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Clinical Anatomy > Pectoral Region, Breast, Axilla > Flashcards

Pectoral Region, Breast, Axilla Flashcards

1
Q

Jugular notch

A

Notch in between the elevated sternal ends

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2
Q

Clavicle

A

Elongated, S-shaped bone that rests horizontally at the sternum across the upper part of the ribcage and the acromial end of the scapula

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3
Q

Sternal angle

A
  • Synarthrotic joint formed by the articulation of the manubrium and the body of the sternum
  • Also known as transverse thoracic plane

*Palpable clinical landmark in surface anatomy.

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4
Q

Sternum

A

Long flat bone over central chest

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5
Q

Xiphoid process

A

Smallest, most inferior part of sternum

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6
Q

Scapula

A

Triangle-shaped shoulder blade

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7
Q

Acromion process

A

Bony process of the scapula that extends laterally over the shoulder joint

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8
Q

Coracoid process

A

Small hook-like structure on the lateral edge of the superior anterior portion of the scapula

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9
Q

Medial pectoral nerve(s)

A

Supplies:
- Pectoralis minor + pectoralis minor

Origin:
- Medial cord

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10
Q

Lateral pectoral nerve(s)

A

Supplies:
- Pectoralis major

Origin:
- Lateral cord of brachial plexus

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11
Q

Anterior cutaneous nerves

A

Superior neurovasculature supplying skin/cutaneous aspects anteriorly
*changes planes

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12
Q

What does the thoracoacromial artery supply?

A

Supplies:

  • Deltoid
  • Pectoralis major
  • Pectoralis minor
  • Subclavius
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13
Q

Cephalic vein

A
  • Superficial vein of UE
  • Ascends into SC tissue
  • Goes up lateral border of wrist + anterolateral surface of forearm + arm
  • Passes between deltoid + pectoralis muscles
  • Enters clavipectoral triangle
  • Pierces costocoracoid membrane (part of clavipectoral fascia)
  • Enters axillary vein
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14
Q

Subclavian vein

A

Right below subclavius muscle

*Brachial vein –> axillary vein (at inferior teres major border) –> subclavian vein (at lateral part of 1st rib)

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15
Q

Subclavius (origin + insertion)

A

Origin:
Junction + costocartilage of 1st rib

Insertion:
Inferior surface of mid third of clavicle

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16
Q

Nipple

A

Protuberance of breast through which lacteriferous ducts open

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17
Q

Areola

A

Circular pigmented area surrounding the nipple

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18
Q

Lactiferous ducts

A
  • Ducts that converge + form branched system connecting the nipple to the lobules of the mammary gland
  • Move milk to nipple by smooth muscle contractions along the ductal system
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19
Q

Pectoralis fascia

A
  • Thin lamina covering the surface of pectoralis major

- Attachment to front of sternum, to the clavicle, + is continuous with fascia of the shoulder, axilla, + thorax

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20
Q

What is the retromammary space?

A
  • Loose connective tissue plane between breast + pectoral fascia
  • Allows for mobility of breast
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21
Q

What would a tumor in the retromammary space typically present as?

A

Immobility of the breast

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22
Q

Suspensory (Cooper’s) ligaments (of breast)

A
  • Firmly attach mammary glands to dermis of overlying skin
  • Help support mammary gland lobules
  • Prevent breast from sagging
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23
Q

Axillary process (tail) of breast

A

Extension of mammary gland in the superolateral quadrant

24
Q

Breast cancer is most common in which quadrant?

A

Upper outer (left or right)

25
Q

What symptom presents when breast cancer interferes with the dermal lymphatics?

A
  • Lymphedema in skin of breast
26
Q

What is the most common site of metastasis in breast cancer?

A

Axillary lymph nodes

27
Q

Orange-peel appearance of breast

A

Results from puffy skin between dimpled pores of breast in inflammatory breast cancer

28
Q

Name common changes in appearance of breast due to presence of cancer

A
  • Skin dimpling/retraction
  • Orange-peel appearance
  • Nipple retraction/deviation
  • Abnormal contours
29
Q

Mammary glands are what type of glands?

