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Anatomy- Week 15 > Axilla - Diogo > Flashcards

Axilla - Diogo Flashcards

1
Q

Physical examination of a patient with a suspicious breast mass should include careful palpation of lymph nodes in ?

A

both the left and right axillary regions and in both the lower left and lower right regions of the anterior part of the neck

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2
Q

(1) there are palpable lymph nodes in the axilla which filter most of the lymph drained from the _________________,
(2) there are palpable lymph nodes in the lower neck which may filter some of the lymph drained from _______________, and
(3) there are palpable lymph nodes in the axilla and lower neck which may filter a small portion of the lymph drained from ______________

A

lateral half of the ipsilateral breast

the uppermost part of the ipsilateral breast

the contralateral breast

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3
Q

axillary artery

A
  • The axillary artery and axillary vein are the largest blood vessels of the axilla.
  • provide almost all the blood supply to the upper limb
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4
Q

axillary vein

A

The axillary artery and axillary vein are the largest blood vessels of the axilla.

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5
Q

mammary gland of the breast

A

mammary gland is discussed because most of its arterial supply is provided by a branch of the axillary artery and most of its venous and lymphatic drainage is directed toward the axilla

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6
Q

What is the axilla?

A

the pyramid-shaped region spanning the space between the lateral surface of the upper chest wall and the medial region of the upper arm

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7
Q

What forms the border between the neck and the axilla?

A

The lateral border of the 1st rib

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8
Q

What forms the border between the axilla and the arm?

A

The lower border of teres major’s insertion tendon

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9
Q

What is abduction of the arm?

A

(of a muscle) move (a limb or part) away from the midline of the body or from another part.

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10
Q

When the arm is partially abducted, it becomes evident that the axilla has muscle-bearing folds of tissue extending between the upper chest wall and the arm. The anterior fold is called the anterior axillary fold. What forms most of its muscular mass?

A

pectoralis major

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11
Q

What comprises most the muscular mass of the posterior fold also called the posterior axillary fold?

A

latissimus dorsi and teres major

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12
Q

What comprises most the muscular mass of the posterior fold of the axilla also called the posterior axillary fold?

A

latissimus dorsi and teres major

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13
Q

What forms the anterior and posterior borders of the axilla?

A

The anterior and posterior axillary folds respectively

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14
Q

The apex of the heart lies where?

A

Its more pointed apex extends slightly to the left & rests on the diaphragm, approximately at the level of the 5th intercostal space. Apex points downward & is inferior to the base in the chest cavity.

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15
Q

What, upon extending laterally through the root of the neck, passes over the 1st rib, and at the lateral border of the 1st rib, becoming continuous with the axillary artery?

A

subclavian artery

-this relationship between the subclavian and axillary arteries is the same on both sides of the body

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16
Q

Where does the axillary artery begin and end?

A

The axillary artery begins at the lateral border of the 1st rib. Each axillary artery extends distally through the axilla to end at the level of the lower border of teres major’s insertion onto the humerus.

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17
Q

Where does the axillary artery begin and end?

A

The axillary artery begins at the lateral border of the 1st rib. Each axillary artery extends distally through the axilla to end at the level of the lower border of teres major’s insertion onto the humerus.

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18
Q

What is the largest artery of the arm and what becomes continuous with it?

A

brachial artery

-the axillary artery is continuous with the brachial artery

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19
Q

The anterior view of the heart and the aorta as it extends upward from the heart. The short segment of the aorta that extends upward from the heart is called the ascending aorta. The ascending aorta is continuous with the segment of the aorta that, because it arches over the heart, is called the aortic arch.

The aortic arch gives rise to what three relatively large arteries?

A
  • brachiocephalic trunk: extends for a short distance to the lower end of the right side of the neck before dividing into the right common carotid artery and the right subclavian artery
  • left common carotid artery: branches directly from the arch of aorta
  • left subclavian artery: are named for the fact that they lie in the lower end of the neck deep to the clavicles (the lower end of the neck is called the root of the neck)
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20
Q

What are the branches of the subclavian artery? ???????

