sheath to the base of the skull.

Aged↗

PubMed1980

Closed injuries of the pectoralis major muscle.

Direct and indirect trauma can cause injury to various portions of the pectoralis major muscle in varying degrees. Sprains and partial tears of the pectoralis major muscle are not uncommon. Surgical repair in acute injuries can often produce excellent results in selected patients. Complete injuries of the muscle tendon itself (Type IIID) are best treated with surgical repair in otherwise healthy patients. Delayed diagnosis and delayed repair may prevent excellent results. A functional classification as presented here can aid in the diagnosis and treatment of these injuries.

Adolescent↗

PubMed1998

Light and electron microscopic evaluation of the pectoralis major muscle following tissue expansion for breast reconstruction.

The placement of tissue expanders under the pectoralis major muscle has become a common procedure in breast reconstruction after mastectomy. Little information is available regarding the changes caused by tissue expansion on human skeletal muscle. In this study, we report the light and electron microscopic changes observed in 20 expanded pectoralis major muscles from 12 patients undergoing two-stage breast reconstruction procedures. Standard 400-cc round Radovan tissue expanders were placed, eight bilaterally and four unilaterally. Three biopsies were taken from each muscle at different locations during both the first stage (pre-expansion) and 23 weeks later at the second stage (postexpansion). The operative procedures and expansion protocol were the same in all reconstructions. No postoperative radiation therapy was added. The histologic changes were reported in a blind fashion by one pathologist. Light microscopy did not show significant pathologic changes. All but one of the pre-expansion specimens examined by electron microscope were reported as normal, whereas all of the postexpansion biopsies were grossly altered. Focal muscle fiber degeneration with glycogen deposits and mild interstitial fibrosis was noted. In addition, some fibers showed disorganization of the myofilaments in the sarcomeres. The above ultrastructural changes are significant morphologic alterations, which may be the result of muscle hypoxia. Whether these changes indicate permanent or transient transformation is yet unclear. Patient follow-up did not reveal any functional muscular deficit. We conclude that there is definite evidence to suggest significant muscular structural damage after routine subpectoral expansion for breast reconstruction.

Adult↗

PubMed1986

Pectoralis major muscle flap with amnion in oral cavity reconstruction.

The pectoralis major myocutaneous flap provides an excellent method for reconstruction of oral cavity defects. This flap has been used since 1978. However, the flap is not without problems. The major problem that has been seen is necrosis of the cutaneous and subcutaneous aspects of the flap. However, in all such instances the muscular portion of the flap survived. This complication was found to occur more commonly in the elderly, diabetics, patients with peripheral vascular disease and patients with excessive adipose or breast tissue superimposed between the cutaneous and muscular components of the flap. In this study the technique of oral cavity reconstruction in the high risk patient group has been modified to avoid using the skin component of the pectoralis major myocutaneous flap. Instead, pectoralis major muscle covered with amnion is used for reconstructive purposes with rapid healing and with very satisfactory functional and cosmetic results.

Amnion↗

PubMed2007

Fascial release of the pectoralis major: a technique used in pectoralis major muscle closure of the mediastinum in cases of mediastinitis.

BACKGROUND: The authors' goal was to demonstrate a technique of gaining added width from the right pectoralis major muscle flap through muscle fascia release, with the hope of attaining sturdier, tension-free dead space closure of the debrided mediastinum in cases of mediastinitis. METHODS: The authors measured the preincisional and postincisional widths of the right pectoralis major flap following release of the fascia in nine patients who underwent mediastinal reconstruction using pectoralis major muscle flaps from 2002 to 2004 at the Detroit Medical Center. RESULTS: The average width of the nine muscles was 16.3 +/- 1.7 cm before fascia release and 22.1 +/- 1.3 cm after release. The average increase in width was 5.8 +/- 1.3 cm, with a 95 percent confidence interval of 4.8 to 6.8 cm. A value of p < 0.0001 indicated that this increase in width was statistically significant. After fascial release, the width of the muscles increased by an average of 26.1 percent, with a 95 percent confidence interval of 21.6 to 30.6 percent. CONCLUSIONS: The authors present a new technique that can be used to gain additional width from the right pectoralis major muscle in cases of mediastinal reconstruction using the pectoralis major muscle flap. With the added 26 percent of width obtained from the right pectoralis major muscle with fascia release, the authors contend that a sturdier and tension-free closure of the mediastinal dead space can be obtained, further expanding the indications for use of the pectoralis major muscle flap as the sole closure modality in even the most complicated cases of mediastinitis.

Fasciotomy↗

PubMed1998

Inspiratory and expiratory patterns of the pectoralis major muscle during pulmonary defensive reflexes.

