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Anatomy > The Axilla and Breast > Flashcards

The Axilla and Breast Flashcards

1
Q

where is the axilla located in relation to the glenohumeral joint

A

inferior

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2
Q

what junction is the axilla located at

A

the arm and the thorax

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3
Q

what is the axilla an important passageway for

A

neurovascular structures between axilla and pectoral region

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4
Q

what shape is the axilla

A

pyramid shaped

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5
Q

what does the fascia of the pectoral region consist of

A

superficial and deep layers that define borders, invest muscles, and create potential spaces

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6
Q

describe the superficial fascia

A

skin and subcutaneous fatty, loose CT (like campers fascia)

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7
Q

describe deep fascia

A

-surrounds muscles
-attaches to bone in most cases

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8
Q

what muscle does the superficial fascia contain

A

platysma muscle

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9
Q

where is the platysma muscle located

A

muscle over lower mandible, neck and upper thoracic/shoulder region

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10
Q

what nerves does the superficial fascia contain

A

-supraclavicular nerves- cutaneous branches from C3 and C4 cervical spinal nerves
- anterior and lateral branches of intercostal nerves

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11
Q

what layer is the platysma located in

A

mostly subcutaneous

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12
Q

what layers are anterior and lateral branches of intercostal nerves located in

A

come up through deeper layers of fascia to subcutaneous layers

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13
Q

what type of fascia is located in the deep fascia of the pectoral region

A

-pectoral fascia
-axillary fascia
-clavipectoral fascia
-deltoid fascia

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14
Q

where is the pectoral fascia located

A

attaches to clavicle and sternum, invests pectoralis major muscle, continuous with fascia of anterior abdominal wall (scarpas fascia)

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15
Q

what does the pectoral fascia become

A

the axillary fascia

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16
Q

what does the axillary fascia form

A

the floor of axilla

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17
Q

where is the clavipectoral fascia located

A

deep to pectoralis major muscle

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18
Q

what does the clavipectoral fascia invest

A

subclavius and pectoralis minor muscles

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19
Q

what does the costocoracoid membrane connect

A

located in clavipectoral fascia that connects subclavius to pectoralis minor

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20
Q

what does clavipectoral fascia attach to

A

clavicle

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21
Q

what does the clavipectoral fascia become

A

suspensory ligament of axilla

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22
Q

where is the deltoid fascia located

A

surface of deltoid muscle

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23
Q

what does the deltoid fascia attach to

A

clavicle, acromion, and spine of scapula

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24
Q

what is the deltoid fascia continuous with

A

pectoralis fascia

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25
Q

what does the deltoid fascia compartmentalize

A

scapular muscles

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26
Q

what is another name for the clavipectoral triangle

A

deltopectoral triangle

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27
Q

what are the borders of the clavipectoral triangle

A

deltoid, pectoralis major, middle 1/3 of clavicle

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28
Q

what are the contents of the clavipectroal triangle

A

cephalic vein, deltopectoral lymph nodes, deltoid branch of thoracoacromial artery

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29
Q

what is the thoracoacrominal artery a branch of

A

axillary artery

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30
Q

what makes up the apex of the axillary triangle

A
  • clavicle -anterior
  • scapula - posterior
  • 1st rib- medial
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31
Q

what does the apex contain

A

the cervicoaxillary canal

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32
Q

what is the cervicoaxillary canal

A

passageway for neurovascular structures such as axillary vessels and brachial plexus components from the neck to the upper limb

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33
Q

what makes up the base of the triangle

A

-skin and superficial fascia
- anterior axillary fold
- posterior axillary fold
-chest wall

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34
Q

what is the axillary fossa

A

the armpit

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35
Q

what does the anterior axillary fold contain

A

pectoralis major muscle

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36
Q

what does the posterior axillary fold contain

A

-latissimus dorsi muscle
-teres major muscle

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37
Q

what does the chest wall contain

A

serratus anterior muscle

38
Q

what makes up the anterior wall of the axilla triangle

A

-clavicle: superior
- subclavious muscle: superior
- pectoralis major muscle
-pectoralis minor muscle

39
Q

what makes up the posterior wall of the axillary triangle

A

-scapula
-subscapularis muscle
-latissimus dorsi muscle
-teres major muscle

40
Q

what makes up the lateral wall of the axillary triangle

A

-intertubercular sulcus (bicipital groove)
- tendon of long head of biceps
- coracobrachialis tendone

41
Q

what is the separate fascial compartment within the axilla

A

the axillary sheath

42
Q

what is the axillary sheath

A

an extension of the prevertebral layer of deep cervical fascia into the cervicoaxillary canal (apex) of the axilla

43
Q

what are the contents of the axillary sheath

A

-vascular: axillary artery and vein
-neurological: cords of the brachial plexus
- lymphatic: axillary lymph nodes

44
Q

what is the axillary artery a continuation of and what does it continue as in the arm

A

continuation of subclavian artery and it continues into the arm as the brachial artery

