General Anatomy

Question 1

What are Montgomery’s glands?

Answer 1

Sebaceous glands in areolar region that lubricate areola and nipple

Question 2

Where do breasts develop from?

Answer 2

Thickening of the ectoderm

Question 3

Milk production in the breast?

Answer 3

1. Produced in alveoli lined with milk secreting cuboidal cells
2. Alveoli form lobules
3. Lobules drain in to lobes (15-20 per breast)
4. Drain into lactiferous ducts then to lactiferous sinus

Question 4

Why skin dimpling in breast malignancies?

Answer 4

1. Lobes of breast seperated by suspensory ligaments of the breast (Cooper’s)
2. Ligaments connected to subcutaneous tissue
3. If malignancy infiltrates ligaments then causing contracture and this dimpling of the skin

Question 5

Define: Radical mastectomy

Answer 5

Removal of entire breast along with axiliiary lymph nodes

NB. In a classical radical mastectomy pec muscles also removed

Question 6

Boundaries of quadrangular space?

Answer 6

Medial: long head of triceps
Lateral: humeral shaft
Superior: teres minor
Inferior: teres major

Question 7

Contents of quadrangular space?

Answer 7

Axillary nerve

Posterior circumflex humeral artery

Question 8

Surface anatomy of breast in relation to thoracic skeleton?

Answer 8

2-6th ribs
Extend from sternal edge to mid-axilliary line
Floor is pec major

Question 9

Blood supply of the breast?

Answer 9

• Internal thoracic
• Lateral thoracic
• Thoracoacromial

Question 10

Lymphatic drainage of the breast?

Answer 10

75% into ipsilateral LN’s

1. Sub-areolar plexus
2. Axilliary LN’s (5 groups)
3. Then para-aortic LN’s (following intercostal arteries)

Question 11

What is contained in the axilla?

Answer 11

1. Axilliary a and v
2. Axilliary LN’s
3. Brachial plexus branches
4. Long and short heads of biceps brachii

Question 12

Axilliary lymph node levels?

Answer 12

1 = Distal to lower border pec major
2 = Lie deep to pec major
3 = Medial to upper border of pec minor