Final: Lecture 15

Question 0

Arterial/Venous supply of the Breast

Answer 0

• mammary branches from anterior intercostal, lateral thoracic, and internal thoracic arteries
• venous mainly to axillary via lateral thoracic veins and medial mammary.
• some drainage to internal thoracic vein via anterior intercostal

Question 1

The Breast

Answer 1

• cutaneous sturcture, modified sweat gland, rests on pectoral fascia
• retromammary space is potential space between breast and pectoral fascia (can be place where tumors grow)
• innervated by intercostal nerves 4-6, some from supraclavicular nerve branches
• attaches to dermis of skin via suspensory ligaments (Cooper’s Ligaments)
• 15-20 lactiferous ducts open at nipple

Question 2

Lymphatic drainage of breast tissue

Answer 2

1. Nipple, areola, lactiferous lobules: subareolar lymph nodes
2. > 75% of lymph from breast: axillary lymph nodes (pectoral, central apical)
3. Remaining lymph: parasternal and abdominal lymph nodes

Question 3

Superficial Fascia of the pectoral region

Answer 3

•platysma, supraclavicular nerves, anterior and lateral branches of intercostal nerves

Question 4

Deltopectoral (clavipectoral) Triangle

Answer 4

• deltoid, pec major, middle 1/3 of clavicle make up borders
• cephalic vein
• deltopectoral lymph nodes
• deltoid branch of thoracoacromial artery

Question 5

Clavipectoral Fascia of pectoral region

Answer 5

• invests subclavius and pec minor
• attaches to clavicle and anterior thoracic wall
• cephalic vein, thoracoacromial a, and lateral pectoral nerves pierce it
• becomes suspensory ligament of axilla

Question 6

Pectoralis Major

Answer 6

• Proximal: clavicular and sternocostal attachments, ant surface of medial 1/2 of clavicle, ant surface of sternum and superior 6 costal cartilages
• Distal: lateral lip of intertubercular sulcus (bicipital groove)
• Actions: adducts and medial rotates humerus, draws scapula anteriorly and inferiorly, clavicular portions flexes humerus, sternal portion can extend humerus while it is in flexed position
• Blood supply: pectoral branches of thoracoacromial arterial trunk
• Innervation: lateral and medial pectoral nerves

Question 7

Pectoralis Minor

Answer 7

• Proximal: 3rd-5th ribs, near coastal cartilages
• Distal: coracoid process of scapula
• Actions: stabilizes scapula by pulling it anteriorly and inferiorly against posterior thoracic wall
• Blood supply: pectoral branches of thoracoacromial arterial trunk
• Innervation: medial pectoral nerve (C8, T1) usually pierced by this nerve

Question 8

Subclavius

Answer 8

• Proximal: juction of 1st rib and its costal cartilage
• Distal: inferior surface of middle 1/3 of clavicle
• Actions: anchors and depresses clavicle
• Blood supply: clavicular branches of thoracoacromial arterial trunk
• Innervation: nerve to subclavius

Question 9

Serratus Anterior

Answer 9

• Proximal: external surfaces of lateral parts of ribs 1-9
• Distal: anterior surface of medial border of scapula
• Actions: protracts scapula, rotates scapula, holds scapula against thorax
• Blood supply: lateral thoracic artery
• Innervation: long thoracic nerve

Question 10

Subclavian artery 3 divisions

Answer 10

• part 1: medial to the anterior scalene muscle
• part 2: posterior to the anterior scalene muscle
• part 3: lateral to the anterior scalene muscle

Question 11

Thyrocervical Arterial Trunk

Answer 11

• Transverse cervical artery (superficial and deep brach, may arise independently, when they do form trunk, referred to as cervicodorsal trunk)
• Inferior thyroid artery
• ascending cervical artery
• suprascapular artery

Question 12

Lateral border of first rib is point at which the subclavian artery becomes the ________?

Answer 12

•axillary artery

Question 13

Note regarding the dorsal scapular artery…

Answer 13

• Arise either some part of subclavian, or from the transverse cervical (about 30% of the time, called deep branch..)
• Either way runs along the vertebral border of scapula is always referred to as dorsal scapular