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Skin MS: Week 2 > Anatomy (Breast, Pectoral - 11/2) > Flashcards

Anatomy (Breast, Pectoral - 11/2) Flashcards

1
Q

Location of Nipple

A

Mammary papilla (nipple) is just below center of gland at approximately the 4th intercostal space

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2
Q

Axillary Tail

A

Superolateral part frequently projects toward axilla as an axillary tail (of Spence) in relation to pectoralis major muscle and pectoral axillary lymph nodes

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3
Q

Suspensory Ligaments of Breast

A

Run from dermis of skin, vertically through gland to deepest part of superficial fascia. The ligaments are well developed over upper breast.

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4
Q

Nipple

A

skin wrinkled; contains smooth muscle fibers that contract on tactile stimulation inducing firmness and prominence.

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5
Q

Areolar glands

A

sebaceous glands - enlarge in pregnancy and secrete an oily substance to provide a protective lubricant for areola and nipple. Respond to estrogen. Produce little irregularities or small projections in areolae.

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6
Q

Blood supply to Mammary Glands

A

Axillary artery - branches include the superior thoracic, pectoral branch of thoracoacromial, and LATERAL THORACIC (major supply to breasts) arteries Intercostal arteries - cutaneous branches in 3rd to 5th spaces Internal thoracic artery - perforating branches in 2nd to 4th interspaces (AKA internal mammary - outdated)

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7
Q

Blood from Mammary Glands – veins

A

form anastomotic circle around papilla. Branches pass peripherally from this to axillary, internal thoracic, lateral thoracic, and upper intercostal veins.

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8
Q

Nerves of Mammary Glands

A

from anterior and lateral cutaneous branches T2-6 intercostal nerves

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9
Q

Lymphatic Drainage of Mammary Glands

A

Principal drainage - lymph follows the lactiferous ducts to the areola where a subareolar plexus is found. From here, lymph drains by two trunks into the pectoral group of axillary nodes. Secondary drainage - From medial side of gland to parasternal nodes. Some cross to opposite gland. - From upper gland to apical axillary nodes or to supraclavicular nodes. - From lower gland, vessels pass to abdominal lymph nodes (subdiaphragmatic nodes).

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10
Q

Clinical Changes in Breast (Pregnancy, menstruation, aging)

A

Branching of lactiferous ducts - occur during menstrual cycle, pregnancy Pregnancy - breasts ready for milk secretion by mid-pregnancy but do not secrete milk until after parturition, may secrete colostrum (rich in protein, immune agents, growth factors) at end of pregnancy/beginning of nursing If multiple pregnancies - breasts may become large/pendulous Older women - atrophy of glandular tissue and decrease in fat

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11
Q

Breast Quadrants

A

Superolateral/medial and Inferolater/medial + Clock references

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12
Q

Carcinoma of the Breast (Clinical Signs & Prevalence)

A

Usually adenocarcinoma, may block/interfere with lymph nodes –> edema. Edema may cause dimpling of pores, swelling of skin. Tumor may cause CT degeneration/fibrosis –> dimpling/inversion of nipple. Most common form of cancer in women.

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13
Q

Carcinoma of the Breast (Metastasis)

A

Via veins and lymphatic channels as well as along fibrous tissue to deeper structures. Most commonly to axillary nodes (also supra/infraclavicular, abdomen, brain/vertebrae)

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14
Q

Mammography & Mastectomy

A

Mammography = radiography of breast, cancer appears dark, skin thickened over tumor, nipple depressed Simple mastectomy = breast is removed down to the retromammary space Radical mastectomy = remove the primary tumor, underlying fascia, pectoral muscles, and axillary lymph nodes (most common site of metastases). Lumpectomy/Quadrantectomy = remove the tumor only (more common now).

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15
Q

Polymastia, Polythelia, Amastia

A

Polymastia - supernumerary breast Polythelia - supernumerary nipple Anywhere along mammary crest (from axilla to groin - from development), may develop to be noticeable with pregnancy Amastia - no development of breast. May be nipple/areola, but no glandular tissue.

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16
Q

Gynecomastia

A

Breast hypertrophy in males (after puberty) - rare - age/drug related, hormone imbalance - may be a symptom of something else (i.e. suprarenal cancer, testicular cancer) - XXY (Klinefelter) 40% have gynecomastia

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17
Q

3 parts of sternum

A

Manubrium, body, xiphoid process

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18
Q

Joint between manubrium & sternal body

A

sternal angle, manubriosternal joint (fibrous)

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19
Q

Joint between body and xiphoid process

A

xiphisternal joint (fibrous)

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20
Q

First rib attached to _____ (ant)

A

Manubrium

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21
Q

Second rib attached to _____ (pos)

A

Sternal angle

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22
Q

Costal margin

A

inferior surface of rib cage (ribs 7-10)

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23
Q

Head of humerus - Scapula

A

Glenoid fossa

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24
Q

Muscle in subscapular fossa

A

subscapularis (rotator cuff)

