PRELIMS: THORAX - REGIONAL ANATOMY (PECTORAL REGION) Flashcards by Jacqueline Ritualo

The region external to the anterior thoracic wall and helps anchor the upper limb to the trunk.

PECTORAL REGION

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What are the components of the pectoral region

~SUPERFICIAL COMPARTMENT

~DEEP COMPARTMENT

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The compartment that consists of the skin, superficial fascia, and breasts

SUPERFICIAL FASCIA

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The compartment that consists of the muscles and associated structures

DEEP FASCIA

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Structures that emerge from the thoracic wall, axilla, and neck

~NERVES
~VESSELS
~LYMPHATICS
FROM THE SUPERFICIAL COMPARTMENTS

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Components of breast

~MAMMARY GLANDS
~ASSOCIATED SKIN
~CONNECTIVE TISSUES

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Modified sweat glands in the superficial fascia anterior to the pectoral muscle and anterior thoracic wall
Consist of a series of ducts and associated secretory lobules

MAMMARY GLANDS

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Mammary glands converge to form this

It also open independently into the nipple

15 TO 20 LACTIFEROUS DUCTS

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The nipple is surrounded by a circular pigmented area that is called what?

AREOLA

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Well developed structure that surrounds the ducts and lobules of the mammary gland

CONNECTIVE TISSUE STROMA

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A well defined ligament that is formed by condensed connective tissue stroma that is continuous with the dermis of the skin and supports the breast.

SUSPENSORY LIGAMENTS OF BREAST

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Creates tension on ligaments that causes pitting of the skin

CARCINOMA OF THE BREAST

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What is the predominant component of breast in nonlactating women

FAT

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What is the predominant component of breast in lactating women

GLANDULAR TISSUE

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Lies on the deep fascia related to the pectoralis major muscle and the other surrounding muscle

BREAST

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A layer of loose connective tissue that separates the breast from the deep fascia and provides some degree of movement over underlying structures

RETROMAMMARY SPACE

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How does the base, or the attached surface of each breast extends?

VERTICALLY= FROM RIBS 2 TO 6
TRANSVERSELY= FROM STERNUM TO MIDAXILLARY LINE

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TRUE OR FALSE:
The breasts is related to the thoracic wall and to structures associated with the upper limb which means that vascular supply and drainage can occur by multiple routes

TRUE

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The vascular supply and drainage that occurs laterally

VESSELS FROM THE AXILLARY ARTERY
~SUPERIOR THORACIC
~THORACO-ACROMIAL
~LATERAL THORACIC
~SUB-SCAPULAR ARTERIES

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The vascular supply and drainage that occurs medially

BRANCHES FROM THE INTERNAL THORACIC ARTERY

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Where does the vascular and drainage supply happen for the 2nd to 4th intercostal arteries?

BRANCHES THAT PERFORATES THE THORACIC WALL AND OVERLYING MUSCLE

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The veins that drains the breast is parallel to the arteries and then drains into the axillary, internal thoracic, and intercostal veins

STATEMENT TO REMEMBER FOR THE VENOUS DRAINAGE OF THE PECTORAL REGION

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Where is the breast innervated?

VIA ANTERIOR AND LATERAL CUTANEOUS BRANCHES OF THE 2ND TO 6TH INTERCOSTAL NERVES

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What innervates the nipples

4TH INTERCOSTAL NERVES

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75% of the Lymphatic drainage that drains laterally and superiorly into axillary nodes

LYMPHATIC VESSELS

TRUE OR FALSE Most of the remaining drainage happens into the parasternal nodes deep to the anterior thoracic wall and associated with the internal thoracic artery

TRUE

TRUE OR FALSE Some drainage may occur via lymphatic vessels that follow the lateral branches of posterior intercostal arteries and connect with intercostal nodes situated near the heads and necks of ribs

TRUE

Nodes that drain into the subclavian trunk.

AXILLARY NODES

Nodes that drain into the bronchomediastinal trunks

PARASTERNAL NODES

Nodes that drains into the thoracic duct or bronchomediastinal trunks

INTERCOSTAL NODES

Describe the breast in men

RUDIMENTARY AND CONSISTS ONLY OF SMALL DUCTS AND CORDSOF CELLS THAT DOES NOT NORMALLY EXTEND BEYOND THE AREOLA

YES OR NO: | Can breast cancer occur in men

YES

One of the most common malignancies in women that develops in the cell of acini, lactiferous ducts and lobules of the breast

BREAST CANCER

Depends on the exact cellular site of the origin of cancer

TUMOR GROWTH AND SPREAD

Factors that affects the response to surgery

~CHEMOTHERAPY | RADIOTHERAPY

Spreads via the lymphatics and veins or by direct invasion

BREAST TUMOR

How is the diagnosis of breast cancer confirmed

BIOPSY AND HISTOLOGICAL EVALUATION

Steps in staging the tumors

1. size of primary tumor 2. exact site of primary tumor 3. number and sites of lymph node spread 4. organs to which thetumor may have spread

A procedure that may be carried out to look for any spread to the lungs, liver, or bones

