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MSS - MSK Exam 2 > Pectoral Region and Axilla > Flashcards

Pectoral Region and Axilla Flashcards

1
Q

median furrow

A

between sternal attachments of pectoralis major muscle

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2
Q

sternal angle

A

between manubrium and sternum

**junction of second rib

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3
Q

nipple

A

male/pre-pubertal female

-at point of junction with second rib

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4
Q

anterior axillary fold

A

lateral border of pectoralis major

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5
Q

deltopectoral triangle

A

junction of:
clavicle
deltoid
pectoralis major

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6
Q

deltopectoral groove

A

between deltoid and pectoralis major

-cephalic vein location

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7
Q

supraclavicular nerves

A

C3 and C4 from cervical plexus

-superficial structure

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8
Q

anterior and lateral cutaneous branches

A

from ventral rami of thoracic spinal nerves

-superficial structure

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9
Q

cephalic vein

A

travels in interval between deltoid and pectoralis major

  • dives into deltopectoral triangle
  • pierces costocoracoid membrane
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10
Q

breast changes during puberty?

A

increased in number of ducts
proliferation of glands
increased fat deposition
further proliferation with each menstrual cycle
pregnancy - increase in glandular tissue dramatic

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11
Q

supernumary?

A

extra rudimentary breasts or nipples

-along milk line

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12
Q

axillary tail

A

superolateral extension of breast

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13
Q

glandular structure of breasts?

A

parenchyma
apex directed toward nipple
-drained by single lactiferous duct

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14
Q

lactiferous sinus

A

storage area for secreted products

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15
Q

supportive structures of breast?

A

stroma

each lobe surrounded by connective tissue
-rests upon deep fascia

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16
Q

fat in breast

A

between glandular tissue and skin

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17
Q

coopers ligaments

A

collagens bundles within superficial fascia and run between the skin and deep fascia

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18
Q

sphincter in nipple?

A

smooth muscle layer

-sphincter for excretory ducts

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19
Q

mammary glands?

A

modified sweat glands

no fibrous capsule
no specialized vascular supply, nerve, or lymph drainage

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20
Q

vascular supply of the breast?

A

internal thoracic artery sends perforating arteries through intercostal spaces 2-4

lateral thoracic artery (2nd portion of axillary artery)

anterior and lateral cutaneous branches of intercostal arteries 3-5 (enter gland from deep side)

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21
Q

veins of breast?

A

venae comitantes of arterial supply

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22
Q

lymphatic drainage of breast

A

75% to axillary lymph nodes
25% to parasternal nodes

drainage can also go to other side
-circumareolar

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23
Q

attachment of pectoralis major

A

origin:
medial inferior border of clavicle, manubrium, sternum, costal cartilage 2-6, external abdominal oblique aponeurosis

insertion:
crest of greater tubercle of humerus

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24
Q

action of pectoralis major

A

adducts and medially rotates humerus

clavicular head flexes humerus

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25
Q

innervation of pectoralis major

A

medial and lateral pectoral nerves

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26
Q

attachment of pectoralis minor

A

origin:
outer surface of rib 3-5 )or 2-5)

insertion:
coracoid process of scapula

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27
Q

action of pectoralis minor

A

protracts and depresses scapula

also, accessory muscle for respiration

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28
Q

innervation of pectoralis minor

A

medial pectoral nerve

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29
Q

attachment of subclavius

A

origin:
upper border of 1st rib and costal cartilage

insertion:
inferior surface of clavicle

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30
Q

action of subclavius

A

pulls lateral end of clavicle downward and forward

resists excessive elevation and protraction

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31
Q

innervation of subclavius?

A

nerve to subclavius

32
Q

clavipectoral fascia

A

envelopes subclavius and pectoralis minor

33
Q

costocoracoid membrane

A

upper portion of clavipectiral fascia
medial and lateral attachments
-spans interval between subclavius and pec minor

34
Q

what pierces costocoracoid membrane

A

cephalic vein
thoracoacromial artery
lateral pectoral nerve

35
Q

suspensory ligament of axilla

A

lower portion of clavipectoral fascia after it sweeps from both sides of pec minor to form single thickened sheet which terminates at floor of axilla

**dome-like configuration of the axilla floor

36
Q

axilla

A

tetrahedral shaped space at junction of upper limb and thorax
-boundaries form a passageway for nerves from neck and vessels from thorax

37
Q

apex of axilla?

A

junction of clavicle, scapula, and first rub forming the cervicoaxillary canal

38
Q

base of axilla?

A

axillary fascia

39
Q

anterior wall of axilla?

