Anatomy (Breast, Pectoral - 11/2) Flashcards Preview

Skin MS: Week 2 > Anatomy (Breast, Pectoral - 11/2) > Flashcards

Flashcards in Anatomy (Breast, Pectoral - 11/2) Deck (59)
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1

Location of Nipple

Mammary papilla (nipple) is just below center of gland at approximately the 4th intercostal space

2

Axillary Tail

Superolateral part frequently projects toward axilla as an axillary tail (of Spence) in relation to pectoralis major muscle and pectoral axillary lymph nodes

3

Suspensory Ligaments of Breast

Run from dermis of skin, vertically through gland to deepest part of superficial fascia. The ligaments are well developed over upper breast.

4

Nipple

skin wrinkled; contains smooth muscle fibers that contract on tactile stimulation inducing firmness and prominence.

5

Areolar glands

sebaceous glands - enlarge in pregnancy and secrete an oily substance to provide a protective lubricant for areola and nipple. Respond to estrogen. Produce little irregularities or small projections in areolae.

6

Blood supply to Mammary Glands

Axillary artery - branches include the superior thoracic, pectoral branch of thoracoacromial, and LATERAL THORACIC (major supply to breasts) arteries Intercostal arteries - cutaneous branches in 3rd to 5th spaces Internal thoracic artery - perforating branches in 2nd to 4th interspaces (AKA internal mammary - outdated)

7

Blood from Mammary Glands -- veins

form anastomotic circle around papilla. Branches pass peripherally from this to axillary, internal thoracic, lateral thoracic, and upper intercostal veins.

8

Nerves of Mammary Glands

from anterior and lateral cutaneous branches T2-6 intercostal nerves

9

Lymphatic Drainage of Mammary Glands

Principal drainage - lymph follows the lactiferous ducts to the areola where a subareolar plexus is found. From here, lymph drains by two trunks into the pectoral group of axillary nodes. Secondary drainage - From medial side of gland to parasternal nodes. Some cross to opposite gland. - From upper gland to apical axillary nodes or to supraclavicular nodes. - From lower gland, vessels pass to abdominal lymph nodes (subdiaphragmatic nodes).

10

Clinical Changes in Breast (Pregnancy, menstruation, aging)

Branching of lactiferous ducts - occur during menstrual cycle, pregnancy Pregnancy - breasts ready for milk secretion by mid-pregnancy but do not secrete milk until after parturition, may secrete colostrum (rich in protein, immune agents, growth factors) at end of pregnancy/beginning of nursing If multiple pregnancies - breasts may become large/pendulous Older women - atrophy of glandular tissue and decrease in fat

11

Breast Quadrants

Superolateral/medial and Inferolater/medial + Clock references

12

Carcinoma of the Breast (Clinical Signs & Prevalence)

Usually adenocarcinoma, may block/interfere with lymph nodes --> edema. Edema may cause dimpling of pores, swelling of skin. Tumor may cause CT degeneration/fibrosis --> dimpling/inversion of nipple. Most common form of cancer in women.

13

Carcinoma of the Breast (Metastasis)

Via veins and lymphatic channels as well as along fibrous tissue to deeper structures. Most commonly to axillary nodes (also supra/infraclavicular, abdomen, brain/vertebrae)

14

Mammography & Mastectomy

Mammography = radiography of breast, cancer appears dark, skin thickened over tumor, nipple depressed Simple mastectomy = breast is removed down to the retromammary space Radical mastectomy = remove the primary tumor, underlying fascia, pectoral muscles, and axillary lymph nodes (most common site of metastases). Lumpectomy/Quadrantectomy = remove the tumor only (more common now).

15

Polymastia, Polythelia, Amastia

Polymastia - supernumerary breast Polythelia - supernumerary nipple Anywhere along mammary crest (from axilla to groin - from development), may develop to be noticeable with pregnancy Amastia - no development of breast. May be nipple/areola, but no glandular tissue.

16

Gynecomastia

Breast hypertrophy in males (after puberty) - rare - age/drug related, hormone imbalance - may be a symptom of something else (i.e. suprarenal cancer, testicular cancer) - XXY (Klinefelter) 40% have gynecomastia

17

3 parts of sternum

Manubrium, body, xiphoid process

18

Joint between manubrium & sternal body

sternal angle, manubriosternal joint (fibrous)

19

Joint between body and xiphoid process

xiphisternal joint (fibrous)

20

First rib attached to _____ (ant)

Manubrium

21

Second rib attached to _____ (pos)

Sternal angle

22

Costal margin

inferior surface of rib cage (ribs 7-10)

23

Head of humerus - Scapula

Glenoid fossa

24

Muscle in subscapular fossa

subscapularis (rotator cuff)

25

Rotator cuff muscles

Subscapularis, teres minor, infrascapularis, suprascapularis

26

3 muscles attach to coracoid process

Pectoralis minor, coracobrachialis, short head biceps brachii

27

Supraglenoid tubercle = attachment site for _____

Long head biceps brachii

28

Infraglenoid tubercle = attachment site for _______

Long head triceps brachii

29

Anatomical neck of humerus

Site of epiphyseal plate, attachment for joint capsule

30

Greater tubercle (attachments)

Supraspinatus, infraspinatus, teres minor (3 of 4 muscles of rotator cuff)