Pectoral Region, Axilla and Intro to Lymphatics

Question 1

What are the bones of the pectoral girdle?

Answer 1

Clavicle and the scapula

Question 2

The clavicle attaches to what?

Answer 2

The manubrium on the sternum

Question 3

How does the clavicle act as a strut?

Answer 3

To hold the arm away and transmit force from the upper limb to the axial skeleton

Question 4

1) The clavicle 2/3 medially is what?

Answer 4

Convex

Question 5

2) The clavicle 1/3 laterally is what?

Answer 5

Concave

Question 6

3) Where are the common breaks of the clavicle?

Answer 6

In the body between the convex and concave portions

Question 7

4) The axilla is what?

Answer 7

A pyramidal space between arm and the thorax that is the passageway for vessels and nerves between the root of the neck and upper limb.

Question 8

5) What does the apex of the axilla include?

Answer 8

a. Upper border of the scapula, b. Lateral border of the 1 rib, c. Clavicle

Question 9

6) What is the base of the axilla?

Answer 9

Skin between anterior fold and posterior folds of axilla

Question 10

7) What 3 muscles make up the anterior wall of the axilla?

Answer 10

a. Pectoralis major, b. Pectoralis minor, c. Subclavius

Question 11

8) What is the origin of pectoralis major?

Answer 11

Upper 6 costal cartilages, b. Sternum, c. Clavicle

Question 12

9) Where does pectoralis major insert?

Answer 12

Pectoralis major inserts the lateral portion of the bicipital groove of the humerus

Question 13

10) What nerves innervate pectoralis major?

Answer 13

Lateral and medical pectoral nerves from the brachial plexus

Question 14

11) What is the action of pectoralis major?

Answer 14

a. Adduct, b. Flex, c. Medially rotate the arm at the shoulder joint

Question 15

12) What divides pectoralis major from the deltoid muscle? Where?

Answer 15

Cephalic vein in the deltopectoral triangle

Question 16

13) What is the origin for pectoralis minor?

Answer 16

ribs 3, 4, and 5

Question 17

14) Where does pectoralis minor insert

Answer 17

medial side of coracoid process

Question 18

15) Pectoralis minor What is it innervated by

Answer 18

Pectoralis minor is innervated by medial pectoral nerve

Question 19

16) What is the action of pectoralis minor?

Answer 19

Depresses the shoulder

Question 20

17) Where does the subclavius originate?

Answer 20

1st costal cartilage

Question 21

18) Where does the subclavius insert?

Answer 21

the inferior surface of the clavicle

Question 22

19) What is the action of subclavius?

Answer 22

Depresses the clavicle

Question 23

20) What nerve innervates it?

Answer 23

Nerve to subclavius

Question 24

21) What surrounds and covers the subclavius and pectoralis minor?

Answer 24

Clavipectoral fascia

Question 25

22) What is in the clavipectoral fascia?

Answer 25

Cephalic vein, lateral pectoral nerve, thoracoacromial artery and lymphatic vessels

Question 26

23) What is clavipectoral fascia continuous with?

Answer 26

Suspensory ligament

Question 27

24) What is the medial wall of the axilla made of?

Answer 27

a. Upper 4-5 ribs and intercostals spaces, b. Serratus Anterior

Question 28

25) Where does serratus anterior originate from?

Answer 28

Originates from upper 8 ribs

Question 29

26) Where does it insert?

Answer 29

Serratus anterior inserts on the anterior surface of the medial border

Question 30

27) What innervates it?

Answer 30

Long thoracic nerve (on the anterior surface)

Question 31

28) If long thoracic nerve is damaged what results?

Answer 31

Winged scapula

Question 32

29) What is the action of serratus anterior?

Answer 32

Proctract the scapula

Question 33

30) What is on the lateral wall of the axilla?

Answer 33

a. Biceps brachii, b. Humerus, c. Coracobrachialis

Question 34

31) What is on the posterior wall of the axilla?

Answer 34

a. Latissimus dorsi, b. Teres major, c. Subscapularis, d. Proximal long head of triceps brachii

Question 35

32) What is the action of the first three muscles?

Answer 35

Medially rotate the arm

Question 36

33) What nerves innervates teres major?

