A8 Pectoral and Breast

Question 1

sections of chest, reference points

Answer 1

Anterior median (midsternal line)

mid clavicular line

posterior axillary line

Mid axillary line

Anterior axillary line

Question 2

pectoral girdle

Answer 2

clavicle and scapula

sternoclavicular joint articulation between upper extremity and axial skeleton
-adds mobility

Question 3

Pars of the “sternum

Answer 3

Manubrium

Sternum

Body

Xiphoid

Question 4

clavicle and break

Answer 4

trapezius cannot support lateral fragment: shoulder drop

lateral fragment pulled medially by pectoraliz major

medial fragment elevated by sternocleidomastoid

Question 5

corocoid process

Answer 5

anterior facing scapula ridge

Question 6

humeral morphology

Answer 6

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?

Question 7

Pectoral associated fascia

Answer 7

pectoral fascia

clavipectoral Fascia (envelopes pectoralis minor)

Question 8

axioappendicular muscles (anterior)

Answer 8

pectoralis major

pectoralis minor

subclavius

serratus anterior

Question 9

pectoralis major

Answer 9

PA: Clavicle and sternum
DA: lateral lip of intertubercular sulcus of humerus
ACT: adduction medial rotation of humerus
Inn: lateral and medial pectoral nerves

Question 10

pectoralis minor

Answer 10

PA: ribs 3-5
DA: coracoid process of scapula
ACT: Istabilize scapula, project upper limb forward while reaching
Inn: Medial pectoral Nerve

Question 11

deltopectoral groove

Answer 11

between deltoid and pectoralis major, contains thoraco-acromial artery and cephalic vein

possible to palpate the coracoid process in deltopectoral triangle

Question 12

Structures that pierce clavipectoral fascia

Answer 12

thoracoacromial artery
cephalic vein
lateral pectoral N
medial pectoral nerve (inferior to lateral)

Question 13

subclavius

Answer 13

helps clavicle resist dislocation at ac joint

PA: rib 1
DA: inf surface of clavicle
ACT: stabilize, depress clavicle
InnL nerve to subclavius

Question 14

serratus anterior

Answer 14

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)

Question 15

axillary artery

Answer 15

divided by pectoralis minor into three parts

superior thoracic artery

thoracoacromial artery

• pectoral branch
• clavicular branch
• acromial branch
• deltoid branch

lateral thoracic artery

Question 16

Cephalic Vein

Answer 16

drains upper limbs, combines with axillary vien (larger, more inferior) and becomes subclavian vein

Question 17

lymphatic drainage

Answer 17

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

Question 18

brachial Plexus

Answer 18

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

Question 19

Breast

Answer 19

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

Question 20

suspensory ligaments (of cooper)

Answer 20

ligaments that make sections in breast tissue, firmly attached to overlying dermis

Question 21

Breast Fat and within)

Answer 21

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

Question 22

quadrants

Answer 22

clinical descriptions

clock face

uppler inner (medial superior)
lower, outer etc....

Question 23

blood supply

Answer 23

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

Question 24

nodes associated with veins

Answer 24

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