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CVR > CVR 3 > Flashcards

CVR 3 Flashcards

1
Q

Is the breast always subcutaneous

A

no the axillary tail goes deeper

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2
Q

What runs in the deltopectoral groove

A

the cephalic vein

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3
Q

What are the suspensory ligaments of cooper

A

network of connective tissue. Disease process can distort the breast

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4
Q

Describe lymph drainage of the breast?

A

Mainly axilla.
Can also mestastates to the parasternal lymph.
Posterior chest wall
Clavicular

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5
Q

Describe lymph drainage of the breast?

A

Mainly axilla.
Can also mestastates to the parasternal lymph.
Posterior chest wall
Clavicular

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6
Q

Where is the highest incident of breast cancer

A

Upper outer

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7
Q

Where does mid axillary fold peirce

A

deep fascia

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8
Q

What is peau d orange

A

block of lymph giving orange appearance

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9
Q

Causes and treatments of gynaecomastia

A

puberty, weight, cannabis (continue)

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10
Q

Causes and treatments of gynaecomastia

A

puberty, weight, cannabis (continue)

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11
Q

Describe the breast (basics)

A

Paired structures, both genders, anterior chest wall, contains exocrine glands, modified sweat glands

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12
Q

Describe clavicle (most important)

A

Inferior surface rough underneath, sternal round end is medial, medial is convex, lateral is concave, impressions for pectoralis major, deltoid tubercle, impression for costoclavicular ligament, subclavian groove, conoid tubercle, arcromial facet, trapezoid line

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13
Q

Scapula basics

A

Spine at T3, Inferior angle at T7, superior angle border, medial border, coracoid process, suprascapular notch, infra supra spinous,

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14
Q

Humerus basics

A

arrow head anterior, deltoid tuberosity, attach for lateral head of triceps, attach for cocachobrachialis, radial groove, greater tubercle

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15
Q

What does pec minor do?

A

protraction

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16
Q

What does subclavius do?

A

nerve to subclavius and stabilises clavicle

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17
Q

What peirces the clavipectoral fascia?

A

lateral pectoral nerve
thoracoacromial artery
cephalic vein
lymphatics

18
Q

Basics of serratus anterior

A

upper 8 rib to anteromedial scapula
long thoracic nerve of bell risk during axilarry operations
protract scapula and assist in lateral rotation of scapula winging

19
Q

Describe the breast?

A

12-20 lobes divided into lobules
Contains acini - clusters of epithelial cells which produce milk
Lobules lead to lactiferous ducts which lead to lactiferous sinuses converging onto nipple where secretions are expelled.
The nipple has circular and longitudinal muscle.
Raised points on areola are Montgomerys tubercles which have sebaceous glands and secrete sebum making it waterproof.

20
Q

Surface anatomy of breast

A

base of breast goes from 2nd to 6th costal cartilage mid clavicular line to lateral sternum.

Base is 2/3 over pec major and 1/3 over serratus anterior.

Conical shaped.

Nipple is at the 4th intercostal in a young male.

21
Q

How is the breast suspended?

A

Suspensory ligaments of Cooper. Network of connective tissue for parenchyma. Attach on clavicle, dermis, deep fascia.

22
Q

How does the breast develope?

A

Mammary buds begin in week 6 as a thickening on the chest called Mammary ridge or milk line. Buds come from ectoderm and supporting tissue from mesenchyme. Lactiferous ducts are present. Additional nipples can occur. polythelia (xtra nips) polymastia (breasts)

23
Q

What happens at puberty?

A

Mammary glands develope influenced by oestrogen and progesterone increasing fat and connective tissue

24
Q

What happens at pregancy in breasts?

A

Increase in first 8/40 weeks. areola darkens, montgomery tubercles increase. Intralobular ducts develope forming acini cells which produce milk.

25
Q

What happens to breasts post menopause?

A

involution of ducts, glands, relacement of fat, atrophy. Can begin at 35 and post partum.

26
Q

What is the blood supply to the breast plus veins?

A

Internal thoracic from first part of subclavian.
Lateral thoracic artery giving to intercostals.
Thoracoacromial artery.

27
Q

Nerves of breast?

A

anterior and lateral branches of intercostals T2-6

28
Q

Lymph drainage of breast?

A 
Two lymphatic plexuses of the breast.
Subareolar
Submammary
Axillary - 75%
Parasternal 25% along internal mammary
Central
Anterior = CANCER
Posterior
Lateral
29
Q

How do you find the Sentinel Lymph node?

A

Identifies the first draining lymph node of the breast. Outrules metastatic breast cancer.

30
Q

Where is the highest incidence of cancer?

A

upper outer quadrant

31
Q

Name benign and malignant breast cancer

A

benign - cysts, fibrocystic, adenoma
Malignant - tumours, ductal carcinoma, lobular medullary - 1% of tumours
Can occur in men

32
Q

Signs and symptoms of breast cancer?

A

Lump - hard ireegular fixed
Pain - rare
Asymmetry
Skin - tethering peau d orange ulceration
Nipple - discahrge inversion pagets
Signs of metastatese - lymphatic local haematological

33
Q

What does Peau d’orange signify?

A

blockage of lymph

34
Q

What to look out for in breast check?

A 
lump palpated
unusual nipple discharge
skin tethering
lump in axilla
new nipple inversion
peau d orange
35
Q

Name some treatments of breast cancer?

A

Surgery, radiotherapy, systemic treatment (hormonal chemo)

36
Q

Where are implants placed?

A

submammary and subglandular

37
Q

Some causes of gynaecomastia?

A

puberty, excess weight, cannabis, meds, liver disease

38
Q

What is amastia?

A

congenital absense of breast rare

39
Q

What is the diep flap?

A

operative surgical removal and displacement

40
Q

The breast can be considered to composed of two regions

A

circular largetst and most prominent and axillary smaller running along ht e lateral edge of pec major towards axillary fossa

CVR (43 decks)

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