- Synarthrotic joint formed by the articulation of the manubrium and the body of the sternum - Also known as transverse thoracic plane Palpable clinical landmark in surface anatomy.

- Superficial vein of UE - Ascends into SC tissue - Goes up lateral border of wrist + anterolateral surface of forearm + arm - Passes between deltoid + pectoralis muscles - Enters clavipectoral triangle - Pierces costocoracoid membrane (part of clavipectoral fascia) - Enters axillary vein

- Ducts that converge + form branched system connecting the nipple to the lobules of the mammary gland - Move milk to nipple by smooth muscle contractions along the ductal system

Pectoral Region, Breast, Axilla Flashcards by Mary Nguyen

Jugular notch

Notch in between the elevated sternal ends

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Clavicle

Elongated, S-shaped bone that rests horizontally at the sternum across the upper part of the ribcage and the acromial end of the scapula

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Sternal angle

Synarthrotic joint formed by the articulation of the manubrium and the body of the sternum
Also known as transverse thoracic plane

*Palpable clinical landmark in surface anatomy.

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Sternum

Long flat bone over central chest

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Xiphoid process

Smallest, most inferior part of sternum

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Scapula

Triangle-shaped shoulder blade

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Acromion process

Bony process of the scapula that extends laterally over the shoulder joint

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Coracoid process

Small hook-like structure on the lateral edge of the superior anterior portion of the scapula

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Medial pectoral nerve(s)

Supplies:
- Pectoralis minor + pectoralis minor

Origin:
- Medial cord

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Lateral pectoral nerve(s)

Supplies:
- Pectoralis major

Origin:
- Lateral cord of brachial plexus

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Anterior cutaneous nerves

Superior neurovasculature supplying skin/cutaneous aspects anteriorly
*changes planes

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What does the thoracoacromial artery supply?

Supplies:

Deltoid
Pectoralis major
Pectoralis minor
Subclavius

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Cephalic vein

Superficial vein of UE
Ascends into SC tissue
Goes up lateral border of wrist + anterolateral surface of forearm + arm
Passes between deltoid + pectoralis muscles
Enters clavipectoral triangle
Pierces costocoracoid membrane (part of clavipectoral fascia)
Enters axillary vein

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Subclavian vein

Right below subclavius muscle

*Brachial vein –> axillary vein (at inferior teres major border) –> subclavian vein (at lateral part of 1st rib)

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Subclavius (origin + insertion)

Origin:
Junction + costocartilage of 1st rib

Insertion:
Inferior surface of mid third of clavicle

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Nipple

Protuberance of breast through which lacteriferous ducts open

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Areola

Circular pigmented area surrounding the nipple

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Lactiferous ducts

Ducts that converge + form branched system connecting the nipple to the lobules of the mammary gland
Move milk to nipple by smooth muscle contractions along the ductal system

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Pectoralis fascia

Thin lamina covering the surface of pectoralis major

- Attachment to front of sternum, to the clavicle, + is continuous with fascia of the shoulder, axilla, + thorax

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What is the retromammary space?

Loose connective tissue plane between breast + pectoral fascia
Allows for mobility of breast

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What would a tumor in the retromammary space typically present as?

Immobility of the breast

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Suspensory (Cooper’s) ligaments (of breast)

Firmly attach mammary glands to dermis of overlying skin
Help support mammary gland lobules
Prevent breast from sagging

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Axillary process (tail) of breast

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Extension of mammary gland in the superolateral quadrant

Breast cancer is most common in which quadrant?

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Upper outer (left or right)

What symptom presents when breast cancer interferes with the dermal lymphatics?

- Lymphedema in skin of breast

What is the most common site of metastasis in breast cancer?

Axillary lymph nodes

Orange-peel appearance of breast

Results from puffy skin between dimpled pores of breast in inflammatory breast cancer

Name common changes in appearance of breast due to presence of cancer

- Skin dimpling/retraction - Orange-peel appearance - Nipple retraction/deviation - Abnormal contours

Mammary glands are what type of glands?

