The Axilla & Breast- Exam IV Flashcards
(173 cards)
1
Q
What shape is the axilla described as?
A
pyramid
2
Q
What borders makeup the pyramid consuming the axilla?
A
anterior, posterior, lateral and medial
3
Q
armpit region
A
axilla
4
Q
What is the scientific term for armpit?
A
axillary fossa
5
Q
The axillary fossa is located inferiorly to what joint?
A
glenohumeral joint
6
Q
The axilla is essentially the region we think of as the:
A
deep compartment of the armpit
7
Q
What is another name for glenohumeral joint?
A
shoulder joint
8
Q
The axilla is inferior to the glenohumeral joint at the junction of the:
A
arm and thorax
9
Q
The axilla is an important ________ to the upper limb
A
passageway for neurovascular structures
10
Q
The axilla is a pyramid-shaped spaces that is invested in:
A
layers of fascia
11
Q
Some of the layers of fascia that the axilla is invested in are continuous with:
A
The Thorax and upper limb
12
Q
The glenohumeral joint is where the ____ attaches to the ____.
A
humerus to scapula
13
Q
The rough pyramid shape is associated with bony elements that include: (anteriorly, posteriorly, laterally, medially)
A
anterior: clavicle
posterior: scapula
lateral: humerus
medial: torso & ribs
14
Q
The fascia of the pectoral region consists of ___ and ____ layers
A
superficial and deep
15
Q
The fascia of the pectoral region consists of superficial and deep layers that do what 3 things?
A
- define borders
- invest muscles
- create potential spaces
16
Q
Fascia of the upper limb will be named:
A
regionally
17
Q
Fascia with respect to the musculoskeletal system is important because it encases routes of muscles that ______. It connects groups of muscles that do ______, and also encases ______.
A
- functionally do the same thing
- different things
- singular muscles
18
Q
What fascia of the upper limb is composed of adipose tissue, and loose areolar connective tissue?
A
superficial fascia
19
Q
Superficial fascia of the upper limb is analogous to what type of fascia in the abdomen?
A
campers fascia of abdomen
20
Q
What fascia of the upper limb is described as subcutaneous?
A
superficial
21
Q
What fascia of the upper limb plays a role in compartmentalizing, surrounds muscles, and attaches to bone in most cases?
A
deep fascia
22
Q
What fascia of the upper limb defines the axillary fossa?
A
deep fascia
23
Q
What fascia of the upper limb contains many lymph nodes?
A
superficial fascia
24
Q
The deep fascia of the upper limb is analogous to _______ fascia of the abdomen
A
Campers
25
Fascia covering the pectoral region:
pectoral fascia
26
Fascia defining the axillary region?
axillary fascia
27
Fascia covering the deltoid region?
deltoid fascia
28
Fascia covering the arm?
brachial fascia
29
Smaller chest muscle that connects some of the ribs to the scapula:
pectoralis minor
30
Large anterior upper chest muscle:
pectoralis major
31
Within the axillary region, we have compartmentalization that happens from the pectoral fascia contributions and then deep to the pectoral fascia we have:
clavipectoral fascia
32
The pectoralis major muscle is covered in _____ fascia
pectoral
33
The pectoralis minor muscle is covered in ____ fascia
clavipectoral fascia
34
The clavipectoral fascia is connecting from the ______ to the _____.
subclavius to pectoralis minor
35
What fascia is located inferior to the pectoral muscles?
axillary fascia
36
The pectoral fascia and the clavipectoral fascia connect together essentially creating a nice fascia plane of deep:
axillary fascia
37
Superficial fascia is composed of: (2)
skin and subcutaneous fatty tissue
38
Muscle over lower mandible, neck, and upper thoracic/shoulder region; a very superficial skeletal muscle that is mostly subcutaneous:
platysma muscle
39
Nerves from the brachial plexus that are cutaneous branches from C3 & C4 spinal nerves
supraclavicular nerves
40
Nerves that provide cutaneous innervation over the neck and very top portion of the pectoral region:
supraclavicular nerve
41
What type of innervation comes from the supraclavicular nerve
cutaneous innervation
42
The supracalvicular nerve is composed of cutaneous branches from:
C3 and C4 cervical spinal nerves
43
Anterior and lateral branches of intercostal nerves come up through ____ to _____.
