LEC 12: Thoracic Wall and Breast Anatomy - 08.25.14 Flashcards Preview

STRUCTURES - WEEK 2 > LEC 12: Thoracic Wall and Breast Anatomy - 08.25.14 > Flashcards

Flashcards in LEC 12: Thoracic Wall and Breast Anatomy - 08.25.14 Deck (35):
1

What are the two parts of the skeleton

1. apical

2. appendicular

2

Intercostal muscles

  • 3 layers
    • external intercostal (fibers point down)
    • internal intercostal (fibers point up)
    • innermost intercostal (fibers point up, don't extend as far anteriorly as internal intercostals)
  • expand/contract thorax
  • rotate ribs

A image thumb
3

What innervates upper extremity, serrati (serratus anterior), and intercostal muscles

Ventral rami of spinal nerves

4

Deep back muscles (and overlying skin) are innervated by...

Dorsal rami

5

Superficial muscles (attached to upper extremity), intercostals, intermediate muscles (serratus posterior, inferior and superior) are innervated by...

Ventral rami of spinal nerves

6

Where does the intercostal nerve run

Runs in costal groove under rib between intercostal muscle layers (slopes downward from back to front)

7

Describe dermatones in ventral surface (thoracic region)

Slope downward (correspond with nerve sloping)

8

Describe order of nerves and vessels in intercostal space

VAN = Vein, Artery, Nerve

situated directly under rib, so always want to do a pleural tap or chest tube placement above the rib

9

Where does intercostal rib drain

azygos

10

Where does intercostal artery arise from

aorta

11

Where does intercostal nerve arise from

intervertebral foramen

12

What path do arteries, veins, and lymphatics take in intercostal neurovascular plane

Arteries, veins, and lymphatics parallel the path of ribs (and spinal nerves) in intercostal neurovascular plane

13

collateral circulation

circulation in an area of tissue or organ with a number of different pathways for blood to reach it

14

anastamoses

branches formed between adjacent blood vessels (can be arterial system or venous system)

15

lymphatic drainage follows...

blood supply

16

Where do lymphatics drain above umbilicus? Below umbilicus?

Above umbilicus drains to Axillary Nodes; below umbilicus drains to Inguinal Nodes

17

gynecomastia

male breast enlargement due to hormone imbalance

18

lipomastia

male breast enlargement due to obesity

19

mammary gland

modified sweat gland found in female breast

20

In which layer of fascia is breast found

superficial fascia (anterior to deep fascia of pectoralis major)

21

retromammary space

loose connective tissue plane separates mammary gland from deep pectoral fascia (covering pectoralis major)

separation allows breast to move freely over pectoralis major muscle

22

areola

pigmented area surrounding nipple (pigmentation and size is highly variable)

23

Montgomery's glands

big goose-bumps in areola region; lubricate nipple and areola to prevent chapping

24

nipple erection

contraction of smooth muscle under areola causes nipple erection (similar mechanism to getting goose-bumps, Autonomic response because its smooth muscle)

25

in men, where is the nipple line

Intercostal Space 4 (ICS 4) near midclavicular line

26

suspensory ligaments (of Cooper)

form boundaries for compartments that contain glandular tissue and fat

  • fibrous bands
  • anchor to skin
  • divide into lobes
  • seen in breast x-ray as white connective tissue bands

 

A image thumb
27

mammography

breast x-ray

Two Views

  • oblique (medial-lateral) includes axillary portion, where breast cancer tumors frequently occur
  • superior-inferior

28

How do breast cancer cells spread

  • Cancer cells spread by following major lymphatic drainage (mostly axillary nodes)
  • these are thus considered sentinel nodes for biopsies

29

Mammary Gland function

lactation = milk production

30

anatomy of mammary gland

  • lobules - gather lobes together
  • lobes - arranged radially around nipple

 

A image thumb
31

lactiferous ducts

channel milk towards the nipple

32

Where is milk stored in the breast

lactiferous sinuses

A image thumb
33

Breast feeding

  • engorged lactiferous sinuses
  • tactile/visual stimulation
  • nipple erection
  • oxytocin release 
  • milk ejection reflex (milk "let down" in gland - gushing)
  • baby "latches on"
  • compression of lactiferous sinuses
  • "stripping" of nipple (baby does this with tongue)

 

34

breast function

1. reproduction

  • sexual attractiveness
  • possible cushioning in missionary position

2. provides all nutrition necessary for baby's growth

3. transfer of maternal antibodies in colostrum (pre-milk) and milk will protect baby in first few months

 

35

accessory (supernumerary) nipple or breast

accessory (supernumerary) nipple or breast can appear anywhere along the milk ridge (milk line)