Breast, Axilla, Brachial Plexus 8.22 Flashcards
_ ducts in breast
Approximately 15‐25 ducts converge on the nipple/areolar complex
Retromammary space
Between the breast and the pectoral fascia is a loose connective tissue plane or potential space— the retromammary space. The retromammary space allows some movement of the breast on the thoracic wall
N188
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N190
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Breast Quadrants
• Quadrants used to describe location of pathology in the breast • Any finding (palpable lump, scar, skin discoloration, etc.) is noted on schematic
Lymphatic Drainage in breast
- Initially most lymph drains to subareolar lymphatic plexus 2. Most lymph then drains to pectoral (anterior) nodes of axillary group then central, apical and clavicular nodes, then to main lymphatic trunk to venous system 3. Remaining to parasternal lymph nodes 4. In some cases lymph may drain deeply to abdominal lymph nodes or to the opposite breast
Cooper’s Ligaments
Network of fibrous connective tissue tethers superficial and deep fascial layers and provides support for lobules
Peau d’orange
• Peau d’orange = orange‐colored appearance of breast in inflammatory breast cancer • Due to infiltration of tumor into dermal lymphatics and skin
Common Form of Breast Cancer
Carcinomas of the breast are usually adenocarcinomas arising from epithelial cells of the lactiferous ducts of the mammary gland • Typically spreads by means of lymphatic vessels (may also spread via venous system) • Because most of lymphatic drainage of the breast is to the axillary lymph nodes, they are the most common site of metastasis from a breast cancer • Abundant communications among lymphatic pathways and among axillary, cervical, and parasternal nodes may also cause metastases from the breast to develop in the supraclavicular lymph nodes, the opposite breast, or the abdomen
Parts and Divisions of Axillary Artery
N418
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Veins of Axilla
N416
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Anterior Arm Compartment
Anterior compartment:
Coracobrachialis, Biceps brachii & Brachialis muscles
Posterior Arm Compartment
Posterior compartment:
Triceps brachii & Anconeus mm.
N421
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N422
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N419
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Upper trunk brachial plexus damage
• Upper trunk brachial plexus damage (Erb’s Paralysis, Waiter’s Tip Position). Injuries most commonly result from injuries involving C5 & C6 nerves.
Lower Trunk Brachial Plexus
Lower trunk brachial plexus damage (Klumpke’s Paralysis). The symptoms are due to injuries involving C8 & T1 nerves.
Damage to Long Thoracic Nerve
Lower trunk brachial plexus damage (Klumpke’s Paralysis). The symptoms are due to injuries involving C8 & T1 nerves.
Crutch Palsy
• Crutch palsy. Due to excessive and prolonged pressure on the radial nerve. Symptoms may include loss of extension at elbow and/ or wrist (wrist drop).
