Pectoral and Axillary Regions

Question 0

Which ribs are “true” ribs?

Answer 0

ribs 1-7

Question 1

which ribs are atypical?

Answer 1

1,2, 11, & 12

Question 2

what ribs are “false” ribs?

Answer 2

ribs 8-10

Question 3

what ribs are “floating” ribs?

Answer 3

11 & 12

Question 4

what innervates the breast?

Answer 4

intercostal n. 4-6

Question 5

what attaches the dermis of overlying skin of breast?

Answer 5

suspensory ligaments (Cooper’s ligaments)

Question 6

arterial supply to breast?

Answer 6

mammary branches from anterior intercostal, lateral thoracic, and internal thoracic arteries

originally subclavian and axillary a.

Question 7

a 57yo female pt presents with tenderness and swelling in the inferolateral quadrant of her right breast. Upon exam, her clinician notes enlarged lymph nodes in pt right axilla. Pathway of lymph drainage?

Answer 7

most lymph from breast drains to pectoral then axillary lymph nodes

Question 8

Besides the 4th-6th intercostal n. what else may supply innervation of breast tissue?

Answer 8

supraclavicular n. branches

Question 9

the deltopectoral triangle is also referred to as?

Answer 9

clavipectoral triangle

Question 10

what is the deltopectoral triangle surrounded by?

Answer 10

clavicle, deltoid, pectoralis major

Question 11

what are 3 things within superficial fascia of pectoral region?

Answer 11

platysma,
supraclavicular n.,
anterior & lateral branches of intercostal n.

Question 12

what is contained within the deltopectoral triangle?

Answer 12

cephalic v., deltopectoral lymph nodes, deltoid branch of thoracoacromial a. (from axillary a; supply to deltoid)

Question 13

what things does the clavipectoral fascia attach to?

Answer 13

clavicle and anterior thoracic wall

Question 14

what does the clavipectoral fascia become?

Answer 14

suspensory ligament of axilla

Question 15

What pierces clavipectoral fascia?

Answer 15

cephalic v., thoracoacromial a., and lateral pectoral n.

Question 16

muscles of the pectoral region are innervated by?

Answer 16

ventral rami of spinal nerves via branches of the brachial plexus

Question 17

innervation of pectoralis major?

Answer 17

lateral and medial pectoral nerves (C5, C6 clavicular portion, C7, C8, T1 sternocostal portion)

Question 18

blood supply to pectoralis major?

Answer 18

pectoral branches of thoracoacromial arterial trunk

Question 19

distal attachment of pectoralis major?

Answer 19

lateral lip of intertubercular sulcus (bicipital groove)

Question 20

proximal attachment of pectoralis major?

Answer 20

clavicular and sternocostal attachments

ant. surface of medial 1/2 of clavicle
ant. surface of sternum and superior 6 costal cartilages

Question 21

MAIN action of pectoralis major?

Answer 21

adducts and medial rotates humerus

Question 22

secondary actions of pectoralis major?

Answer 22

draws scap. ant & inf (via clavicle)
clavicular portion flexes humerus
sternal portions extends humerus while in flexed position

Question 23

medial pectoral nerve arises from what cord?

Answer 23

medial cord

Question 24

lateral pectoral nerve arises from which cord?

Answer 24

lateral cord (not named for position within body!!!!)

Question 25

a pt arrives to ED with knife protruding from left ant shoulder, just above the armpit, below clavicle. What artery is likely ligated?

Answer 25

axillary a.

Question 26

pectoral region is primarily supplied by what artery?

Answer 26

axillary

Question 27

pt arrives to ED with knife protruding from L ant. shoulder, just above armpit, clinician determine that lacteraction is in 3rd part of axillary a., just proximal to its large tributary, the subscapular a. what muscle is a landmark that divides the axillary into 3 main parts?

Answer 27

pectoralis minor

Question 28

part one of the axillary a. is what in relation to P. minor?

Answer 28

proximal/medial

Question 29

part one of axillary a. branches into what a?

Answer 29

superior thoracic a.

Question 30

Part 2 of axillary a. is what in relation to P. minor?

Answer 30

behind

Question 31

what does part 2 of axillary a. branch into?

Answer 31

thoracoacromial trunk (pectoral, deltoid, acrocromial, and clavicular branches) and lateral thoracic a.

Question 33

same knifed patient, 3rd part of axillary artery. Although this injury threatens pt’s blood supply to upper extremity, the clinicians are not overly concerned because collateral blood supply to the rest of the upperd limb is possible via what anastomosis?

Answer 33

Scapular

Question 34

what vein drains the pectoral region?

Answer 34

the axillary v.

Question 35

basilic veins continue as the…?

Answer 35

axillary v.

Question 36

where does the cephalic v drain into?

Answer 36

axillary before it becomes the subclavian

Question 37

what makes up the apex of the axilla?

Answer 37

clavicle, scapula, and 1st rib

Question 38

base of the axilla?

Answer 38

skin and superficial fascia, anterior axillary fold (pec major), posterior axillary fold (lat dorsi, teres major), chest wall (serratus anterior)

Question 39

anterior wall of axilla?

Answer 39

(clavicle and subclavius), pectoralis major and minor

Question 40

posterior wall of axilla?

Answer 40

scapula, subscapularis, latissimus dorsi, teres major

Question 41

lateral boundary of axilla?

Answer 41

intertubercular sulcus (bicipital groove), tendon of long head of biceps, coracobrachialis tendon

Question 42

contents of axilla

Answer 42

axillary sheath around: axillary v., axillary a., and brachial plexus (cephalic and basilic v. too?)