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MSK Exam II > Pectoral And Axillary Regions > Flashcards

Pectoral And Axillary Regions Flashcards

1
Q

What is the difference in pectoral region surface anatomy between males and females?

A

Pec major m. forms contour in males, whereas this is formed by breast in females

Nipple is usually located in 4th intercostal space along midclavicular line in males, while in females the location varies significantly after puberty

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2
Q

What skeletal muscle of facial expression extends from the mandible to the upper thorax, just inferior to the clavicle?

A

Platysma m.

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3
Q

What are the 2 cutaneous nerves associated with the pectoral region?

A

Supraclavicular nn. C3-C4 from the cervical plexus

Intercostal nn. T1-T7

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4
Q

What cutanous nerves of the pectoral region supply the skin associated with intercostal spaces?

A

Intercostal nn. T1-T7

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5
Q

What cutaneous nerves of the pectoral region innervate the skin of the 1st and 2nd intercostal spaces?

A

Supraclavicular nn. C3-C4 from cervical plexus

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6
Q

The female breast is located vertically from ribs _____-____ and horizontally from ________ to __________

A

2-6

Sternum to midaxillary line

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7
Q

The female breast is completely contained within ______ _____ and is located anterior to the ________ ________ muscle

A

Superficial fascia

Pectoralis major m.

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8
Q

The _________ space lies between the breast and pec major muscle in females

A

Retromammary

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9
Q

Female nipples contain 15-20 openings to _______ _______, each of which drains milk from 1 mammary gland

A

Lactiferous ducts

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10
Q

Pigmented skin around the nipple is called the

A

Areola

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11
Q

Female breasts are mad eup of 15-20 ________ glands, ________ CT, and condensations of fascia that form ________ _______ and septa which separate lobules from one another

A

Mammary; fatty; suspensory ligaments

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12
Q

What are the 3 arteries that typically supply the female breast?

A

Lateral thoracic a.
Intercostal a.
Internal thoracic a. (Perforating branches in intercostal spaces 3-6)

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13
Q

What 2 veins supply the female breast?

A

Internal thoracic v.

Axillary v.

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14
Q

Where do most lymphatic vessels converge in the breast tissue?

A

On subareolar lymph plexus beneath the skin of the areola

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15
Q

Most lymphatic vessels converge on subareolar lymph plexus beneath the skin of the areola. From here, several major lymph vessels transport to various locations.

75% of lymph vessels travel to the ______ nodes

A

Pectoral nodes

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16
Q

Most lymphatic vessels converge on subareolar lymph plexus beneath the skin of the areola. From here, several major lymph vessels transport to various locations.

75% of lymph vessels travel to the pectoral nodes, which drain to ______ nodes

A

Axillary

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17
Q

Most lymphatic vessels converge on subareolar lymph plexus beneath the skin of the areola. From here, several major lymph vessels transport to various locations.

75% of lymph vessels travel to the pectoral nodes which drain to axillary nodes

25% of lymph vessels travel to what 4 groups of nodes?

A

Infraclavicular
Parasternal
Contralateral
Abdominal

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18
Q

Most lymphatic vessels converge on subareolar lymph plexus beneath the skin of the areola. From here, several major lymph vessels transport to various locations.

75% of lymph vessels travel to the pectoral nodes which drain to axillary nodes

25% of lymph vessels travel to infraclavicular, parasternal, contralateral, and abdominal nodes. What is the significance of these nodes if a patient presents with cancer in the right breast?

A

It can spread to the liver

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19
Q

_____________ nodes on one side are connected to contralateral nodes by lymphatic vessels which cross anterior midline

A

Parasternal

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20
Q

Origin of the clavicular part of pectoralis major m.

A

Medial 1/2 of clavicle

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21
Q

Origin of sternal part of pectoralis major m.

A

Manubrium and body of sternum

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22
Q

Origin of costal part of pectoralis major m.

A

Costal cartliages 1-6

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23
Q

Insertion of pectoralis major m.

A

Tendon of insertion has 2 laminae:

Anterior - from clavicular and upper sternocostal parts

Posterior - from lower sternocostal part - insert highest on humerus, as they pass laterally, they twist to attain a more superior position relative to fibers of anterior lamina

Bilaminar tendon crosses the intertubercular groove of the humerus to insert on the crest of the greater tubercle

24
Q

What 2 nerves innervate pectoralis major m.?

A

Lateral pectoral n. (C3-7) - supplies most of upper portion

Medial pectoral n. (C8-T1) - supplies lower portion after passing through or around pectoralis minor m.

25
Q

Actions of pectoralis major m.

A

Adduction and medial rotation of humerus

26
Q

Origin of pectoralis minor

A

Ribs 2-5 or 3-6

27
Q

Insertion of pectoralis minor m.

A

Coracoid process of scapula

28
Q

Innervation of pectoralis minor m.

A

Medial pectoral n.

29
Q

Action of pectoralis minor m.

A

Depressor and downward rotator of scapula

30
Q

The boundaries of the axillary region are made up of an anterior wall, posterior wall, medial wall, lateral wall, base, and apex.

What structures make up the anterior wall?

A

Clavicle
Pectoralis major m.
Pectoralis minor m.

31
Q

What 2 muscles form the anterior axillary fold?

A

Pectoralis major m.

Pectoralis minor m.