45
Q

what does the axillary artery provide blood to

A

shoulder, thorax, and axillary region

46
Q

what is the axillary vein formed by

A

the junction of brachial vein(s) and the basilic vein

47
Q

what joins the axillary vein as it becomes the subclavian vein

A

the cephalic vein

48
Q

what type of veins are cephalic and basilic veins

A

superficial veins of the upper limb

49
Q

what is the spatial relationship between the cephalic and basilic vein

A

cephalic is lateral/superior and basilic is medial/inferior

50
Q

where is the brachial plexus located

A

network of spinal nerves from C5-T1 that emerge from the neck and travel into the axilla

51
Q

where are the cords of the brachial plexus located

A

within the axillary sheath

52
Q

what does the brachial plexus provide innervation to

A

shoulder, pectoral region, scapular region and upper limb

53
Q

what are the groups of axillary lymph nodes

A

-pectoral (anterior) lymph nodes (3-5)
-subscapular (posterior) lymph nodes (6-7)
-humeral (lateral) lymph nodes (4-6)
- central (center/base) lymph nodes (3-4)
- apical (apex) lymph nodes

54
Q

where are the pectoral lymph nodes located and what vein are they clustered aroun

A

located in medial wall of axilla
-cluster around lateral thoracic vein

55
Q

where are subscapular lymph nodes located in what vein are they clustered around

A

posterior axillary fold, cluster around subscapular vessles

56
Q

where are humeral lymph nodes located and what vein are they clustered around

A

lateral wall of axilla, near axillary vein

57
Q

where are central lymph nodes located and what vein are they clustered around

A

base of axilla, near axillary vein

58
Q

where are apical lymph nodes located and what vein are they clustered around

A

apex, near axillary vein

59
Q

what glands are the mammary glands

A

modified sweat glands

60
Q

what type of structure is the breast and what does it rest on

A

cutaneous structure, rests on pectoral fascia

61
Q

what is the retromammary space

A

potential space between breast and pectoral fascia

62
Q

what is the blood supply to the breast

A

from tributaries of subclavian and axillay arteries

63
Q

what is the breast innervated by

A

-anterior and lateral branches of intercostal nerves 4-6
-supraclavicular nerve branches

64
Q

what does the breast attach to

A

dermis of overlying skin via suspensory ligaments

65
Q

what are the suspensory ligaments in the breast tissue

A

cooper’s ligaments

66
Q

where do mammary gland lobules converge

A

on the nipple

67
Q

where do lactiferous ducts drain into

A

lactiferous sinuses which open at the nipple

68
Q

what is the nipple surrounded by

A

a pigmented areola

69
Q

what types of innervation innervates the breast tissue and where

A

somatosensory to skin and autonomic to blood vessels and smooth muscle

70
Q

what is the primary blood supply to the breast

A

medial mammary branches and lateral mammary branches

71
Q

where do medial mammary branches come from

A

internal thoracic artery which comes from the subclavian artery

72
Q

where do lateral mammary branches come from

A

lateral thoracic artery which comes from the axillary artery

73
Q

what is the primary venous drainage of the breast

A

-mainly to axillary vein via lateral thoracic veins and medial mammary veins via internal thoracic vein
- some drainage to internal thoracic vein via anterior intercostal veins

74
Q

what drains the lymph from the nipple, areola, lactiferous lobules

A

subareolar lymph nodes

75
Q

what drains more than 75% of lymph from breast

A

axillary lymph nodes (pectoral, central, apical)

76
Q

where is the remaining lymph from the breast drained from

A

parasternal (internal mammary) and abdominal lymph nodes

77
Q

what is polythelia

A

accessory nipple

78
Q

what is polymastia

A

accessory breast tissue

79
Q

what may polymastia and polythelia include

A

glandular tissue

80
Q

where do polymastia and polythelia appear

A

along the embryonic mammary crest which extends from axilla to groin area

81
Q

what do adenocarcinomas of the breast arise from

A

glandular tissue, epithelial cells of lactiferous ducts

82
Q

where do most metastasis go

A

to axillary lymph nodes

83
Q

what are examples of retraction signs of the breast

A

-lymphedema by blocking flow of lymph leading to dimpling of the skin of breast
-Peau d’orange sign

84
Q

what can invasion of glandular tissue and fibrosis cause

A

larger, fingertip sized dimpling

85
Q

what does invasion of retromammary space and pectoral fascia cause

A

the breast to elevate when pectoral muscles contract

86
Q

what is a clinical sign of advanced breast cancer

A

breast elevating when pectoral muscles contract

87
Q

how can metastatic cancer cells from breast tissue spread

A

via parasternal lymph node communication with internal thoracic (internal mammary) veins which drain into intercostal veins

88
Q

where do intercostal veins carrying metastatic cancer cells eventually drain

A

azygos venous system in the posterior thorax and provide the route by which cancers of the breast tissue can spread to thoracic and skeletal structures

89
Q

what does involvement of vertebral venous plexus provide a route for in metastatic cancer

A

cancer cells to spread to the brain and cranium

90
Q

where may metastatic breast cancer also spread

A

the liver

Anatomy (27 decks)

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