COMPUTED TOMOGRAPHY SCANNING OF THE BODY

Tumor spread to the lungs

PULMONARY METASTASES

Tumor spread in the liver

HEPATIC METASTASES

Tumor spread in the bone

BONY METASTASES

Further imaging that uses radioactive isotopes that is avidly taken up by tumor metastases in bone

BONE SCANNING

A procedure that can visualize active foci of the metastatic disease in the body

PET-CT

TRUE OR FALSE: | Lymph drainage of the breast is complex

TRUE

Where does lymph vessels pass through

IT PASSES THROUGHAXILLARY, SUPERCLAVICULAR, AND PARASTERNAL NODES AND MAY EVEN PASS TO ABDOMINAL LYMPHNODES, AS WELL AS TO THE OPPOSITE BREAST.

TRUE OR FALSE: Containment of nodal metastatic breast cancer is potentially difficult because it can spread through many lymph node groups

TRUE

What does the subcutaneous lymphatic obstruction and growth pull on that results in peau d'orange on the surface of the breast

CONNECTIVE TISSUE LIGAMENTTS IN THE BREAST

Further subcutaneous spread of tumor can induce a rare manifestation of breast cancer that produces a hard, woody texture to the skin called what?

CANCER EN CUIRASSE

a surgical procedure that involves the excision of breast tissue

MASTECTOMY

Damage to this nerve can result in paralysis of the serratus anterior muscle, producing a "winged" scapula

THORACIC NERVE

What are the 3 muscles of the pectoral region

~PECTORALIS MAJOR ~PECTORALIS MINOR ~SUBCLAVIUS

Where does the muscles of the pectoral region originate from?

FROM THE ANTERIOR THORACIC WALL AND INSERT INTO BONES OF THE UPPER LIMB

What is the largest and most superficial muscle of the pectoral region muscles? It also has a broad origin that includes the anterior surfaces of the medial half of the clavicle, sternum, and related costal cartilages.

PECTORALIS MAJOR

The pectoralis major directly underlies this structure which is separated by the deep fascia and the loose connective tissue of the retromammary space

BREAST

What are the origin of the pectoralis major?

~MEDIAL HALF OF THE CLAVICLE AND ANTERIORSURFACE OF THE STERNUM ~FIRST SEVEN COSTAL CARTILAGES ~APONEUROSIS OF EXTERNAL OBLIQUE

What are the insertion of the Pectoralis major

~LATERAL LIP OF INTERTUBERCULAR SULCUS OF HUMERUS

What are the innervations of the Pectoralis major

~MEDIAL PECTORAL NERVES | ~LATERAL PECTORAL NERVES

What are the functions of the Pectoralis major?

~ADDUCTION ~MEDIAL ROTATION ~FLEXION OF THE HUMERUS AT THE SHOULDER JOINT IT ALSO ADDUCTS, FLEXES, AND MEDIALLY ROTATES THE ARM

What are the origin of the subclavius?

RIB 1 AT THE JUNCTION BETWEEN RIB AND COSTAL CARTILAGE

What are the insertion of the subclavius?

GROOVE ON THE INFERIOR SURFACE OF MIDDLE THIRD OF CLAVICLE

What are the innervations of the subclavius?

NERVE TO SUBCLAVIUS

What are the functions of the subclavius?

~PULLS THE CLAVICLE MEDIALLY TO STABILIZE STERNOCLAVIVULAR JOINT ~DEPRESSES TIP OF SHOULDER

What are the origin of the pectoralis minor?

~ANTERIORSURFACE OF THE 3RD, 4TH, AND 5TH RIBS | ~DEEP FASCIA OVERLYING THE RELATED INTERCOSTAL SPACES

What are the insertion of the pectoralis minor?

CORACOID PROCESS OF THE SCAPULA

What are the innervations of pectoralis minor?

MEDIAL PECTORAL NERVES

What are the functions of the pectoralis minor?

~DEPRESSES THE TIP OF THE SHOULDER | ~PROTRACTS THE SCAPULA

Muscle fibers converge to form what structures that inserts into the lateral lip of the intertubercular sulcus of the humerus?

FLAT TENDON

What are the Muscles of the pectoral region that lies under the pectoralis major that pulls the tip of the shoulder inferiorly?

~SUBCLAVIUS | ~PECTORALIS MINOR

A small muscle that passes laterally from the anterior and medial part of rib 1 to the inferior surface of the clavicle

SUBCLAVIUS

A muscle that passes from the anterior surfaces of rib 3 to 5 to the coracoid process of the scapula

PECTORALIS MINOR

A continuous layer of deep fascia that encloses the subclavius and the pectoralis minor and attaches to the clavicle above and to the floor of the axilla below

CLAVIPECTORAL FASCIA

What forms the anterior wall of the axilla?

MUSCLES OF PECTORAL REGION

A region between the upper limb and the neck through which all major structures pass

ANTERIOR WALL OF AXILLA

PRELIMS: THORAX - REGIONAL ANATOMY (PECTORAL REGION) Flashcards

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