Experiments were conducted to determine the discharge pattern of the pectoralis major muscle during pulmonary defensive reflexes in anesthetized cats (n = 15). Coughs and expiration reflexes were elicited by mechanical stimulation of the intrathoracic trachea or larynx. Augmented breaths occurred spontaneously or were evoked by the same mechanical stimuli. Electromyograms (EMGs) were recorded from the diaphragm, rectus abdominis, and pectoralis major muscles. During augmented breaths, the pectoralis major had inspiratory EMG activity similar to that of the diaphragm, but during expiration reflexes the pectoralis major also had purely expiratory EMG activity similar to the rectus abdominis. During tracheobronchial cough, the pectoralis major had an inspiratory pattern similar to that of the diaphragm in 10 animals, an expiratory pattern similar to that of the rectus abdominis in 3 animals, and a biphasic pattern in 2 animals. The pectoralis major was active during both the inspiratory and expiratory phases during laryngeal cough. We conclude that, in contrast to the diaphragm or rectus abdominis muscles, the pectoralis major is active during both inspiratory and expiratory pulmonary defensive reflexes.

Anesthesia↗

PubMed1988

[Regulation of the expression of alpha and beta tropomyosin genes during development of the pectoral muscle in the chicken].

Accumulation of mRNAs coding for alpha and beta skeletal tropomyosins was investigated using specific probes and normalized to muscle creatine kinase (M-CK) mRNA by slot-blot assays. In developing pectoralis muscle, the ratio of alpha TM messenger/M-CK remained constant until hatching, at which time the messenger disappeared within a week. However, in the leg, this ratio remained constant until 8 days after hatching, whereafter it decreased progressively to reach 30% in the adult. The alpha TM/M-CK ratios were almost the same in the embryonic leg and pectoralis muscle. After hatching, there was a large increase in pectoralis muscle (x 3 at day +4, x 0 at day +21) whereas, the increase was less pronounced and more progressive in the leg (x 3 at day 21). Run-on assays showed that nuclei isolated from 15-day in ovo leg and pectoralis muscles had similar patterns of muscle specific gene transcription whereas post-hatched pectoralis muscle nuclei were shown to have a higher rate of alpha to beta tropomyosin gene transcription. These data are in accordance with the results obtained for protein analysis of leg and pectoralis muscles and support the notion that changes in the protein pattern of developing muscle can be relevant to coordinate regulation of gene transcription.

Animals↗

PubMed1986

The pectoralis major muscle in head and neck reconstruction.

From June 1980 to June 1985 51 pectoralis major muscle flaps have been used for one-stage reconstruction of extensive defects in the head and neck following cancer surgery. The pectoralis major muscle was used as a myocutaneous flap on 28 occasions, as a muscle covered with split thickness skin on 17 occasions, and as a muscle-only flap six times. The muscle, in its various forms, was used for reconstruction of the pharyngooesophageal segment, the tongue, floor of the mouth and oropharynx, to replace the skin of the face and neck, and to provide a well vascularized recipient bed for a split-rib graft, used to replace a defect of the anterior arch of the mandible. Many of the problems associated with the use of a pectoralis major myocutaneous flap can be avoided by the judicious use of a muscle flap on its own or covered by a split thickness skin graft.

Aged↗

PubMed1993

Arterial supply in the human pectoralis minor muscle.

In the following, we report our findings obtained as a result of injecting an acrylic pigment in the arteries supplying the pectoralis minor muscle in 50 lateral chests of 26 Japanese adults (15 males and 11 females). In the pectoralis minor muscle, the muscular bundle near the terminal is supplied by A. processus coracoideris (Pc, Sato-Takafuji, '85) or A. coracobrachialis (Cb, Sato, '80) of A. axillaris (Ax), while its middle upper and lower peripherals are supplied by A. thoracoacromialis (Ta) and A. partis abdominalis (Pab, Sato, '76), respectively. Further, the upper and lower peripherals at its origin are supplied by A. thoracica suprema (Ts) and A. thoracica lateralis (Tl), respectively. Pc, Cb, Pab and Ts may occasionally be absent. Arteries supplying this muscle are classified according to their origins and routes of distribution, as follows. Type I-a: Pc or Cb, Ta, Pab, Ts and Tl are present, 32%; Type II-a: Ts is absent from Type I-a, 14%; Type III-a: Pb and Pc are absent from Type I-a, 20%; Type IV-a: Cb, Pc and Ts are absent from Type I-a, 10%. Type b is Type a without Pab. The rates of appearance of Type I-b, II-b, III-b and IV-b were all 6%. The ratios of distribution in area a were as follows, in order of decreasing ratio: 37.6% for Pab (37 cases), 32.4% for Tl (49 cases), 30.2% for Ta (49 cases), 10.8% for Ts (32 cases), 7% for Cb (9 cases), and 6.37% for Pc. In the pectoralis minor muscle, the major supplying arteries are Pab, Tl and Ta, and where Pab was absent, this was compensated for by a branch of Ta. The total number of supplying arteries in this muscle was two to five, with the majority, or 36%, having four arteries. As for sex differences in the incidence of each type, Type I-a appeared more often in males (40%) than in females (20%). The rates according to the ribs of origin were 46%, 36%, 16%, and 2% for types 2.3.4.5, 3.4.5, 2.3.4, and 2.3.4.5.6, respectively. It was interesting that all Type II and Type IV cases without Ts corresponded to Type 3.4.5 without the muscular bundle arising from the second rib, as it suggests the process of degeneration of the pectoralis minor muscle in Homo.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1999

Injuries of the pectoralis major muscle: evaluation with MR imaging.