Modified sweat glands (apocrine)

Lactiferous sinus

Dilated area of the duct just deep to the areola

Terminal duct lobular unit (TDLU)

- Basic functional unit of breast | - Is the lobule

Polymastia

Supernumerary breast appearing as rudimentary nipple with underlying glandular tissue along milk line

Mammary ridges (milk lines)

- Origin of breast development - Along either side of the body from axilla to inguinal canal - Site of polythelia & polymastia

Polythelia

Supernumerary nipples (mistaken for moles)

Where does most lymphatic drainage of the breast go?

Most to axillary lymph nodes (75%)

Where does most breast lymph first drain to?

Pectoral (anterior) nodes

Where does lymph from medial breast typically drain to?

Parasternal lymph nodes or to opposite breast

Arterial supply of the breast

- Internal mammary artery (IMA) | - Lateral thoracic artery

Mediolateral oblique (MLO) view

- Superior top | - Inferior bottom

Craniocaudal (CC) view

- Lateral top | - Medial bottom

Pectoralis major (origin + insertion)

Origin: - Clavicular head: Anterior surface of medial 1/2 of clavicle - Sternocostal head: Anterior surface of sternum, costal cartilages 2-6, aponeurosis of external abdominal oblique muscle Insertion: - Lateral lip of intertubercular groove of the humerus

Pectoralis major (function + innervation)

Function: - Flex arm - ADduct arm - Medial rotation of arm (in climbing, draws body upward) Innervation: - Lateral pectoral nerve - Medial pectoral nerve (C8, T1)

Pectoralis minor (origin + insertion)

Origin: - Anterior aspect of the 3rd, 4th, and 5th ribs Insertion: - Coracoid process of the scapula

Pectoralis minor (function + innervation)

Function: - Protract scapula Innervation: - Medial pectoral nerve (C8, T1)

Where is a pacemaker typically inserted?

- Infraclavicular area parallel to middle 1/3 of clavicle | - Subcutaneous pocket typically superficial to pectoralis major

Bony boundaries of axillary apex (cervicoaxillary canal)

- Clavicle (ant) - Superior border of scapula (post) - Lateral border of 1st rib (medial)

Boundaries of axillary fossa

- P. major, p. minor, clavipectoral fascia (ant) - Scapula, subscapularis, t. major, lat. dorsi (post) - Ribs 1-4, Intercostal muscles, serratus anterior (medial)

Where does the subclavian artery become the axillary artery?

Lateral border of 1st rib

Where does the axillary artery become the brachial artery?

Inferior border of teres major muscle

Name the branches of the axillary artery

First: - Superior thoracic artery Second: - Thoraco-acromial - Lateral thoracic artery Third: - Subscapular - Anterior circumflex humeral - Posterior circumflex humeral

What muscles does the axillary artery pass posterior to?

Pectoralis minor

What are the four branch of the thoraco-acromial artery?

1) Clavicular 2) Acromial 3) Deltoid 4) Pectoral *Cadavers Are Dead People

How many lobes does the typical inactive adult mammary gland have?

15-20

Common sites of breast implant placement

- Subglandular position (on surface of the muscle but behind the gland) - Sub muscular positon (behind Pectoralis major attachment is attached - Bi plane implantation (below pectoralis major muscle but also in plane with the superficial fascia)

What incisions can be made for breast implant placement?

- Periareolar - Inferior mammary fold (IMF) - Transaxillary

What are the cells inside of mammary glands?

- Glandular cuboidal cells (produce milk) - Myoepithelial cells (can contract and squeeze aveoli) - Stromal cells (plasma produces IgA)

What 2 nerves does the subscapular nerve branch into?

- Thoracodorsal | - Circumflex scapular

Pectoral Region, Breast, Axilla Flashcards

(57 cards)