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Gross Anatomy Block 1 > Pectoral Region > Flashcards

Pectoral Region Flashcards

1
Q

The skin of the pectoral region innervated by?

A

Branches of the supraclavicular nerve and the ventral rami of the intercostal nerves

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2
Q

Pectoral fascia

  1. Superior attachment ?
  2. Inferior/lateral attachment?
  3. Division?
  4. What does it form and where?
A
  1. Sternum and clavicle
  2. Continuous with fascia of the shoulder, axilla, and thorax
  3. Anterior and posterior: attach to spinous processes of thoracic vertebrae
  4. Forms the axillary fascia at the axillary space when closing interval between pec major and lats
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3
Q

Clavipectoral fascia:

Structures that pierce it and what direction

A

Outwards: lateral pectoral nerve and thoraco-acromial artery

Inwards: cephalic vein and lymphatics (from breast to apical group of axillary group of lymph nodes)

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4
Q

Clavipectoral fascia

  1. This fascia is deep to ____
  2. It occupies the space between ___ and ___
A
  1. The clavicular head of the pectoralis major muscle

2. The clavicle and pectoralis minor

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5
Q

Clavipectoral fascia:

It runs vertically from ___ to ____; its upper part splits into 2 laminae to enclose what muscle?

A

Clavicle above to axillary fascia below; subclavius muscle

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6
Q

Clavipectoral fascia

What ligament maintains the concavity of the axilla?

A

Suspensory ligament

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7
Q

Where is clavipectoral fascia connected medially?

Laterally?

Where does the costocoracoid ligament run between?

A

Medially: first rib and costoclavicular ligament

Laterally: coracoid process and blends with the coracoclavicular ligament

Thick upper part of the fascia extending from the first rib near costochondral junction to coracoid process

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8
Q

What muscles are enclosed within the clavipectoral fascia?

A

Pectoralis minor and subclavius

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9
Q

4 muscles of the pectoral region

A

Pectoralis major and minor, subclavius and serratus anterior

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10
Q

Pectoralis major

Origin
Insertion
Innervation
Action
Arterial supply
A

Origin: clavicular head- front of the medial 1/3 of clavicle; sternocostal head- anterior aspect of sternum/upper 6 costal cartilages

Insertion: lateral lip of bicipital groove of humerus

Innervation: lateral pectoral nerve (C5-C7) and medial pectoral nerve (C8-T1)

Action: adduction and medial rotation of the arm; flexion of the arm (clavicular portion)

Arterial: pectoral branch of the thoracoacromial trunk

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11
Q

3 branches of the medial cord of the brachial plexus

A

Medial pectoral nerve, medial cutaneous nerve of arm and medial cutaneous nerve of forearm

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12
Q

Pectoralis minor

Origin
Insertion
Innervation 
Action
Arterial
A

Origin: ribs 3-5 near their cartilage

Insertion: medial aspect of coracoid process

Innervation: medial pectoral nerve (C8-T1)

Action: depresses point of shoulder, elevates the ribs of origin (when the scapula is fixed)

Arterial: pectoral branch of the thoracoacromial trunk

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13
Q

Subclavius

Origin
Insertion
Innervation
Action

A

Origin: first costal cartilage

Insertion: lower surface of clavicle (subclavius groove)

Innervation: nerve to the subclavius (C5-C6)

Action: depresses the clavicle, stabilizes the clavicle during movements of the shoulder girdle

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14
Q

Serratus anterior

Origin
Insertion
Innervation
Action
Arterial
A

Origin: outer surface of upper 8 ribs (medial)

Insertion: medial border of scapula/ inferior angle of scapula

Innervation: long thoracic nerve (C5-C7)

Action: protraction and rotation of the scapula

Arterial: lateral thoracic artery

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15
Q

What type of gland is the mammary gland?

Where is your nipple located

A

Apocrine (large sweat gland that produces fluid)

4th intercostal space

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16
Q

5 arteries of the mammary gland

A 
Internal thoracic artery 
Lateral thoracic artery
Superior thoracic artery
Acromio-thoracic artery
Lateral branches of posterior intercostal artery
17
Q

Veins follow the arteries in their course and adopt their names

These veins form an anastomotic venous circle around the nipple that divides into:

Superficial anastomosis veins: drain into ?
Deep venous anastomosis: drain into?

