Breast, thorax, lungs Flashcards
Nipple anatomy
Has multiple lactiferous ducts for each lobe (15-20)
Areola has sebaceous glands
Accessory nipples will be along “milk line” - shoulder to groin
Gross anatomy of breast
Within superficial fascia (on top of pectoralis muscle)
Retromammary space allows for movement (and implants)
Divided into quadrants (upper vs lower, inner vs outer)
Axillary tail has normal glandular tissue
Glandular organization of breast
Alveoli -> lobules -> lobes (15-20 per breast)
Each lobe has separate lactiferous duct
Supported by suspensory ligaments to dermis and adipose tissue
Vasculature of breast
Internal thoracic
Axillary artery
Intercostal arteries
Lymphatic drainage of breast
Primarily to axillary nodes
Medial lobes to parasternal and even across midline
Occassionally to supracervical and abdominal
External anatomy of thorax
Clavicle (SC and AC joint)
Manubrium with jugular/suprasternal notch
Angle of Louis/sternal angle to body
Xiphoid process at inferior end of sternum
Costal cartilage to ribs
Coracoid process of scapula visible
Intercostal space
Three layers of muscles: External, internal, innermost
Vein, artery, nerve (VAN) just under inferior border of rib
Smaller VAN bundle at superior border of rib
Vasculature of ribcage
Posterior intercostals directly from thoracic aorta
Subclavian arteries -> internal thoracic arteries -> anterior intercostal arteries
Internal thoracics terminate at superior epigastric and musculophrenic
Anterior and posterior intercostals form anastamoses
Veins similar - posterior to azygous or anterior to internal thoracic
Innervation of ribcage
Ventral ramus -> intercostal nerves
Innervation of muscles (mostly for expiration) and cutaneous sensory
Gross anatomy of thorax
Superior to superior thoracic aperture (clavicle, first rib)
Inferior border is diaphragm
Two pleural cavities on sides (lungs only)
Mediastinum in middle, contains everything else
Pleura anatomy
Visceral covers lung
Parietal on outside (costal or diaphragmatic)
Simple squamous epithelia with small amount of serous fluid in interpleural space (no air!)
Reflection = folds back (ie costal -> diaphragmatic)
Recess = parietal pleura against itself (ie at bases past lung)
Develop from “fist in the balloon”
Gross anatomy of lungs
Right - three lobes - upper (horizontal fissure) middle (oblique fissure) lower
- middle lobe is only inferior medial area
Left - two lobes - upper (oblique fissure) lower
Lower borders of lung, pleura
Lung - ribs 6 (midclavicular), 8 (midaxillary), 10 (posterior)
Pleura - ribs 8, 10, 12
Respiratory tree
Trachea branches at carina -> Main bronchi -> Lobar bronchi -> Segmental bronchi Right main stem bronchus is most vertical (ie choking)
Vasculature of lungs
Pulmonary arteries travel with bronchi
Pulmonary veins travel between segments
Smaller bronchial arteries have oxygenated blood
Lymphatic drainage of lungs
All towards hilum
- > bronchopulmonary nodes
- > tracheobronchial nodes
Movement of ribcage
Inspiration from flattening of diaphragm (small contribution of intercostals) Expiration passive (elasticity of lungs), can be forced with abdominals and intercostals