A
  • subcapsular artery which branches into the circumflex artery
  • supracapsular artery
  • thyrocervical trunk: the major branch
  • dorsal scapular artery
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21
Q

What is the chief source of blood supply to the tissues in the lateral half of the breast and is one of the major anatomical connections between the axilla and the breast?

A

lateral thoracic artery, which is a branch of the axillary artery

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22
Q

branches of the subscapular artery anastomose with (that is, join with) branches of the thyrocervical trunk to form an extensive arterial network around the scapula (the thyrocervical trunk is a major branch of the subclavian artery)

Why is this anastomotic arterial network around the scapula important?

A
  • provides for collateral circulation (that is, parallel routes of circulation) across the shoulder joint whenever an arm movement restricts blood flow through the axillary artery
  • also makes it possible to place (during an operation) a surgical ligature on the subclavian or the axillary artery between the origins of the thyrocervial trunk and the subscapular artery without risking loss of blood supply to the arm, forearm, and hand
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23
Q

What is the chief source of blood supply to the head of the humerus?

A

anterior circumflex humeral artery, a branch of the axillary artery

The axillary artery also gives rise to another circumflex humeral artery called the posterior circumflex humeral artery. The anterior and posterior circumflex humeral arteries curve around opposite sides of the surgical neck of the humerus to form a vascular ring around the surgical neck of the humerus

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24
Q

Where does the axillary vein begin and end? ???????

A

The axillary vein begins at the level of the lower border of teres major’s insertion tendon; in other words, the axillary vein begins at the level where the axillary artery ends.

The axillary vein begins at the union of the basilic vein with the brachial veins. The basilic vein is the major superficial vein on the medial side of the arm. The brachial veins are the pair of veins that lie alongside the brachial artery in the arm. An older name for the paired brachial veins is the venae comitantes of the brachial artery. The term venae comitantes is Latin for ‘accompanying veins.’ In general, the venae comitantes of an artery drain blood from the tissues supplied by the artery. The cephalic vein, which is the major superficial vein on the lateral side of the arm, is the largest vein to join the axillary vein.

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25
Q

The axilla are made by what two folds?

A

anterior axillary fold (pectoralis major m.)

posterior axillary fold (latissimuss dorsi m.)

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26
Q

What are the 3 main branches of the aortic arch?

A 
brachiocephalic trunk 
-branches off going to the limbs (arm)
-branches off going to the head
left common carotid artery 
left subclavian artery
27
Q

The left subclavian artery changes name to what after passing the 1st rib and to what after passing the insertion of the teres major m.?

A

subclavian artery
axillary artery
brachial artery

28
Q

What are the 6 branches of the left subclavian artery?

A
  • superior thoracic artery
  • thoracoacromial trunk
  • lateral thoracic artery (goes to the breast)
  • suprascapular artery which branches into circumflex scapular artery and thoracodorsal artery
  • anterior and posterior circumflex humeral artery
  • deep brachial artery
29
Q

What forms the quadrangular space? Why is it significant?

A

upper part: teres minor m. or scapula
medial part: long head of the triceps
Lower part: teres major m.
lateral part: humerus

It is where the axillary nerve goes through to go from anterior to posterior to innervate the deltoid and teres minor m.

30
Q

What nerve and artery goes through the quadrangular space?

A

axillary nerve

posterior circumflex humeral artery

31
Q

What is the function of the brachial plexus?

A

the brachial plexus is responsible for cutaneous and muscular innervation of the entire upper limb

with two exceptions: the trapezius muscle innervated by the spinal accessory nerve (CN XI) and an area of skin near the axilla innervated by the intercostobrachial nerve.

32
Q

Strands of connective tissue in the interlobar spaces extend from the deep fascia of the chest wall to the dermis of the skin. These strands of connective tissue are called what? They help support the mass of the mammary gland ( keeps the breast lifted up).

A

suspensory ligaments of the breast (cooper’s ligaments:)

33
Q

The mammary glands are located mainly within the superficial fascia of the breasts. The glands are well-developed in the adult female only. In the adult female, the central region of each gland overlies parts of what muscles?

A

pectoralis major m.

serratus anterior m.

34
Q

Each mammary gland consists of 15 to 20 well-developed, radially aligned lobes of glandular tissue. Each lobe is drained by what?

