Breast and Lymphatic System Flashcards
where is the breast in relation to the deep and superficial fascia
inside of superficial fascia, separated from deep fascia by retromammary space
where is the breast in relation to the retromammary space
anterior to it
why is venous drainage of the breast by posterior intercostal veins clinically significant in the case of cancer
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
does the breast normally move when the patent contracts the pecs? when does it move?
does not move with pectoralis major contraction
moves if there is a tumor which creates adhesions between the breast and the pectoralis fascia
what is the mammary ridge and what forms it
aka milk line
runs from axilla to groin and then disappears everywhere except the breasts
lymph drains from the body via what ducts and where do they drain
right thoracic duct and the thoracic duct
both ducts return via the intersection of the jugular and subclavian veins
where is the breast
lateral sternal boarder to mid axillary line laterally
ribs 2-6 vertically
what is the most prominent area of the breast
nipple
where is the nipple
ICS 4- only in young women and children
what is the darker area around the nipple
aerola
what is in the aerola
sebaceous glands that secrete a lubricant that protects the nipple during breast feeding
what are the 3 components of the breast
glandular tissue
fibrous tissue
adipose
what is the purpose of glandular tissue
milk production
what is the purpose of fibrous tissue
support of the breast via suspensory ligaments of cooper
what happens with the presence of a carcinoma in the breast
tumor puts tension on the suspensory ligaments of cooper, causing dimpling of the skin
where is the fibrous tissue most developed
superiorly
what is the purpose of adipose
shape and contour of the breast
what muscles are posterior to the breast
2/3 over the pectoralis major
1/3 over serratus anterior
what is the axillary tail
extension in upper outer quadrant that extends toward the axilla
why is the axillary tail significant
swells during menstration
what is the retromammary space
potential space between the breast and pectoralis fascia
contains fat that allows for movement of the breast over the pectoralis major
what are the components of the mammary gland
lobules
lactiferous ducts
lactiferous sinuses
smooth muscle
what are lobules
where milk production occurs
15-20 per breast
what are lactiferous ducts
drainage routes from the lobules to the nipple
what are lactiferous sinuses
pouches in the lactiferous ducts that stores milk for the initial release when suckling begins
where is smooth muscle
around lactiferous ducts, contracts during nipple stimulation which produces erect nipples
what is the path of arterial supply to the breast
subclavian–>axillary–>thoracoacromial and lateral thoracic
what arteries originate medially to supply the breast
perforating branches from the internal thoracic artery
medial mammary branches of 2-4 perforating branches
what arteries originate laterally to supply the breast
lateral thoracic
pectoral branches of thoracoacromial trunk
what arteries originate posteriorly to supply the breast
posterior intercostal
what is the main venous drainage of the breast
axillary vein, but some to internal thoracic vein and posterior intercostal veins
what provides innervation to the breast
anteiror and lateral cutaneous branches of intercostal nerves 2-6
what information do the nerves that innervate the breast carry
sensory fibers to the skin
sympathetic fibers to smooth muscle over the skin and nipple as well as blood vessels
what is polymastia
extra breast- rare
what is polythelia
extra nipple- must be along milk line
what is gynecomastia
breast development in males
what causes gynecomastia
usually during puberty
also change in liver sex hormone metabolism, aging, and cancer treatments
what organs do not have lymph vessels/nodes
CNS
eyes
nails/teeth
bone and marrow
what is lymphogenesis
metastasis of cancer cells via lymphatics
what are the functions of the lymphatic system
drain interstitial fluid back to circulatory system
lacteals absorb and transfer fat to the venous system
defense mechanism against foreign substances (filtering and lymphocytes)
what is a lymphatic plexus
network of lymphatic capillaries in the intercellular spaces
what are lymphatics
network of vessels coming from the lymphatic plexuses
what are lymph nodes
enlargements along lymphatic vessels that filter
what are lymphocytes
immune cells
what are lymphoid organs
wall of alimentary canal
spleen
thymus
tonsils
what are the 4 rules of lymphatic drainage
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
path of lymphatic system
interstitial fluid-> lymphatic plexus-> afferent lymphatic vessel -> lymph node-> efferent lymphatic vessel->lymphatic trunk-> lymphatic ducts-> venous system
what are the lymphatic trunks and what do they drain
subclavian- upper limb
jugular- head/neck
brachiomediastinal- thoracic region
what are the lymphatic ducts and what do they drain
right thoracic duct- RUQ
thoracic duct- everything else
where do the lymphatic ducts drain
intersection of the jugular and subclavian veins
left lung drainage
lower lobe of left lung drains to the right side
what is the lateral lymphatic drainage path of the right breast
axillary nodes–> calvicular nodes-> right subclavian trunk->right lymphatic duct
what is the medial lymphatic drainage path of the right breast
parasternal nodes-> right bronchiomediastinal trunk–>right lymphatic duct
where does the inferior lymphatic drainage of the right breast go
abdominal nodes
what is lymphedema
swelling due to excess fluid caused by a blockage in the lymphatic system preventing drainage
usually in upper or lower limbs
what is lymphangitis
inflammation of lymph vessel due to injury or infection
vessels may appear as red streaks in the skin
what is lymphadenitis
inflammation of a lymph node due to injury or infection
