Scapula, Pectoral, and Breast

Question 1

Two vessels embedded in superficial fascia

Answer 1

1. Cephalic v.
   -Travels laterally
   -Pierces part of the clavipectoral fascia
2. Basilic v.
   -Travels medially
   -Pierces brachial fascia

Both drain into axillary v.

Question 2

Deltoid muscle

Answer 2

O: Lateral 1/3 clavicle, acromion, spine of scapula
I: Deltoid tuberosity of humerus
Inn: Axillary n.
Action(s): Clavicular: flex and medially rotate
Acromial: abducts arm (beyond initial 15 degree)
Spinal: extends & laterally rotates arm

Question 3

Teres Major Muscle

Answer 3

Lats little helper
O: Posterior surface of inferior angle of scapula
I: Medial lip of bicipital groove of humerus
Inn: Lower subscapular n.
Action(s): Adduct, & medially rotates arm

Question 4

Supraspinatus muscle

Answer 4

O: Supraspinous fossa of scapula
I: Superior facet of greater tubercle of humerus
Inn: Suprascapular n.
Action(s): Assists deltoid with abduction of the arm (initial 15 degrees)

Question 5

Infraspinatus Muscle

Answer 5

O: Infraspinous fossa of scapula
I: Middle facet of greater tubercle of humerus
Inn: Suprascapular n.
Action(s): Laterally rotates the arm

Question 6

Teres Minor Muscle

Answer 6

O: Middle part of lateral border of scapula
I: Inferior facet of greater tubercle of humerus
Inn: Axillary n.
Action(s): Laterally rotates the arm

Question 7

Subscapularis muscle

Answer 7

O: Subscapular fossa of scapula
I: Lesser tubercle of humerus
Inn: Upper & lower subscapular nn.
Action(s): Medially rotates the arm

Question 8

Bursa

Answer 8

trying to prevent friction with movement

Question 9

Rotator cuff injuries

Answer 9

-Repeated abduction and flexion (e.g., a throwing motion) causes wear on the tendons as they rub on the acromion and coracoacromial ligament
-The tendon of the supraspinatus is most vulnerable to injury
-Weakest inferiorly

Question 10

Shoulder dislocation

Answer 10

Anterior humeral dislocation

Question 11

Pectoralis Major Muscle

Answer 11

O: clavicular attachment and sternocostal head
I: lateral lip of bicipital groove of humerus
Inn: lateral & medial pectoral nn.
Action(s): Adducts and medially rotates humerus, draws scapular anteriorly and inferiorly
Acting alone: clavicular head flexes while sternocostal head extends the humerus from a flexed position

Question 12

Pectoralis Minor muscle

Answer 12

O: 3rd to 5th ribs never costal cartilages
I: Coracoid process of scapula
Inn: Medial pectoral n.
Action(s): Stabilizes scapula by drawing it inferiorly and anteriorly against the thoracic wall

Question 13

Subclavius muscle

Answer 13

O: Junction of 1st rib & costal cartilage
I: Inferior surface of clavicle
Inn: N. to subclavius
Action(s): Depresses & anchors clavicle

Question 14

Serratus Anterior Muscle

Answer 14

O: Lateral part of ribs 1-8
I: Medial border of scapula
Inn: Long thoracic n.
Action(s): Protracts, rotates, & holds scapular against thoracic wall

Question 15

Quadrangular Space

Answer 15

Boarders:
Sup: teres minor
Inf: teres major
Med: triceps brachii long head
Lat: shart of the humerus
Contents: axillary n. & posterior circumflex humeral artery

Question 16

Triangular space

Answer 16

Boarders:
Sup: teres minor
Inf: teres major
Lat: triceps brachii long head
Contents: circumflex scapular a.

Question 17

Breast shape

Answer 17

round and mostly from fat, 2/3 rests on pectoralis major and 1/3 on serratus anterior fascia
oEnlarges during puberty and pregnancy from new glandular tissue

Question 18

Nipples

Answer 18

don’t have far, hair or sweat glands, tip is fissured with lactiferous ducts opening, composed of circularly arranged smooth muscle fibers

Question 19

Areola

Answer 19

contains numerous sebaceous glands, secrete protective oily substance

Question 20

Breast Quadrants

Answer 20

used for anatomical description and location of a hard mass or cyst

Question 21

Suspensory ligaments

Answer 21

condensations of fibrous connective tissue- support lactiferous ducts and lobules

Question 22

Lactiferous ducts

Answer 22

give rise to buds that develop into 15-20 lobules

Question 23

Lobules of mammary gland

Answer 23

are parenchyma (functional substance)- enlargement during lactation

Question 24

Lactiferous sinus

Answer 24

are dilated portion of each duct located deep to the areola, where milk will accumulate or remain in a nursing mother, causing “let-down reflex”

Question 25

Neurovascular of the breast

Answer 25

-Inn: anterior and lateral cutaneous branches of the 4th- 6th intercostal nn.
-Lateral thoracic a.
-Medial internal intercostal a. & posterior intercostal aa.
-Axillary v.

Question 26

Lymphatic drainage of the Breast

Answer 26

-Most of the breast drains via pectoral, central, and apical axillary nodes to subclavian lymph trunk
oMedial breast drains to parasternal nodes
-Subclavian lymph trunk drains into venous system at subclavian and internal jugular junction
-Lymph-> central -> subclavian -> r. lymphatic duct and thoracic duct

Question 27

Potential breast cancer abnormalities

Answer 27

Skin dimpling, edema of skin, nipple retraction, abnormal contours