Thorax: Breast Flashcards
(53 cards)
1
Q
Anterior Axillary Line
A
- Vertical line through anterior axillary fold
2
Q
Posterior Axillary Line
A
- Vertical line through posterior axillary fold
3
Q
Midaxillary Line
A
- Vertical line midway between the anterior and posterior axillary lines
4
Q
Anterior Median Line
A
- Vertical line down the midline
5
Q
Midclavicular Lines
A
- Parasagittal vertical lines through midpoint of the clavicle
6
Q
Breast
A
- Accessory reproductive organ
- Glandular tissue embedded in fat (connective tissue)
- Located in the superficial fascia
- Anterior to deep fascia
- Located from mid-axillary line to sternum, ribs 2-6
- Axillary process (tail of Spence)
7
Q
Areola
A
- Pigmented area of skin
8
Q
Montgomery Tubercles
A
- Sebaceous glands located in areola
9
Q
Nipple
A
- Lacks hair, fat, and sweat glands
- Smooth muscle
- Fissured by lactiferous duct openings
10
Q
Retromammary Space
A
- Between the superficial and deep fascia
- Allows for breast movement on pectoral fascia
11
Q
Glandular Tissue
A
- 15-20 lobes of glandular tissue (parenchyma of the breast)
- Each lobe contains 20-40 terminal ductal lobular units
12
Q
Terminal Ductal Lobular Unit (TDLU)
A
- Each lobe drained by a lactiferous duct
- Supported by suspensory ligaments (of Cooper)
- Form fibrous septa, anchored to skin and deep fascia
13
Q
Lactiferous Sinus
A
- Dilated portion of duct
14
Q
Parenchyma
A
- Refers to functional tissue of an organ (breast in this case)
15
Q
Medial Breast Arterial Supply
A
- Perforating branches of internal thoracic artery (medial mammary arteries)
16
Q
Lateral Breast Arterial Supply
A
- Superior thoracic artery (lateral mammary arteries)
- Lateral thoracic artery (lateral mammary arteries)
- Pectoral branch of thoracoacromial artery
17
Q
Anterior and Posterior Intercostal Arteries
A
- Mammary branches
18
Q
Cutaneous Innervation of Breast
A
- 2nd – 6th Intercostal nerves
- Lateral & anterior branches
- Nipple is supplied by 4th intercostal nerve (ventral ramus of T4)
19
Q
Lymph Nodes of the Breast
A
- Axillary lymph nodes
- Anterior (pectoral) nodes
- Posterior (subscapular) nodes
- Central nodes
- Apical nodes
- Parasternal nodes
- Interpectoral nodes
20
Q
Axillary Lymph Nodes
A
- Anterior (pectoral) nodes
- Posterior (subscapular) nodes
- Central nodes
- Apical nodes
21
Q
Lymph Drainage
A
- Axillary pathway: 75% of lymph
- Axillary nodes (anterior axillary nodes)
- Can bypass the axillary nodes and drain directly - Internal thoracic pathway(mammary) to the parasternal lymph nodes
- Can communicate with lymph vessels of the opposite breast - Retropectoral and Transpectoral pathways
- Subdiaphragmatic pathway
22
Q
Tumors
A
- Can invade through retromammary space and deep fascia
- Breast fixation
23
Q
Shortened Suspensory Ligaments
A
- Skin dimpling and nipple retraction
24
Q
Pectoral Fascia
A
- Covers anterior and posterior of pectoralis major
becomes axillary fascia (floor of axilla)
25
Clavipectoral Fascia
- Attaches to clavicle
- Envelopes subclavius and pectoralis minor muscles - Pierced by cephalic vein, thoracoacromial artery, lateral pectoral nerve
- Called suspensory ligament of axilla below pec minor
- Connects to and supports axillary fascia
26
Anterior Axio-Appendicular Muscles
- Connect the pectoral girdle and humerus to the axial skeleton
- Primarily function in moving the pectoral girdle and humerus
27
Move the Pectoral Girdle and Humerus
- Pectoralis major
- Pectoralis minor
- Subclavius
- Serratus anterior
28
Pectoralis Major
- 2 heads
| - Forms anterior axillary fold
29
Proximal Attachment of Pectoralis Major
- Medial ½ clavicle, anterior sternum, upper 6 costal cartilages, aponeurosis of external oblique muscle
30
Distal Attachment of Pectoralis Major
- Lateral lip of intertubercular sulcus
31
Pectoralis Major Innervation
- Lateral and medial pectoral nerves
32
Pectoralis Major Function
- Adduct, medial rotation, flexion and extension of humerus
33
Aponeurosis
- Flat tendon that part of the muscle attaches to
34
Flexion vs. Extension
- Muscle can act both ways depending on body position in gravity
35
Pectoralis Minor
- Deep to pec major
- Important landmark (axillary artery, brachial plexus)
- Subcoracoid space
36
Subcoracoid Space
- Brachial plexus, axillary vessels
37
Proximal Attachment of Pectoralis Minor
- Ribs 3-5
38
Distal Attachment of Pectoralis Minor
- Coracoid process
39
Pectoralis Minor Innervation
- Medial pectoral nerve
40
Function of Pectoralis Minor
- Stabilize scapula, pulls against thoracic wall (lateral angle moves inferiorly)
- Accessory muscle of respiration
41
Proximal Attachment of Subclavius
- 1st rib/costal cartilage jxn
42
Distal Attachment of Subclavius
- Inferior, middle 1/3 of clavicle
43
Innervation of Subclavius
- Nerve to subclavius
44
Function of Subclavius
- Stabilize SC joint, depress clavicle
45
Serratus Anterior
- Boxer’s muscle
| - Scapula protractor
46
Proxima Attachment of Serratus Anterior
- Lateral aspect of ribs 1-8 (9)
47
Distal Attachment of Serratus Anterior
- Anterior surface of medial scapular border
48
Innervation of Serratus Anterior
- Long thoracic nerve
49
Function of Serratus Anterior
- Scapular protraction and rotation, stabilizes against thorax
50
Long Thoracic Nerve Injury
- Branch of the brachial plexus
- This nerve has a superficial location
- Injured in: mastectomy, knife injury, chest tube
51
Causes of Long Thoracic Nerve Injuries
- Weakness or paralysis of serratus anterior
52
Effects of Long Thoracic Nerve Injuries
- Winging of the scapula
| - Difficulty with arm elevation (abduction)
53
Winging of Scapula
- Medial border of scapula will no longer be against thorax and will stick out toward the back
