Lecture 26 Axilla and Breast Flashcards
(71 cards)
1
Q
What is the axilla?
A
- the axilla is essentially the region that we think of as the deep compartment of the armpit
2
Q
Where is the axilla located?
A
- inferior to the glenohumeral joint at the junction of the arm and thorax
3
Q
Is the axilla an important passageway for neurovascular structures?
A
- yes
4
Q
What is the shape of the axilla?
A
- pyramid shaped
5
Q
What types of fascia does the axillary region contain?
A
- superficial and deep
6
Q
What is significant about the fascia of the pectoral region?
A
- consists of superficial and deep layers that define borders, invest muscles, and create potential spaces
7
Q
What nerves travel through the superficial fascia?
A
- supraclavicular nerves (C3 and C4 spinal nerves)
- anterior and lateral branches of intercostal nerves
8
Q
What muscle is contained in the superficial fascia of the axilla?
A
- platysma muscle
- (muscle over lower mandible, neck and upper thoracic/shoulder region; a very superficial skeletal muscle that is mostly subcutaneous)
9
Q
What fascias are considered deep?
A
- pectoral fascia
- axillary fascia
- clavipectoral fascia
- deltoid fascia
10
Q
What does the pectoral fascia do?
A
- attaches to clavicle and sternum; invests pectoralis major muscle; continous with fascia of anterior abdominal wall
11
Q
What fascia will become the axillary fascia?
A
- pectoral fascia
12
Q
What fascia forms the floor of axilla?
A
- axillary fascia
13
Q
What fascia is deep to the pectoralis major muscle?
A
- clavipectoral fascia
14
Q
What connects the subclavius muscle and pectoralis minor?
A
- costocoracoid membrane
15
Q
What fascia is the costocoracoid membrane a part of?
A
- clavipectoral fascia
16
Q
what becomes the suspensory ligament of axilla?
A
- clavipectoral fascia
17
Q
What does the clavipectoral fascia do?
A
- invests subclavius and pectoralis minor muscles
- attaches to clavicle
- becomes suspensory ligament
18
Q
What are the features of the deltoid fascia?
A
- attaches to clavicle, acromion, and spine of scapula
- continous with pectoralis fascia
- compartmentalizes scapular muscles
19
Q
What does the suspensory ligament of axilla connect?
A
- the axillary fascia and clavipectoral fascia
20
Q
What are the borders of the clavipectoral triangle?
A
- deltoid (lateral)
- pectoralis major (medial)
- middle 1/3 of clavicle (superior)
21
Q
What is the function of the clavipectoral triangle?
A
- allows passage of neurovascular structures between axilla and pectoral region
22
Q
What does the clavipectoral triangle contain?
A
- cephalic vein
- deltopectoral lymp nodes
- deltoid branch of thoracoacromial artery (from axillary a.)
23
Q
What is the superior boundary of the axillary?
A
- clavicle
24
Q
What are the walls of the axilla?
A
- apex (clavicle)
- lateral wall (shoulder joint/arm)
- base (fossa/armpit)
- medial wall (ribs)
25
What makes up the apex of the axilla?
- clavicle
- scapula
- 1st rib
26
What does the apex contain?
- the cervicoaxillary canal
27
What is the passageway for neurovascular structures from the neck to the upper limb?
- the cervicoaxillary canal
28
what makes up the base of the axilla?
- skin and superficial fascia (axilla fossa aka armpit)
- anterior axillary fold (lateral border of pec. major muscle)
- posterior axillary fold
- chest wall
29
what muscle makes up the posterior axillary fold?
- latissimus dorsi muscle
| - teres major muscle
30
What muscle makes up the chest wall of the base of the axilla?
- serratus anterior muscle
31
What makes up the anterior wall of the axilla?
- clavicle (superior)
- subclavius muscle (superior)
- pectoralis major muscle
- pectoralis minor muscle
32
What makes up the posterior wall of the axilla?
- scapula
- subscapularis muscle
- latissimus dorsi muscle
- teres major muscle
33
What makes up the lateral wall of the axilla?
- intertubercular sulcus
- tendon of long head of biceps
- coracobrachialis tendon
34
What vessels does the axillary sheath contain?
- axillary vein
- axillary artery
- brachial plexus
35
The ______ is an extension of the prevertebral layer of deep cervical fascia into the cervicoaxillary canal of the axilla?
- axillary sheath
36
The axillary is the continuation of what artery?
- subclavian
37
What does the axillary artery supply?
- shoulder
- thorax
- axillary region
38
What does the axillary artery continue into the arm as?
- brachial artery
39
What forms the axillary vein?
- the brachial and basilic vein
40
What forms the subclavian vein?
- the cephalic and axillary vein
41
What nerves contribute to the brachial plexus?
- C5-T1
42
Where do the cords of the brachial plexus travel within?
- axillary sheath
43
Where does the brachial plexus provide innervation?
- the shoulder
- pectoral region
- scapular region
- upper limb
44
What are the 5 groups of lymph nodes?
- Pectoral
- subscapular
- humeral
- central
- apical
45
Where are the pectoral (anterior) lymph nodes?
- medial wall of axilla
| - cluster around the lateral thoracic vein
46
Where are the sub scapular (posterior) lymph nodes?
- posterior axillary fold
| - cluster around sub-scapular vessels
47
Where are the humeral (lateral) lymph nodes?
- lateral wall of axilla
| - near axillary vein
48
Where are the central lymph nodes?
- base of axilla
| - near axillary vein
49
Where are the apical lymph nodes?
- apex (cericoaxillary canal)
| - near axillary vein
50
What innervates the breast?
- intercostal nerves (4-6)
51
How does the breast attach to dermis of overlying skin?
- suspensory ligaments
52
What do the breasts rest on?
- pectoral fascia
53
the breast is a modified _____ gland?
- sweat
54
What drain into lactiferous sinuses which open at nipple?
- lactiferous ducts
55
What converge on the nipple?
- mammary gland lobules
56
What is the darkened skin surrounded the nipple?
- pigmented areola
57
Where does most of the lymph from the breast drain?
- axillary lymph nodes
58
What supplies the breast?
- medial mammary branches
| - lateral mammary branches
59
Where do the medial mammary branches come from?
- from internal thoracic artery (subclavian artery)
60
Where do the lateral mammary branches come from?
- from lateral thoracic artery (from axillary artery)
61
What is the primary venous drainage of the breast?
- mainly to axillary vein via lateral thoracic veins and medial mammary veins via internal thoracic vein
62
Where is some of the drainage of breast?
- internal thoracic vein (and then subclavian) via anterior intercostal veins
63
Where is the lymph drainage of the nipple, areola, and lactiferous lobules?
- subareolar lymph nodes
64
Where does remaining lymph drain?
- parasternal (internal mammary) and abdominal lymph nodes
65
What is polythelia?
- an accessory nipple
66
What is polymastia?
- an accessory breast tissue
67
What does breast elavation during contraction signal?
- advanced cancer
68
What are some refraction signs?
- lymphedema (excess subcutaneous fluid) by blocking lymph flow
- dimpling of the skin of the breast
- edema of skin
69
Can cancer spread to other organs in the body?
- yes
70
Can breast cancer spread to the thoracic, brain, skeletal an cranial structures?
- yes
71
Can breast cancer spread to liver?
- yes
