Remove the skin and superficial fascia (do not remove the cephalic vein) along the following lines:

  1. From the jugular notch to the acromion along the clavicle (do not dissect superior to the clavicle and accidentally remove the platysma).
  2. From the jugular notch to the xiphoid process.
  3. From the xiphoid process laterally to meet the skin incision from the back dissection.
  4. From the acromion to a point approximately 5 cm inferior to the elbow and then encircle the proximal forearm.
  5. Attempt to identify the following:

  6. The anterior cutaneous branches of the thoracic (intercostal) nerves penetrating the pectoralis major muscle.
  7. The lateral cutaneous branches of the thoracic (intercostal) nerves.
  8. The medial and lateral cutaneous nerves of the arm.
Platysma Reflected
Anterior Cutaneous Branches of Thoracic Nerves (penetrating pectoralis major muscle)
Lateral Cutaneous Branches of Thoracic Nerves
Cutaneous Nerves of the Arm and Forearm