Pectoral And Axillary Regions

Question 1

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

Answer 1

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

Question 2

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

Answer 2

Platysma m.

Question 3

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

Answer 3

Supraclavicular nn. C3-C4 from the cervical plexus

Intercostal nn. T1-T7

Question 4

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

Answer 4

Intercostal nn. T1-T7

Question 5

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

Answer 5

Supraclavicular nn. C3-C4 from cervical plexus

Question 6

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

Answer 6

2-6

Sternum to midaxillary line

Question 7

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

Answer 7

Superficial fascia

Pectoralis major m.

Question 8

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

Answer 8

Retromammary

Question 9

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

Answer 9

Lactiferous ducts

Question 10

Pigmented skin around the nipple is called the

Answer 10

Areola

Question 11

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

Answer 11

Mammary; fatty; suspensory ligaments

Question 12

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

Answer 12

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

Question 13

What 2 veins supply the female breast?

Answer 13

Internal thoracic v.

Axillary v.

Question 14

Where do most lymphatic vessels converge in the breast tissue?

Answer 14

On subareolar lymph plexus beneath the skin of the areola

Question 15

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

Answer 15

Pectoral nodes

Question 16

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

Answer 16

Axillary

Question 17

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?

Answer 17

Infraclavicular
Parasternal
Contralateral
Abdominal

Question 18

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?

Answer 18

It can spread to the liver

Question 19

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

Answer 19

Parasternal

Question 20

Origin of the clavicular part of pectoralis major m.

Answer 20

Medial 1/2 of clavicle

Question 21

Origin of sternal part of pectoralis major m.

Answer 21

Manubrium and body of sternum

Question 22

Origin of costal part of pectoralis major m.

Answer 22

Costal cartliages 1-6

Question 23

Insertion of pectoralis major m.

Answer 23

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

Question 24

What 2 nerves innervate pectoralis major m.?

Answer 24

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.

Question 25

Actions of pectoralis major m.

Answer 25

Adduction and medial rotation of humerus

Question 26

Origin of pectoralis minor

Answer 26

Ribs 2-5 or 3-6

Question 27

Insertion of pectoralis minor m.

Answer 27

Coracoid process of scapula

Question 28

Innervation of pectoralis minor m.

Answer 28

Medial pectoral n.

Question 29

Action of pectoralis minor m.

Answer 29

Depressor and downward rotator of scapula

Question 30

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?

Answer 30

Clavicle Pectoralis major m. Pectoralis minor m.

Question 31

What 2 muscles form the anterior axillary fold?

Answer 31

Pectoralis major m. | Pectoralis minor m.

Question 32

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?

Answer 32

Scapula Subscapularis m. Teres majorm. Latissimus dorsi m.

Question 33

What muscles form the posterior axillary folds?

Answer 33

Teres major m. | Latissimus dorsi m.

Question 34

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?

Answer 34

Ribs Intercostal mm. Serratus anterior m.

Question 35

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?

Answer 35

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

Question 36

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?

Answer 36

Skin | Superficial fascia of armpit

Question 37

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?

Answer 37

Anterior - clavicle Posterior - scapula Medial - first rib

Question 38

What are the overall contents of the axillary region?

Answer 38

Cords of brachial plexus Axillary a. Axillary v. Axillary lymph nodes Muscle tendons

Question 39

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

Answer 39

Subclavian a.

Question 40

Where does the axillary a. begin and end?

Answer 40

Begins at lateral border of first rib at apex of axilla Ends at lower border of teres major m.

Question 41

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?

Answer 41

Yes, only branch is the supreme thoracic a.

Question 42

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?

Answer 42

Thoracoacromial trunk | Lateral thoracic a.

Question 43

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?

Answer 43

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

Question 44

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

Answer 44

Basilic v.

Question 45

Where does the axillary vein begin and terminate?

Answer 45

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.]

Question 46

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

Answer 46

Apical (infraclavicular) Central nodes Lateral nodes Subscapular nodes

Question 47

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

Answer 47

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

Question 48

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

Answer 48

C. Subscapular nodes

Question 49

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

Answer 49

B. Central nodes on axillary v.

Question 50

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

Answer 50

A. Apical (infraclavicular nodes)

Question 51

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

Answer 51

Apical (infraclavicular nodes)

Question 52

Where are subscapular nodes located?

Answer 52

Next to subscapular a. and v.

Question 53

Where are central nodes of the axillary region located?

Answer 53

Posterior to pectoralis minor m.

Question 54

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

Answer 54

The shoulder

Question 55

What muscle tendons are contained in the axillary region?

Answer 55

Coracobrachialis t. | Biceps brachii tt. (Long and short heads)

Question 56

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

Answer 56

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.

Question 57

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.?

Answer 57

Suprascapular a. Transverse cervical a. Intercostal aa.