A

Superficial drains into internal thoracic and superficial veins of lower neck

Deep drains into internal thoracic, axillary, and posterior intercostal veins

18
Q

Lymphatic drainage

  1. What are the 5 AXILLARY nodes? (Just the name)
  2. Which is the only one that doesn’t drain lymph and what does it do instead?
A 
1. Anterior (pectoral) group
Posterior (subscapular) group
Lateral group
Central group
Apical group
  1. Central group receives lymph from the anterior, posterior, and lateral groups of lymph nodes
19
Q

lymphatic drainage

  1. Where is anterior group located and what does it drain?
  2. Where is posterior group located and what does it drain?
  3. Where is lateral group located and what does it drain?
  4. Where is central group located and and where does it RECEIVE lymph from?
  5. Where is apical group located and what does it drain and what does it receive
A
  1. Lower border of pec minor (along lateral thoracic vessels) and drains outer quadrant of the breast
  2. Posterior wall of axilla along the lower border of the subscapularis. Drains lower outer quadrant of the breast
  3. Over the lateral wall of axilla besides the humerus and drains a minimal quantity of lymph from the breast
  4. In the base of the axilla and it receives lymph from anterior, posterior, and lateral groups of lymph nodes
  5. Deep in the apex of the axilla. Drains the upper medial quadrant and receives lymph from all the above groups.
20
Q

Lymphatic drainage

  1. Internal mammary (parasternal) nodes are located where?
  2. What do they drain?
  3. Clinical: What is the route that metastasis would take
A
  1. Beside the lateral border of the sternum surrounding the internal mammary artery
  2. Drain the medial quadrants of the breast
  3. Cross to the other side and drain to the opposite group of parasternal nodes (would spread disease from one breast to the other)
21
Q
  1. Axillary and parasternal are the two main nodes for lymphatic drainage of the breast, but name 3 others.
  2. Name two lymph plexuses of the breast.
  3. How would disease metastasis from breast to abdomen?
A
  1. Supraclavicular nodes, cephalic (deltopectoral) nodes, and posterior intercostal nodes
  2. Subdiaphragmatic and subperiotoneal lymph plexuses
  3. Through subdiaphragmatic and subperiotoneal lymph plexuses
22
Q
  1. The skin drains into what 3 nodes?

2. The areola and nipple drain to ?

A
  1. Axillary, inferior deep cervical, and infraclavicular nodes
  2. Subareolar lymphatic plexus
23
Q
  1. Nerve supply of the breast?

2. Innervation of the upper and lower portion of the breast?

A
  1. 4th to 6th intercostal nerves from anterior cutaneous branch and lateral cutaneous branch
  2. Suprascapular nerve
24
Q

What does supernumerary mean?

Where does this occasionally occur?

A

It means there is breast tissue growing somewhere it shouldn’t be

Can occasionally occur along a line extending from the axilla to the groin

25
Q

Where do ~60% of carcinomas of the breast occur?

A

In the upper lateral quadrant

26
Q

The lymphatic spread of cancer to other regions of the body is caused by?

A

Obstruction of the normal lymphatic pathways by malignant cells

27
Q
  1. What is micromastia?

2. What is gynecomastia?

A
  1. An excessively small breast on one side due to lack of development (macromastia is opposite)
  2. Unilateral or bilateral enlargement of male breast (probably due to some hormonal imbalance)
28
Q

Two types of winged scapula: medial and lateral

  1. Medial is caused by damage to what nerve? Leading to?
  2. Lateral is caused by damage to what nerve?
    Leading to?

Signs and symptoms ?

A
  1. Long thoracic nerve (C5-C7) leading to serratus anterior paralysis (common)
  2. Accessory nerve leading to atrophy of the trapezius

Scapula slips away from rib cage; limited ability to lift arm above the head

Gross Anatomy Block 1 (12 decks)

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