Lecture 4: Breast, Pectoral Region, & Axilla

Question 1

What type of tissue is the breast comprised of? [2]

Answer 1

Glandular & Adipose

Question 2

What are the ligaments in breast? They go to the skin.

Answer 2

Suspensory Ligaments

Question 3

75% of lymphatic drainage goes to the ______________________ in the breast.

Answer 3

axillary lymph node.

Question 4

In the axillary lymph nodes, which node drains most of the breast?

Answer 4

Pectoral

Question 5

What are the 5 axillary lymph nodes (that account for 75% of drainage)?

Answer 5

Pectoral, subscapular, humeral, central, apical

Question 6

The remaining 25% of lymphatic drainage of the breast goes to which lymph nodes?

Answer 6

Parasternal

Question 7

What do lymph nodes do?

Answer 7

Monitor fluid left behind by circulation

Question 8

Why is it important to understand the path of lymph?

Answer 8

Infections and cancers often follow this path

Question 9

What muscles move the upper limb? [3]

Answer 9

Pectoralis Major
Pectoralis Minor
Serratus Anterior

Question 10

What is the action of the pec. major?

Answer 10

Flexes, ADDucts, & medially rotates arm (shoulder)

Question 11

What is the innervation of the pec. major?

Answer 11

Medial and lateral pectoral nn.

Question 12

What is the action of the pectoralis minor?

Answer 12

Protracts & depresses scapula

Question 13

What is the innervation of the pectoralis minor?

Answer 13

Medial pectoral n.

Question 14

What is the action of the serratus anterior?

Answer 14

Protracts & depresses scapula

Question 15

What is the innervation of the serratus anterior?

Answer 15

Long thoracic n.

Question 16

Define intercostal space

Answer 16

The space between 2 ribs

Question 17

How many intercostal spaces are there on ONE side of the body? (both sides = X2)

Answer 17

11 spaces

Question 18

Intercostal muscles are the muscles of…

Answer 18

Respiration

Question 19

List the intercostal muscles from SUPERFICIAL to DEEP

Answer 19

1. External intercostals
2. Internal intercostals
3. Innermost intercostals + Tranversus Thoracis

Question 20

What is the fiber direction of the external intercostal muscles?

Answer 20

Inferiomedially (hands in pocket)

Question 21

What muscles go from the posterior rib to the beginning of the costal cartilage?

Answer 21

External intercostal muscles

Question 22

What is the fiber direction of the internal intercostal muscles?

Answer 22

Inferolaterlaterally (Clutch your pearls)

Question 23

What muscle goes from sternum to angles of rib?

Answer 23

Internal intercostal muscles

Question 24

What muscle is found deep to internal intercostals?

Answer 24

Innermost intercostal muscles

Question 25

Where are the innermost intercostal muscles located?

Answer 25

Lateral sides of the thoracic wall

Question 26

How do we tell the innermost intercostal muscles apart from the internal intercostals?

Answer 26

Nerves and vessels run between the internal and innermost intercostal muscles. `

Question 27

What do you find in the intercostal space?

Answer 27

VAN (vein, artery, nerve)

Question 28

Where do the main vessels & nerve branches run in the intercostal space?

Answer 28

Costal groove (inferior rib)

Question 29

Where do collateral branches of VAN run in the intercostal space?

Answer 29

Superior to the next rib.

Question 30

What are the 3 parts of the sternum?

Answer 30

Manubrium Body Xiphoid process

Question 31

What is the sternal angle?

Answer 31

The horizontal junction between manubrium and body. It is at the level of the 2nd rib (use to help count ribs)

Question 32

What is the "pyramidal" space at the junction of the arm and thorax?

Answer 32

Axilla (armpit)

Question 33

What is the apex, medial wall, lateral wall, and base of the axilla?

Answer 33

Apex: clavicle, scapula, 1st rib Medial: Thoracic cage + serratus anterior Lateral: humerus and muscles Base: skin and fascia

Question 34

What is within the neurovascular bundle of the axilla?