Answer 36

Lower subscapular nerve

Question 37

34) What nerve innervates subscapularis?

Answer 37

Lower and Upper subscapular nerves

Question 38

35) What nerve innervates latissiumus dorsi?

Answer 38

Thoracodorsal nerve

Question 39

36) What are the contents of the axilla?

Answer 39

Axillary artery, axillary vein, Brachial plexus, lymphatic vessels and nodes, axillary fat

Question 40

37) What are the branches of the axillary artery?

Answer 40

HoTeL SAP 1 part a. Highest thoracic artery, 2 part b. Thoracoacromial Trunk, c. Lateral thoracic artery 3 part c. Subscapular Artery, d. Posterior Circumflex, e. Anterior Circumflex

Question 41

38) What else comes off of the subscapular artery?

Answer 41

a. Circumflex scapular artery and b. Thoracodorsal artery

Question 42

39) The brachial plexus is formed by what spinal nerves?

Answer 42

C5 through T1

Question 43

40) What does it do?

Answer 43

Gives sensory innervation and motor innervation to upper limb

Question 44

41) Lymphatic trunks from the body form 2 major lymph systems. Where does the thoracic duct drain?

Answer 44

It drains to the internal jugular vein and then left subclavian vein. 3/4 of the body (LEFT)

Question 45

42) Upper right?

Answer 45

drains into right lymphatic duct into BRACHIOCEPHALIC VEIN

Question 46

43) The pectoral lymph nodes are where?

Answer 46

along the border of pectoralis minor. They drain lateral quadrants of breast and anterolateral abdominal wall above umbilicus

Question 47

44) What lymph nodes are next superiorly?

Answer 47

Subscapular

Question 48

45) Where are Subscapular lymph nodes?

Answer 48

Lymph nodes are on the subscapularis muscles. Drains superficial back down to iliac crest

Question 49

46) What is next?

Answer 49

Lateral lymph nodes

Question 50

47) Where are they?

Answer 50

Along axillary vein, drains most of the upper limb

Question 51

48) Which lymph nodes are next?

Answer 51

Central nodes

Question 52

49) Where are they?

Answer 52

Center of axillary fat and collect pectoral, subscapular, and lateral lymph node

Question 53

50) What is next?

Answer 53

Infraclavicular nodes

Question 54

51) Where are they?

Answer 54

In deltopectoral triangle and drain lateral part of upper limb

Question 55

52) Whats next?

Answer 55

Apical

Question 56

53) Where are they and what do the drain into?

Answer 56

Receive lymph from all above groups and drain into SUBCLAVIAN TRUNK and then go to lymphatic trunk or thoracic duct

Question 57

54) Where is the adult female breast?

Answer 57

lateral to sternum and in between ribs 2 and 6

Question 58

55) What kind of gland is the breast?

Answer 58

Exocrine gland

Question 59

56) How many lobes are in the mammary gland?

Answer 59

15 to 20 lobes

Question 60

57) What are they drained by?

Answer 60

separate mammary duct

Question 61

58) A masectomy is what?

Answer 61

Removal of the breast

Question 62

59) What may be damaged in a masectomy?

Answer 62

Brachial plexus

Question 63

60) Removal of lymph nodes in a masectomy could do what?

Answer 63

Cause an edema or build up of lymph. Cause drainage problem of upper limb through axilla.

Question 64

61) What separates the gland from the deep fascia?

Answer 64

Connective tissue septa

Question 65

62) Each gland with the lobes and their separate ducts drain into what?

Answer 65

lactiferous ducts and then expands near the nipple (lactiferous sinus) and then drains onto the surface

Question 66

63) What is under the deep fascia?

Answer 66

Muscle called retromammary space

Question 67

64) What is the arterial supply of the breast?

Answer 67

internal thoracic artery, intercostals arteries, thoracoacromial trunk and lateral throracic artery

Question 68

65) Lymphatic drainage of the breast?

Answer 68

The medial quadrants drain to parasternal nodes | The lateral quadrants drain to the pectoral and axillary nodes

Question 69

66) Where is cancer more frequent?

Answer 69

Cancer is more frequent in lateral nodes