A8 Pectoral and Breast Flashcards
sections of chest, reference points
Anterior median (midsternal line)
mid clavicular line
posterior axillary line
Mid axillary line
Anterior axillary line
pectoral girdle
clavicle and scapula
sternoclavicular joint articulation between upper extremity and axial skeleton
-adds mobility
Pars of the “sternum
Manubrium
Sternum
Body
Xiphoid
clavicle and break
trapezius cannot support lateral fragment: shoulder drop
lateral fragment pulled medially by pectoraliz major
medial fragment elevated by sternocleidomastoid
corocoid process
anterior facing scapula ridge
humeral morphology
Greater and lesser tubercles
anatomical neck
surgical neck
lateral lip of the interrubercular groove
intertubercular (bicipital) groove
medial lip of the intertubercular groove
grooves facing anteriorly?
Pectoral associated fascia
pectoral fascia
clavipectoral Fascia (envelopes pectoralis minor)
axioappendicular muscles (anterior)
pectoralis major
pectoralis minor
subclavius
serratus anterior
pectoralis major
PA: Clavicle and sternum
DA: lateral lip of intertubercular sulcus of humerus
ACT: adduction medial rotation of humerus
Inn: lateral and medial pectoral nerves
pectoralis minor
PA: ribs 3-5
DA: coracoid process of scapula
ACT: Istabilize scapula, project upper limb forward while reaching
Inn: Medial pectoral Nerve
deltopectoral groove
between deltoid and pectoralis major, contains thoraco-acromial artery and cephalic vein
possible to palpate the coracoid process in deltopectoral triangle
Structures that pierce clavipectoral fascia
thoracoacromial artery
cephalic vein
lateral pectoral N
medial pectoral nerve (inferior to lateral)
subclavius
helps clavicle resist dislocation at ac joint
PA: rib 1
DA: inf surface of clavicle
ACT: stabilize, depress clavicle
InnL nerve to subclavius
serratus anterior
PA ribs 1-8
DA: medial border of scapula
ACT: protraction and upward rotation of scapula
Inn: long thoracic nerve (runs straight down over serratus
lesion of long thoracic nerve paralyses serratus, pulled back scapula (medially)
axillary artery
divided by pectoralis minor into three parts
superior thoracic artery
thoracoacromial artery
- pectoral branch
- clavicular branch
- acromial branch
- deltoid branch
lateral thoracic artery
Cephalic Vein
drains upper limbs, combines with axillary vien (larger, more inferior) and becomes subclavian vein
lymphatic drainage
Superclavicular lymph nodes
-infraclavicular lymph nodes (axilarry vein)
axillary lymph nodes:
- humeral (lateral)
- central
- apical
- subscapular (posterior)
- pectoral (anterior)
Parasternal lymph nodes
drain map: most outer: humoral nodes and pectoral nodes and subscapular nodes
all drain to the central nodes
then to the apical nodes
tehn to the supraclavicular nodes
then to subclavian lymphatic trunk
brachial Plexus
nerves of the upper extremity
Usually a conglomeration of nerves called cords, and off cords, tou have two nerves that innervate the pectoral mucles, named based on how they emerge not how they are anatomically located
lateral pectoral nerve
medial pectoral nerve
long thoracic nerve
nerve to subclavius
Breast
overlies pectoral fascia and serratus anterior muscle
extends mediolaterally fromt hel ateral border of the sternum to midaxillary line and vertically from 2d to 6th rib.
marray gland lobules
15-20 to drain lactiferous ducts
lactiferous sinses
Retromammary space (key to cancer can cause two sides to fuse), right anterior to pectoral fascia
-separates breast from pectoraliz major
breast IN superficial fascia
movement of breast with contraction of the PM may indicate metastasis
axillary tail, extension of breast tissue into axilla
suspensory ligaments (of cooper)
ligaments that make sections in breast tissue, firmly attached to overlying dermis
Breast Fat and within)
mammary glands
- modified sweat glads
- enlarge at puberty/lactation
lactiferous ducts with sinuses
-common concer origin
Poers
Fibrous connective tissue:
-septate fat, glands
suspensory ligaments
Breast tumors can place traction on suspensory ligaments causing dimpling
quadrants
clinical descriptions
clock face
uppler inner (medial superior) lower, outer etc....
blood supply
thoracoacromial artery- lateral thoracic artery- lateral mammary br.
internal thoracic artery - medial mammary ( from sternum side)
Veins
lateral mammary - lateral thoracic - axillary - subclavian
perforating br - internal thoracic - subclavian
nodes associated with veins
contral nodes, subscapular and pectoral wis where 75% of lymph especially from lateral compartemnts via pectoral notes
subclavicular lymph nodes very litte direct breast lymph but considere sentinel noes
-allows you to predict metastasis