Answer 34

Axillary Artery Axillary Vein Brachial Plexus

Question 35

Subclavian artery --> (1) ---> Brachial artery

Answer 35

1: Axillary artery

Question 36

When does the subclavian artery become the axillary artery?

Answer 36

Lateral 1st rib

Question 37

When does the axillary artery become the brachial artery?

Answer 37

Inferior teres major

Question 38

What muscle divides the axillary artery into 3 parts?

Answer 38

Pectoralis major

Question 39

What is the first branch of the axillary artery?

Answer 39

Superior (supreme) thoracic artery

Question 40

What is the second branch of the axillary artery?

Answer 40

Thoracoacromial Artery Lateral Thoracic artery

Question 41

What is the third branch of the axillary artery?

Answer 41

Subscapular A Anterior Humeral Circumflex A Posterior Humeral Circumflex A

Question 42

What does subscapular A branch into?

Answer 42

Circumflex Scaupular A Thoracodosral A

Question 43

What does the subscapular A. anastomose with?

Answer 43

Suprascapular and dorsal scapular A.

Question 44

What is the path of axillary lymph nodes? [5]

Answer 44

1. Subscapular 2. Pectoral 3. Lateral 4. Central 5. Apical

Question 45

What are the roots of the brachial plexus?

Answer 45

C5-T1

Question 46

The brachial plexus divides into ________ & __________ divisions.

Answer 46

Anterior & Posterior

Question 47

The anterior and posterior divisions of the brachial plexus are both from __________ rami.

Answer 47

Anterior

Question 48

What is the composition or "breakdown" of the brachial plexus?

Answer 48

Roots (rami) - 5 Trunks - 3 Divisions - 2 Cords - 3 Branches (terminal) "Randy Travis Drinks Cold Beer"

Question 49

Where are the brachial plexus roots found?

Answer 49

Between anterior and middle scalenes

Question 50

What nerves come of the roots of the brachial plexus ?

Answer 50

Long thoracic and dorsal scapular nerves

Question 51

What are the trunks of the brachial plexus?

Answer 51

Superior, Middle, and Inferior

Question 52

What roots make up the superior trunk of the brachial plexus?

Answer 52

C5 & C6

Question 53

What roots make up the middle trunk of the brachial plexus?

Answer 53

C7

Question 54

What roots make up the inferior trunk of the brachial plexus?

Answer 54

C8-T1

Question 55

What nerve comes off the trunks of brachial plexus?

Answer 55

Suprascapular n.

Question 56

What are the divisions of the brachial plexus?

Answer 56

Anterior and Posterior

Question 57

What is the lateral cord of the brachial plexus?

Answer 57

Anterior divisions of superior and middle trunks

Question 58

What is the medial cord of the brachial plexus?

Answer 58

The anterior division of the inferior trunk

Question 59

What is the posterior cord of the brachial plexus?

Answer 59

ALL posterior divisions.

Question 60

What branches come off the lateral cord of the brachial plexus?

Answer 60

Lateral pectoral n.

Question 61

What branches come off the posterior cord of the brachial plexus?

Answer 61

Upper subscapular Thoracodorsal (middle subscapular) Lower subscapular

Question 62

What branches come off the medial cord of the brachial plexus?

Answer 62

Medial pectoral n. Medial cutaneous n. of arm Medial cutaneous n. of forearm

Question 63

What are the terminal branches of the brachial plexus?

Answer 63

Axillary N Musculocutaneous N Radial N Median N Ulnar N

Question 64

What does the axillary nerve innervate?

Answer 64

Deltoid Teres Minor Skin on upper lateral arm

Question 65

What does the median nerve innervate?

Answer 65

Most anterior forearm (flexor) muscles Skin and a few muscles of the hand

Question 66

What does the musculocutaneous nerve innervate?

Answer 66

Anterior arm (flexor) muscles Skin on lateral forearm

Question 67

What does the radial nerve innervate?

Answer 67

Posterior arm muscles Posterior forearm muscles Skin on lateral arm Skin on posterior arm Skin on posteriore forearm Skin on part of hand

Question 68

What does the ulnar nerve innervate?

Answer 68

Most hand muscles 1 & 1/2 muscles in forarm Skin on part of hand