Breast/Thoracic Wall/Lungs Flashcards
Pectoralis Major
Lateral innervation
C5-7 (lateral pectoral nerve)
Pectoralis Major
Medial innervation
C8 and T1 (medial pectoral nerve)
Pectoralis Major
Origin
Clavicular and sternocostal heads
Pectoralis Major
Insertion
The crest of the greater tubercle (humerous)
Pectoralis Major
Movement
Upper arm:
Flexion (upper fibers better)
Adduct
Internal rotaion (horizontal flexion)
Can also extend with flexed elbow (lower fibers)
Pectoralis Major
Blood supply
Internal thoracic
lateral thoracic
intercostal
Pectoral branches of thoracoacromial trunk
Pectoralis minor
Origin
Ribs 3-5
Pectoralis minor
Insertion
Medial border of the coracoid process
Pectoralis minor
Innervation
Medial (C8 and T1)
Pectoral nerve
Pectoralis minor
Movement
Stabilizes scapula
Elevates rib cage
Where does the interal thoracic artery originate and what are its branches?
The subclavian arteries give rise to the internal thoracic arteries.
The internal thoracic arteries give rise to the anterior intercostal arteries before dividing into the epigastric and musculophrenic arteries inferiorly
What does the musculophrenic artery arise from and what does it divide into?
Arises from the interal thoracic artery and gives rise to anterior intercostal arteries 6-9
What artery supplies the rectus abdominus?
The epigastric artery (from internal thoracic)
Where is the neurovascular bunds of the ribs located?
The NV bundles runs along the inferior edges of the upper ribs
Serratus anterior
Origin and insertion
Origin - upper borders of ribs 1-8
Insertion - medial scapula
Serratus anterior
Innervation
Long thoracic nerve (C5-7)
Damage to this nerve creates winging of the scapula
What is the functional tissue of the breast?
Glandular lobules
Drain into lactiferous ducts
What gives rise to the dimpling (orange peel appearance of breast)
Glandular tumor of the breast pulling/pushing on the Cooper’s (suspensory) ligaments
Breast
Blood supply
Medial mammory - internal thoracic
Thoracoacromial trunck -pectoral branches supply upper middle
Later - lateral thoracic (mainly supply serratus anterior)
also intercostals
Breast
Lymph node levels
Phrenic nerve (C3,4, and 5)
Somatic motor nerve to skeletal muscle
Where does the diaphragm receive its sensory nerve supply?
Diaphragmatic and medistinal pleura, and pericardial sac
Where does the inferior vena cava cross the diagphragm?
TV 8 through the central tendon
Where does the esophagus cross the diaphragm?
TV 10 through the esophageal hiatus
Vagal trunks tavel through diaphragm with esophagus
Where does the descending aorta cross the diaphragm?
TV 12 through the aortic hiatus
Thoracic duct also travels with aorta
Pain from the organs
sympathetic
Where is the horizontal fissue?
Right lung
Midclavicular line at rib 4
Where is the oblique fissue of the right lung?
The midclavicular line at rib 6
Where does fluid collect in the thorax?
The costodiaphragmatic recess
What anatomical feature marks the bottom of the lungs?
Rib 6 - Anteriorly
Rib 8 - Laterally
Rib 10 - Posteriorly
Always a two rib difference between parietal lining and base of lung (pleura is found two ribs lower)
What is the parietal pleura innervated by?
Intercostal nerves
What is the mediastinal and diaphragmatic pleura innervated by?
The phrenic nerve
VATE as it applies to right lung
Structure of the left lung
Where does the thoracic duct terminate?
The left venous angle
Subclavius muscle
Origin and insertion
Origin - rib 1 near costal cartilage
Insertion - Clavicle (deep)
Subclavius muscle
Innervation
Nerve to subclavius (C5 and 6)
Subclavius muscle
Movement
Depress shoulder and lateral clavicle
What is the only intercostal muscle that elevates ribs for expiration?
The external intercostal
Where doe the posterior intercostal arterites arise?
The descending aorta (form anastomoses with anterior intercostal arteries)
SALT
Serratus
Anterior
Long Thoracic (nerve)
or
Lateral Thoracic (artery)
What gives rise to the lateral thoracic artery?
The axillary artery
True ribs
Ribs 1-7 (attach to the sternum)
False ribs
Ribs 8-10 (attach to the costal cartilage above)
Floating ribs
Ribs 11 and 12
What lymph nodes associate with the axillary tail of Spence?
Level I lymph nodes along the pectoral vein and pectoralis major draining the anterior thoracic wall and most of breast.
What vein do level I lymph nodes associate with?
The axillary vein (drains deep structures of the upper limbs)