32
Q

The boundaries of the axillary region are made up of an anterior wall, posterior wall, medial wall, lateral wall, base, and apex.

What structures make up the posterior wall?

A

Scapula
Subscapularis m.
Teres majorm.
Latissimus dorsi m.

33
Q

What muscles form the posterior axillary folds?

A

Teres major m.

Latissimus dorsi m.

34
Q

The boundaries of the axillary region are made up of an anterior wall, posterior wall, medial wall, lateral wall, base, and apex.

What structures make up the medial wall?

A

Ribs
Intercostal mm.
Serratus anterior m.

35
Q

The boundaries of the axillary region are made up of an anterior wall, posterior wall, medial wall, lateral wall, base, and apex.

What structures make up the lateral wall?

A

Intertubercular sulcus of humerus (contains tendon of long head of biceps brachii)

36
Q

The boundaries of the axillary region are made up of an anterior wall, posterior wall, medial wall, lateral wall, base, and apex.

What structures make up the base?

A

Skin

Superficial fascia of armpit

37
Q

The boundaries of the axillary region are made up of an anterior wall, posterior wall, medial wall, lateral wall, base, and apex.

What structures make up the anterior, posterior, and medial aspects of the apex?

A

Anterior - clavicle
Posterior - scapula
Medial - first rib

38
Q

What are the overall contents of the axillary region?

A

Cords of brachial plexus

Axillary a.
Axillary v.

Axillary lymph nodes

Muscle tendons

39
Q

The axillary a. Is a continuation of what major a.?

A

Subclavian a.

40
Q

Where does the axillary a. begin and end?

A

Begins at lateral border of first rib at apex of axilla

Ends at lower border of teres major m.

41
Q

The axillary artery has 3 parts. The first part is between the first rib and medial border of pec minor m. Does this part have any branches?

A

Yes, only branch is the supreme thoracic a.

42
Q

The axillary artery has 3 parts. The first part is between the first rib and medial border and has one branch - the supreme thoracic a. The second part is deep to pec minor and has 2 branches - what are they?

A

Thoracoacromial trunk

Lateral thoracic a.

43
Q

The axillary artery has 3 parts. The first part is between the first rib and medial border and has one branch - the supreme thoracic a.

The second part is deep to pec minor and has 2 branches - the lateral thoracic a. and the thoracoacromial trunk.

The third part is lateral to the lateral border of pectoralis minor m. And has 3 branches, what are they?

A

Subscapular a.
Anterior humeral circumflex a.
Posterior humeral circumflex a.

44
Q

The axillary v. is a continuation of what vein of the arm?

A

Basilic v.

45
Q

Where does the axillary vein begin and terminate?

A

Begins at lower border of teres major m.

Terminates at lateral border of first rib where it becomes continuous with subclavian v.

[tributaries correspond to branches of axillary a.]

46
Q

Axillary LNs vary in number between 12-36 and there is no sharp distinction between groups. What are the 4 groups of axillary LNs?

A

Apical (infraclavicular)
Central nodes
Lateral nodes
Subscapular nodes

47
Q

Which of the following receive lymph from the upper extremity, but not the shoulder; and send lymph to central nodes?

A. Apical nodes
B. Infraclavicular nodes
C. Lateral nodes
D. Subscapular nodes

A

C. Lateral nodes [on distal part of axillary v.]

48
Q

Which of the following receive lymph from breast and anterior thoracic wall and send lymph to apical and central nodes?

A. Infraclavicular nodes
B. Lateral nodes
C. Subscapular nodes
D. A and C

A

C. Subscapular nodes

49
Q

Which of the following are located posterior to the pectoralis minor m., receive lymph from 3 other lymph node groups, and send lymph to apical nodes?

A. Infraclavicular nodes
B. Central nodes on axillary v.
C. Lateral nodes on distal axillary v.
D. Subscapular nodes

A

B. Central nodes on axillary v.

50
Q

Which of the following receive lymph from ALL other axillary nodes, give rise to subclavian lymph trunk, and connect with the supraclavicular nodes in the neck?

A. Apical (infraclavicular nodes)
B. Central nodes
C. Lateral nodes
D. Subscapular nodes

A

A. Apical (infraclavicular nodes)

51
Q

Which subgroup of axillary LNs are located medially on proximal part of axillary v. close to the apex?

A

Apical (infraclavicular nodes)

52
Q

Where are subscapular nodes located?

A

Next to subscapular a. and v.

53
Q

Where are central nodes of the axillary region located?

A

Posterior to pectoralis minor m.

54
Q

Lateral nodes on the distal part of the axillary vein receive lymph from the upper extremity, except for which area?

A

The shoulder

55
Q

What muscle tendons are contained in the axillary region?

A

Coracobrachialis t.

Biceps brachii tt. (Long and short heads)

56
Q

Collateral circulation around the scapula is extensive. Where might the axillary a. be ligated?

A

Between the thyrocervical trunk and the subscapular a.

This reverses direction of blood flow in subscapular a. So that arterial blood reaches the distal portion of the axillary a.

57
Q

Ligation to the axillary a. distal to the subscapular a. is medical malpractice due to locations of axillary artery anastomosis.

The subscapular a. receives blood via anastomes with what 3 aa.?

A

Suprascapular a.
Transverse cervical a.
Intercostal aa.

MSK Exam II (20 decks)

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