A

pectoralis major and minor and clavipectoral fascia

40
Q

posterior wall of axilla?

A

scapula with associated musclulature:
subscapularis
teres major
latissimus dorsi

41
Q

medial wall of axilla?

A

ribs 1-4 or 5 with associated intercostal musculature covered b serratus anterior muscle

42
Q

lateral boundary of axilla?

A

junction of anterior and posterior axillar walls at intertubercular groove

43
Q

contents of axilla?

A
  • axillary artery and branches
  • axillary vein and tributaries
  • cords and branches of brachial plexus
  • proximal portions of long and short heads of -biceps brachii and coracobrachialis mm.
  • axillary lymph nodes
  • fat
44
Q

axillary sheath?

A

extension of prevertebral cervical fascia that surrounds axillary artery, veins, and brachial cords

45
Q

limits of axillary artery?

A

continuation of subclavian artery lateral to lateral border of 1st rib

becomes brachial artery distal to inferior border of teres major

46
Q

branches of axillary artery?

A

separated into three regions

47
Q

area 1 of axillary artery?

A

medial to pectoralis minor

-supreme thoracic artery

48
Q

supreme thoracic artery

A

first branch of the axillary artery (area 1)

-from inferior surface and goes down to supply intercostal space 1 and 2

49
Q

area 2 of axillary artery?

A

deep to pectoralis minor

thoracoacromial artery
lateral thoracic artery

50
Q

thoracoacromial artery

A

in area 2 of axillary

posterior to pectoralis minor
-medially and pierces costocoracoid membrane

artery possesses a trunk and divides

51
Q

axillary artery courses where?

A

over 1st rib
under pectoralis minor
over teres major

52
Q

lateral thoracic artery

A

in area 2 of axillary

arises behind pectoralis minor and courses inferiorly parallel to its lateral border

branches to lateral intercostal spaces, serratus anterior, pectoralis major and minor, and mammary gland

53
Q

divisions of thoracoacromial artery?

A

acromial
clavicular
deltoid
pectoral

AC/DP !!

54
Q

area 3 of axillary artery?

A

subscapular artery
anterior circumflex humeral artery
posterior circumflex humeral artery

55
Q

largest and most inconsistent branch?

A

subscapular artery

56
Q

subscapular artery

A

very large and inconsistent
first branch of area 3

bifurcates

57
Q

bifurcation of subscapular artery?

A

circumflex scapular artery

thoracodorsal artery

58
Q

circumflex scapular artery

A

bifurcation of subscapular artery

courses posteriorly through triangular space to participate in scapular anastomosis

59
Q

thoracodorsal artery

A

bifurcation of subscapular artery

courses with thoracodorsal nerve on anteromedial surface of latissimus dorsi

THORACODORSAL WILL BE ON THE PRACTICAL

60
Q

anterior circumflex humeral artery

A

from area 3 of axillary
arises from anterolateral surface of axillary artery in region of surgical neck

*anastomoses with the posterior portion

61
Q

posterior circumflex humeral artery

A

arises on anteromedial aspect of axillary artery at surgical neck

courses posteriorly with axillary nerve through the quadrangular space to anastomose with anterior

62
Q

what to know about circumflex humeral arteries?

A

can arise from common trunk

anterior circumflex humeral is always smaller

63
Q

cephalic vein

A

laterally

64
Q

basilic vein

A

medial

65
Q

median cubital vein

A

connects cephalic and basilic at cubital fossa

66
Q

deeper veins?

A

named with the arteries they follow

67
Q

deep veins distal?

A

lie medial to artery

68
Q

deep veins proximal?

A

anterior and inferior to artery

69
Q

axillary vein?

A

formed by union of basilic vein (medial) with brachial veins

**its tributaries are named for branches of axillary artery with which they travel

70
Q

cephalic vein

A

at clavipectoral fascia pierces to join axillary vein

71
Q

superficial lymphatics of upper limb?

A

drain subcutaneous structures

-drain from dorsum ventrally and from distal proximally

72
Q

lymphatic collecting ducts

A

follow course of superficial veins

-most following basilic veins and ending in lateral group of axillary lymph nodes

73
Q

axillary lymph nodes

A

20-30 in number

five groups:

  • pectoral
  • lateral
  • subscapular
  • central
  • apical

all infraclavicular

74
Q

apical lymph node

A

located behind or superior to pectoralis minor tendon

75
Q

all drainage to what?

A

apical nodes > subclavian lymph trunk > right lymphatic trunk > right jugulovenous angle

MSS - MSK Exam 2 (13 decks)

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