PURPOSE: To demonstrate that magnetic resonance (MR) imaging allows evaluation of injuries of the pectoralis major muscle. MATERIALS AND METHODS: Fifteen men underwent MR imaging after injury of the pectoralis major muscle. Most of the patients (nine of 15) were injured while lifting weights, notably bench-pressing. The injuries were evaluated for abnormal morphology and signal intensity, specifically the site of injury, degree of tearing, and amount of tendon retraction. RESULTS: Six injuries occurred at the musculotendinous junction, and five were treated conservatively; eight of the nine cases of distal tendon avulsion were treated with primary surgical repair. The MR imaging findings were confirmed in the nine cases treated surgically. Complete tears (three of 15) were less common than partial tears (12 of 15). The sternal and clavicular heads were torn in 10 patients, only the clavicular head was torn in two patients, and only the sternal head was torn in three patients. Acute tears (10 of 15) demonstrated hemorrhage and edema, whereas chronic tears (five of 15) demonstrated fibrosis and scarring. There was a variable amount of tendon retraction. CONCLUSION: MR imaging allows accurate evaluation of injuries of the pectoralis major muscle and enables identification of patients who would benefit from surgical repair.

Accidental Falls↗

PubMed1981

Avulsion of the insertion of the pectoralis major muscle. A case report.

Avulsion of the insertion of the pectoralis major muscle is a rare injury but should always be considered when asymmetry of the anterior axillary fold is noted after injury to the shoulder region. This case report describes the clinical findings, findings at operation, operative treatment and anatomical considerations.

Adult↗

PubMed2006

Preliminary findings on the classical singer's use of the pectoralis major muscle.

OBJECTIVE: This study aims to further characterize the muscle activity that influences the posture and breathing utilized for classical singing. The activity in the pectoralis major (PC) muscle and the phasing of PC activity to sternocleidomastoideus (STM) activity and upper thorax (UTX) movement were investigated. MATERIAL AND METHODS: Seven professional classical singers (3 sopranos, 1 mezzo, 1 tenor and 2 baritones) and 8 advanced classical singing students (4 sopranos, 1 mezzo, 1 tenor and 2 baritones) participated. Electromyographic activity was recorded from the PC and STM muscles on the right side. UTX movement was traced with a strain gauge sensor placed around the upper thorax. Different arias, freely chosen by the singers from their professional repertoire, served as singing tasks. All subjects performed their task 3 times with variation in vocal loudness (normal, forte, piano). RESULTS: It was observed that a majority of the singers activated the PC during inhalation and that > 50% of the singers activated it during parts of phonation. In general, however, the activity of the PC was relatively low during phonation. CONCLUSION: This study shows that the PC, in idiosyncratic patterns, could be involved in the inspiratory effort recruited when positioning the UTX during inhalation and phonation.

Adult↗

PubMedDate not supplied

[Rupture of the pectoralis major muscle: classification of injuries and results of operative treatment].

AIM: Classification of pectoralis major muscle injuries and results of operative treatment in the Sportsklinik Stuttgart between 1998 and 2004 are analysed. METHODS: 10 sportsmen (2 judo, 8 body-building; 9 male, 1 female) with pectoralis major ruptures received operative treatment in this time period. After clinical examination we used ultrasound, in some cases MRI, for further diagnostics. The follow-up (1-5 years) included a clinical examination, ultrasound, sports level, cosmetics and an isokinetic strength assessment. RESULTS: In 4 cases we found a tear of the musculotendinous junction, 4 cases showed a tear at the humeral insertion and 2 other cases had tears of the muscle belly. There was no sports-specific injury. 6 ruptures underwent immediate (1 week) operative therapy and 4 ruptures had delayed (6 weeks to 4 years) repair of the injury. In 9 cases an anatomic repair was possible, in 1 delayed rupture only an extra-anatomic repair was possible. We had 1 complication with a post-operative wound infection. Based on injury localisation and operative treatment, we classified 3 types of pectoralis major ruptures. The follow-up evaluation showed in 7 cases very good and good results, 2 delayed cases still had a cosmetic defect with reduction of strength. CONCLUSION: From our results on pectoralis major muscle injuries there are 3 types of rupture: type 1: rupture at humeral insertion, type 2: rupture of musculotendinous junction, type 3: rupture of muscle belly. This classification is essential for planning the operative technique and the incision. We recommend, after classification of the rupture, primary operative reconstruction of the pectoralis major muscle.

Adult↗