25
Q

Rotator cuff muscles

A

Subscapularis, teres minor, infrascapularis, suprascapularis

26
Q

3 muscles attach to coracoid process

A

Pectoralis minor, coracobrachialis, short head biceps brachii

27
Q

Supraglenoid tubercle = attachment site for _____

A

Long head biceps brachii

28
Q

Infraglenoid tubercle = attachment site for _______

A

Long head triceps brachii

29
Q

Anatomical neck of humerus

A

Site of epiphyseal plate, attachment for joint capsule

30
Q

Greater tubercle (attachments)

A

Supraspinatus, infraspinatus, teres minor (3 of 4 muscles of rotator cuff)

31
Q

Subscapular muscle attaches to _____

A

Lesser tubercle of humerus

32
Q

Intertubercular groove holds _______

A

Long head of biceps

33
Q

Cephalic vein pathway

A

Tributaries from hand –> lateral side of forearm/arm –> between deltoid/pec major –> deltopectoral triangle —> deep to connect with axillary vein

34
Q

Deltoid attachments, innervation, function

A

Origin: Spine of scapula, acromion, lateral third of clavicle Attach: Deltoid tubercle Nerve: Axillary Nerve Function: Medially rotate, flex arm, abduct arm, laterally rotate, extend arm

35
Q

Pectoralis major

A

Origin: Medial two-thirds clavicle, sternum, anterior surface ribs Attach: humerus lateral to intertubular sulcus Nerve: Medial, lateral pectoral nerves Function: medially rotate, adduct arm (Flex, extend arm)

36
Q

Pectoralis minor/major muscle innervation and nerve origin

A

Pec major - medial and lateral pectoral nerves Pec minor - medial pectoral nerve Lateral pectoral nerve is found medial to the pectoralis minor muscle and originates from the lateral cord of the brachial plexus. The medial pectoral nerve pierces the pectoralis minor which it innervates and continues to the pectoralis major which it also innervates. The medial pectoral nerve originates from the medial cord of the brachial plexus.

37
Q

Clavipectoral Fascia

A

Extends from clavicle to axillary fascia, encircles pectoralis minor muscle Lower part = suspensory ligament Continuous with axillary fascia

38
Q

Sternoclavicular joint

A

Between sternum and clavicles Supported by SC ligaments Divided by articular disc

39
Q

Interclavicular ligament

A

between clavicles

40
Q

Most frequent sites for venipuncture

A

median cubital or basilic veins

41
Q

What stimulates areolar glands?

A

Estrogen

42
Q

Major blood supply to breast

A

Lateral thoracic (off of axillary artery)

43
Q

Principal drainage of lymph (breast)

A

Follow lactiferous ducts to areola - subareolar plexus –> pectoral group of axillary nodes

44
Q

What nerve is important to be preserved in mastectomy?

A

Long thoracic nerve (Serratus anterior - winged scapula)

45
Q

What serves as arbitrary landmark for 3 parts of axillary artery?

A

Pectoralis Minor

46
Q

Subclavius muscle

A

small Lies inferior and slightly posterior to clavicle serves as splint for clavicle fractures protect underlying axillary vessels + brachial plexus

47
Q

Common site of clavicle fractures

A

Junction of middle and outer thirds Distal fragment displaced inferiorly w/ weight of UE

48
Q

What muscles serve to medially rotate and adduct UE?

A

Pectoralis major (also Latissimus dorsi)

49
Q

Pectoralis Minor

A

Nerve supply: Medial Pectoral Nerve Action: Stabilize scapula by drawing inferiorly and anteriorly against thoracic wall Attaches to ribs and corocoid process (of scapula)

50
Q

Serratus Anterior

A

External surface of lateral parts of 1st-8th ribs —> anterior medial border of scapula Long thoracic nerve Protract scapula, hold against thoracic wall, rotate scapula (upwardly)

51
Q

Axillary fascia

A

Pec major to latissimus dorsi, arching inward to form hollow of armpit Continuous with fascia covering muscles bounding axilla

52
Q

Axillary sheath

A

Surrounds brachial plexus + axillary artery Axillary vein NOT in sheath

53
Q

What is axillary artery continuation of/continue onto?

A

Subclavian artery until 1st rib –> axillary artery (6 branches, 3 parts) –> brachial artery at inferior portion teres major

54
Q

Muscles that attach to corocoid process

A

pectoralis minor, coracobrachialis and the short head of the biceps brachii.

55
Q

Supraglenoid and infraglenoid tubercles are where ____ and ____ attach

A

The supraglenoid tubercle serves as the attachment site for the long head of the biceps brachii, while the infraglenoid tubercle is the attachment site for the long head of the triceps brachii.

56
Q

What attaches to greater tubercle of humerus?

A

supraspinatus, infraspinatus, teres minor muscles of the rotator cuff.

57
Q

What attaches to lesser tubercle of humerus?

A

Subscapularis

58
Q

What is in intertubercular groove?

A

Tendon of long head of biceps

59
Q
A

Skin MS: Week 2 (12 decks)

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