A

Modified sweat glands (apocrine)

30
Q

Lactiferous sinus

A

Dilated area of the duct just deep to the areola

31
Q

Terminal duct lobular unit (TDLU)

A
  • Basic functional unit of breast

- Is the lobule

32
Q

Polymastia

A

Supernumerary breast appearing as rudimentary nipple with underlying glandular tissue along milk line

33
Q

Mammary ridges (milk lines)

A
  • Origin of breast development
  • Along either side of the body from axilla to inguinal canal
  • Site of polythelia & polymastia
34
Q

Polythelia

A

Supernumerary nipples (mistaken for moles)

35
Q

Where does most lymphatic drainage of the breast go?

A

Most to axillary lymph nodes (75%)

36
Q

Where does most breast lymph first drain to?

A

Pectoral (anterior) nodes

37
Q

Where does lymph from medial breast typically drain to?

A

Parasternal lymph nodes or to opposite breast

38
Q

Arterial supply of the breast

A
  • Internal mammary artery (IMA)

- Lateral thoracic artery

39
Q

Mediolateral oblique (MLO) view

A
  • Superior top

- Inferior bottom

40
Q

Craniocaudal (CC) view

A
  • Lateral top

- Medial bottom

41
Q

Pectoralis major (origin + insertion)

A

Origin:

  • Clavicular head: Anterior surface of medial 1/2 of clavicle
  • Sternocostal head: Anterior surface of sternum, costal cartilages 2-6, aponeurosis of external abdominal oblique muscle

Insertion:
- Lateral lip of intertubercular groove of the humerus

42
Q

Pectoralis major (function + innervation)

A

Function:

  • Flex arm
  • ADduct arm
  • Medial rotation of arm (in climbing, draws body upward)

Innervation:
- Lateral pectoral nerve
- Medial pectoral nerve
(C8, T1)

43
Q

Pectoralis minor (origin + insertion)

A

Origin:
- Anterior aspect of the 3rd, 4th, and 5th ribs

Insertion:
- Coracoid process of the scapula

44
Q

Pectoralis minor (function + innervation)

A

Function:
- Protract scapula

Innervation:
- Medial pectoral nerve (C8, T1)

45
Q

Where is a pacemaker typically inserted?

A
  • Infraclavicular area parallel to middle 1/3 of clavicle

- Subcutaneous pocket typically superficial to pectoralis major

46
Q

Bony boundaries of axillary apex (cervicoaxillary canal)

A
  • Clavicle (ant)
  • Superior border of scapula (post)
  • Lateral border of 1st rib (medial)
47
Q

Boundaries of axillary fossa

A
  • P. major, p. minor, clavipectoral fascia (ant)
  • Scapula, subscapularis, t. major, lat. dorsi (post)
  • Ribs 1-4, Intercostal muscles, serratus anterior (medial)
48
Q

Where does the subclavian artery become the axillary artery?

A

Lateral border of 1st rib

49
Q

Where does the axillary artery become the brachial artery?

A

Inferior border of teres major muscle

50
Q

Name the branches of the axillary artery

A

First:
- Superior thoracic artery

Second:

  • Thoraco-acromial
  • Lateral thoracic artery

Third:

  • Subscapular
  • Anterior circumflex humeral
  • Posterior circumflex humeral
51
Q

What muscles does the axillary artery pass posterior to?

A

Pectoralis minor

52
Q

What are the four branch of the thoraco-acromial artery?

A

1) Clavicular
2) Acromial
3) Deltoid
4) Pectoral

*Cadavers Are Dead People

53
Q

How many lobes does the typical inactive adult mammary gland have?

A

15-20

54
Q

Common sites of breast implant placement

A
  • Subglandular position (on surface of the muscle but behind the gland)
  • Sub muscular positon (behind Pectoralis major attachment is attached
  • Bi plane implantation (below pectoralis major muscle but also in plane with the superficial fascia)
55
Q

What incisions can be made for breast implant placement?

A
  • Periareolar
  • Inferior mammary fold (IMF)
  • Transaxillary
56
Q

What are the cells inside of mammary glands?

A
  • Glandular cuboidal cells (produce milk)
  • Myoepithelial cells (can contract and squeeze aveoli)
  • Stromal cells (plasma produces IgA)
57
Q

What 2 nerves does the subscapular nerve branch into?

A
  • Thoracodorsal

- Circumflex scapular

Clinical Anatomy (25 decks)

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