A

a lactiferous duct

35
Q

A prolongation of each mammary gland called the __________ extends superolaterally along the lower border of pectoralis major into the axilla.

A

axillary tail

36
Q

The lactiferous ducts converge upon the_______ and open onto the nipple.

A

areola

The areola is the pigmented, annular area surrounding the nipple.

37
Q

Lobes of grandular tissue in the breast will produce which substance?

A

functional part of breast, allows for milk production

-are arranged in 15-20 lobes radiating in a circle surrounding the nipple draining into the lactiferous ducts

38
Q

How many nerves come from the trunk level and what are they?

A

2

su

39
Q

What is the common function between the levator scapulae and rhomboid minor and major?

A

medial rotation of scapula

adduction of the arm

40
Q

What are the two functions of the serratus anterior m.? What nerve innervates it?

A

protraction of the scapula

pulling the inferior angle of scapula lateral rotation for abduction of the arm

innervated by the long thoracic nerve

41
Q

What is the function of the infraspinatus m. that goes perpendicular to the humerus?

A

lateral rotation of the scapula (one of the rotator cuff muscle)

abduction of the arm (the first 20-30 degrees

42
Q

What is the purpose of the subclavius m. ? What is it innervated by nerve?

A

depression of the clavicle since it is below the clavicle

nerve of subclavius

43
Q

Both the medial and lateral cord are __________to the axillary artery.

A

anterior

44
Q

The medial pectoral nerve and the lateral pectoral nerve innervate which muscle respectively?

A

medial pectoral nerve: both pectoralis major and minor m.

lateral pectoral nerve: pectoralis major

45
Q

What are the 3 functions of pectoral major m. ?

A

flexion
adduction
medial rotation

46
Q

What the functions of the pectoralis minor m. ?

A

depression of scapula

protraction of scapula

47
Q

What are the 3 branches of the posterior cord and what do they innervate?

A

upper subscapular nerve: subscapularis m.
thoracodorsal nerve (middle): latissimuss dorsi
lower subscapular nerve: teres major m. and subscapularis m.

48
Q

What is the common function of the three brothers: teres major m., subscapularis m., and latissimus dorsi m. ?

A

medial rotation of scapula

teres major m.: medial rotation, adduction
subscapularis m.: medial rotation
latissimus dorsi m.: extension adduction, medial rotation

49
Q

The dorsal scapular nerve avoids the scapula by going ________to it.

A

medial

50
Q

The suprascapularis nerve avoids the scapula by going ________to it.

A

above

51
Q

The axillary nerve avoids the scapula by going ________to it.

A

lateral

52
Q

The subscapularis nerve avoids the scapula by going ________to it.

A

below

53
Q

What are the two brother muscle innervated by the axillary nerve?

A

deltoid m.

teres minor m.

54
Q

What artery goes together with the axillary nerve through the quadrangular space?

A

posterior circumflex humeral artery

55
Q

What is function of the teres minor m.?

A

lateral rotation (part of the rotator cuff

56
Q

What is the function of the deltoid m. ?

A

abduction

57
Q

How many nerves do we have at the level of the arm?

A 
4 
median nerve 
ulnar nerve 
radial nerve 
musculocutaneous nerve
58
Q

What are the 3 branches of the aortic arch?

A

brachiocephalic trunk
left common carotid artery
left subclavian artery

59
Q

When does the subclavian artery first change name? After what structure?

A

axillary nerve

after the 1st rib

60
Q

What are the 6 branches of the axillary nerve?

A

Region 1:
-superior thoracic artery

Region 2:
-thyroacromical artery (to thoracic and acromial region)
-lateral thoracic artery: blood
supply to breast

Region 3:

  • subscapular artery that branches to to the circumflex artery and thoracodorsal artery
  • anterior circumflex humeral artery that changes to the posterior circumflex humeral artery
  • deep brachial artery
61
Q

What region does the suprascapular nerve come from?

A

trunk region

62
Q

What are the borders of the quadrangular space?

A

upper: teres minor m.
medial: long head of the triceps
lateral: humerus
lower: teres major m.

63
Q

The nerve goes_______ the ligament and the artery __________goes the ligament.

A

below

above

Anatomy- Week 15 (8 decks)

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