Pectoral Region and Axilla Flashcards
What joint is the upper extremity’s only bony connection to the body?
The sternoclavicular joint
The clavicle is a strut that _________ the scapula and the rest of the upper limb, keeping the upper limb at a more functional distance from the body.
suspends
To what is the subclavian artery renamed after it passes the first rib and descends into the axilla?
The axillary artery
As the axillary artery descends the arm past the teres major, what is it renamed to?
The brachial artery
What happens to the brachial artery in the forearm?
It divides into the radial and ulnar arteries, both of which end in the palm of the hand by forming the palmar arches.
Describe the three segments of the axillary artery and its branches in each segment.
Proximal (1st) segment: Found proximal to the border of the pectoralis minor muscle. Has one branch - the supreme/superior thoracic artery.
Deep (2nd) segment: Found deep to the body of the pectoralis minor muscle. Has two branches - the thoracoacromial artery and the lateral thoracic artery.
Distal (3rd) segment: Found distal to the border of the pectoralis minor muscle and has three branches - the subscapular artery, the anterior humeral circumflex artery, and the posterior humeral circumflex artery.
In which quadrant of the breast does cancer occur in 60% of breast cancer cases?
Upper lateral
The upper limb is innervated by the nerve fibers of the ______ ______, which is formed from the ventral primary rami of spinal nerves _____, ______, _____, _____, and _____.
brachial plexus, C5, C6, C7, C8, T1
Nerves from the brachial plexus can be categorized as either preaxial or postaxial nerves. The preaxial nerves supply muscles that act to ________, while the postaxial nerves supply muscles that act to _________.
preaxial nerves supply muscles that flex
postaxial nerves supply muscles that extend
Given that preaxial nerves supply muscles that flex, these muscles are located on the ________ side of the limb and the postaxial nerves supplying muscles that extend are located on the _________ side of the limb.
preaxial (flex) - anterior limb
postaxial (extend) - posterior limb
The cords of the brachial plexus are named according to the position with respect to the ________ _______.
axillary artery
What is the basic organization of the brachial plexus?
5 ventral rami roots coalesce into 3 trunks (superior, middle, inferior), which divide and come back together to form 3 cords (lateral, posterior, medial), which divide to form 5 terminal branches.
Winging of the scapula may occur due to paralysis of the ________ ________ muscle, which is innervated by the _______ _______ nerve.
paralysis of the serratus anterior muscle which is innervated by the long thoracic nerve.
Describe the three types of shoulder separations.
Type 1: Incomplete tears of the acromioclavicular or coracoclavicular ligaments.
Type 2: Complete tear of acromioclavicular ligaments but NOT the coracoclavicular ligaments.
Type 3: All ligaments completely torn.
Lymph from the lower lateral quadrant of the breast drains into the ________ lymph nodes.
pectoral
Lymph from the upper medial quadrant of the breast drains into the ________ lymph nodes.
upper parasternal
Lymph from the lower medial quadrant of the breast drains into the _________ and ________ lymph nodes.
lower parasternal and opposite parasternal nodes (at the other breast)
Roots of the brachial plexus are both motor and sensory, while spinal nerve roots are either ______ or _______.
motor (ventral) or sensory (dorsal)
The long thoracic nerve passes _________ (superficially or deep) to the serratus anterior.
superfically
The median ______ vein is often a site for venous puncture in order to obtain a sample of blood or to administer medication.
median cubital vein
Which three veins are most often used for central venous line catheterization?
- Axillary vein
- Subclavian vein
- Internal jugular vein
Radical masectomy includes removal of the breast and all its related structures, while a modified radical masectomy spares two muscles. Which muscles are they?
Pectoralis major and minor
What is the axillary tail/process? Why is it clinically relevant?
It is the mammary tissue that extends laterally into the axilla. Important in breast exams.
The breast is attached to the deep fascia by ___________ ligaments.
suspensory/Cooper’s ligaments
The __________ space is a potential space covering the pectoralis major below the breast. It allows for movement of the breast upon the pectoralis major and is a common route for __________ to the pectoralis major.
retromammary space
common route for metastasis
Which nerves provide sensory innervation to the breast area?
What dermatome covers the nipple?
Anterior and lateral cutaneous branches of the 2nd-6th intercostal nerves.
The nipple is in the T4 dermatome in both sexes.
The _______ _______ duct drains the right side of the thorax and right side of the head and neck, while the _______ duct collects lymph from the rest of the body.
right lymphatic duct drains right thorax, right head and right neck
thoracic duct drains the rest of the body
What does the thoracic duct drain into?
What does the right lymphatic duct drain into?
Thoracic duct drains into into the venous angle (at the jugulosubclavian vein).
Right lymphatic duct drains into the right venous angle.
Lymph drainage from the nipple, areola, and lobules drain into a ________ _______ plexus.
subareolar (Sappey) plexus
Damage/removal of an axillary lymph node can potentially cause _______.
lymphedema
Branches of the ______ ______ nerve usually pierce the pectoralis minor to reach the deep surface of the pectoralis major.
medial pectoral nerve
What artery supplies the serratus anterior?
Lateral thoracic artery
What arteries supply the pec major? What about pec minor?
Both are supplied by the pectoral branch of the thoracoacromial trunk.
What are the four branches of the thoracoacromial artery trunk?
The thoracoacromial immediately splits into CAPD: clavicular acromial pectoral deltoid
