Breast and Lymphatic System

Question 1

where is the breast in relation to the deep and superficial fascia

Answer 1

inside of superficial fascia, separated from deep fascia by retromammary space

Question 2

where is the breast in relation to the retromammary space

Answer 2

anterior to it

Question 3

why is venous drainage of the breast by posterior intercostal veins clinically significant in the case of cancer

Answer 3

the posterior intercostal drain into the azygous system which in in contact with the internal vertebral venous plexus around the spinal cord which creates a metastasis route to the brain

Question 4

does the breast normally move when the patent contracts the pecs? when does it move?

Answer 4

does not move with pectoralis major contraction

moves if there is a tumor which creates adhesions between the breast and the pectoralis fascia

Question 5

what is the mammary ridge and what forms it

Answer 5

aka milk line

runs from axilla to groin and then disappears everywhere except the breasts

Question 6

lymph drains from the body via what ducts and where do they drain

Answer 6

right thoracic duct and the thoracic duct

both ducts return via the intersection of the jugular and subclavian veins

Question 7

where is the breast

Answer 7

lateral sternal boarder to mid axillary line laterally

ribs 2-6 vertically

Question 8

what is the most prominent area of the breast

Answer 8

nipple

Question 9

where is the nipple

Answer 9

ICS 4- only in young women and children

Question 10

what is the darker area around the nipple

Answer 10

aerola

Question 11

what is in the aerola

Answer 11

sebaceous glands that secrete a lubricant that protects the nipple during breast feeding

Question 12

what are the 3 components of the breast

Answer 12

glandular tissue
fibrous tissue
adipose

Question 13

what is the purpose of glandular tissue

Answer 13

milk production

Question 14

what is the purpose of fibrous tissue

Answer 14

support of the breast via suspensory ligaments of cooper

Question 15

what happens with the presence of a carcinoma in the breast

Answer 15

tumor puts tension on the suspensory ligaments of cooper, causing dimpling of the skin

Question 16

where is the fibrous tissue most developed

Answer 16

superiorly

Question 17

what is the purpose of adipose

Answer 17

shape and contour of the breast

Question 18

what muscles are posterior to the breast

Answer 18

2/3 over the pectoralis major

1/3 over serratus anterior

Question 19

what is the axillary tail

Answer 19

extension in upper outer quadrant that extends toward the axilla

Question 20

why is the axillary tail significant

Answer 20

swells during menstration

Question 21

what is the retromammary space

Answer 21

potential space between the breast and pectoralis fascia

contains fat that allows for movement of the breast over the pectoralis major

Question 22

what are the components of the mammary gland

Answer 22

lobules
lactiferous ducts
lactiferous sinuses
smooth muscle

Question 23

what are lobules

Answer 23

where milk production occurs

15-20 per breast

Question 24

what are lactiferous ducts

Answer 24

drainage routes from the lobules to the nipple

Question 25

what are lactiferous sinuses

Answer 25

pouches in the lactiferous ducts that stores milk for the initial release when suckling begins

Question 26

where is smooth muscle

Answer 26

around lactiferous ducts, contracts during nipple stimulation which produces erect nipples

Question 27

what is the path of arterial supply to the breast

Answer 27

subclavian-->axillary-->thoracoacromial and lateral thoracic

Question 28

what arteries originate medially to supply the breast

Answer 28

perforating branches from the internal thoracic artery | medial mammary branches of 2-4 perforating branches

Question 29

what arteries originate laterally to supply the breast

Answer 29

lateral thoracic | pectoral branches of thoracoacromial trunk

Question 30

what arteries originate posteriorly to supply the breast

Answer 30

posterior intercostal

Question 31

what is the main venous drainage of the breast

Answer 31

axillary vein, but some to internal thoracic vein and posterior intercostal veins

Question 32

what provides innervation to the breast

Answer 32

anteiror and lateral cutaneous branches of intercostal nerves 2-6

Question 33

what information do the nerves that innervate the breast carry

Answer 33

sensory fibers to the skin | sympathetic fibers to smooth muscle over the skin and nipple as well as blood vessels

Question 34

what is polymastia

Answer 34

extra breast- rare

Question 35

what is polythelia

Answer 35

extra nipple- must be along milk line

Question 36

what is gynecomastia

Answer 36

breast development in males

Question 37

what causes gynecomastia

Answer 37

usually during puberty | also change in liver sex hormone metabolism, aging, and cancer treatments

Question 38

what organs do not have lymph vessels/nodes

Answer 38

CNS eyes nails/teeth bone and marrow

Question 39

what is lymphogenesis

Answer 39

metastasis of cancer cells via lymphatics

Question 40

what are the functions of the lymphatic system

Answer 40

drain interstitial fluid back to circulatory system lacteals absorb and transfer fat to the venous system defense mechanism against foreign substances (filtering and lymphocytes)

Question 41

what is a lymphatic plexus

Answer 41

network of lymphatic capillaries in the intercellular spaces

Question 42

what are lymphatics

Answer 42

network of vessels coming from the lymphatic plexuses

Question 43

what are lymph nodes

Answer 43

enlargements along lymphatic vessels that filter

Question 44

what are lymphocytes

Answer 44

immune cells

Question 45

what are lymphoid organs

Answer 45

wall of alimentary canal spleen thymus tonsils

Question 46

what are the 4 rules of lymphatic drainage

Answer 46

drains opposite arterial supply, same as venous filtered through at least 1 lymph node set before returning travels from superficial nodes to deeper ones node groups are named according to- position, region, organs, or blood vessels

Question 47

path of lymphatic system

Answer 47

interstitial fluid-> lymphatic plexus-> afferent lymphatic vessel -> lymph node-> efferent lymphatic vessel->lymphatic trunk-> lymphatic ducts-> venous system

Question 48

what are the lymphatic trunks and what do they drain

Answer 48

subclavian- upper limb jugular- head/neck brachiomediastinal- thoracic region

Question 49

what are the lymphatic ducts and what do they drain

Answer 49

right thoracic duct- RUQ | thoracic duct- everything else

Question 50

where do the lymphatic ducts drain

Answer 50

intersection of the jugular and subclavian veins

Question 51

left lung drainage

Answer 51

lower lobe of left lung drains to the right side

Question 52

what is the lateral lymphatic drainage path of the right breast

Answer 52

axillary nodes--> calvicular nodes-> right subclavian trunk->right lymphatic duct

Question 53

what is the medial lymphatic drainage path of the right breast

Answer 53

parasternal nodes-> right bronchiomediastinal trunk-->right lymphatic duct

Question 54

where does the inferior lymphatic drainage of the right breast go

Answer 54

abdominal nodes

Question 55

what is lymphedema

Answer 55

swelling due to excess fluid caused by a blockage in the lymphatic system preventing drainage usually in upper or lower limbs

Question 56

what is lymphangitis

Answer 56

inflammation of lymph vessel due to injury or infection | vessels may appear as red streaks in the skin

Question 57

what is lymphadenitis

Answer 57

inflammation of a lymph node due to injury or infection