come up through deeper layers of fascia to subcutaneous layers
44
anterior and lateral branches of ______ nerves come up through the deeper layers of fascia to subcutaneous layers
intercostal nerves
45
Intercostal nerves that are innervating the costal muscle are also providing ______ innervation to the skin of the thorax
cutaneous
46
Covers the pectoralis major muscle
pectoral fascia
47
The pectoralis fascia:
1. attaches ____ to _____
2. Invests the ______ muscle
3. Is continuous with the fascia of the _____.
1. clavicle to sternum
2. pectoralis majorm muscle
3. anterior abdominal wall
48
The pectoral fascia will become the:
axillary fascia
49
What type of fascia forms the floor of the axilla?
axillary fascia
50
What fascia is deep to the pectoralis muscle?
clavipectoral fascia
51
The clavipectoral fascia invests what muscle? (2)
subclavius and pectoralis minor muscles
52
What connects the subclavius to the pectoralis minor?
costocoracoid membrane
53
The clavicpectoral fascia attaches to what bone?
clavicle
54
The clavipectoral fascia becomes _____ of the _____.
suspensory ligament of axilla
55
Label:
A- pectoralis major
B- pectoralis minor
C- subclavius
56
Label:
A- costocoracoid membrane
B- Pectoral fascia
C- suspensory ligament of axilla
D- Axillary fascia
57
Deep fascial membranous structure that transmits nerves and vessels that are going form deep in the shoulder to cutaneous in the chest
costocoracoid membrane
58
Where does the clavicpectoral fascia connect to the pectoral fascia?
suspensory ligament
59
Allows for the passage of neurovascular structures between the axilla and pectoral region:
clavipectoral triangle
60
What is another name for clavipectoral triangle?
deltopectoral triangle
61
What are the borders of the clavipectoral triangle? (3)
deltoid, pectoralis major and middle 1/3 of clavicle
62
What are the contents of the clavipectoral triangle? (3)
cephalic vein, deltopectoral lymph nodes, deltoid branch of thoracoacromial artery
63
The deltoid branch of the thoracoacromial artery comes from what artery?
axillary artery
64
What vein and artery is shown?
Cephalic vein; deltoid branch of thoracacromial artery
65
The skin of the axilla is connected to the _____ that is derived from the clavipectoral and pectoral fascia that is pulled up from the suspensory ligament
Axillary fascia
66
What keeps the skin and tissue tucked up into the axilla to prevent droopy armpit skin?
Suspensory ligament
67
The top opening of the axilla coming from the neck:
Apex of axilla
68
Where is the cervicoaxillary canal located?
Apex of axilla
69
Space that is the passageway for neurovascular structures (axillary vessels & brachial plexus components) from the neck and upper limb
Cervicoaxillary canal
70
What borders the apex of the axilla? (3)
Clavicle, scapula, and 1st rib
71
Portion of the axilla that is invested in the superficial fatty, lymphatic axillary fascia that is very protective:
Base of axilla
72
In the base of the axilla:
The anterior axillary fold contains what muscle?
Pectoralis major
73
The base of the axilla:
The posterior axillary fold contains what muscles?
Latissamus dorsi and teres major
74
In the base of the axilla:
What muscles does the chest wall contain?
Serratus anterior muscle
75
In the anterior wall of the axilla, the superior portion contains:
Clavicle and subclavius muscle
76
What are all of the structures associated with the anterior wall of the axilla?
Clavicle, subclavius muscle, pectoralis major muscle and pectoralis minor muscle
77
The medial portions of the anterior wall of the axilla include:
Chest wall- pectoralis major and minor
78
Label
A: anterior wall
B: pectoralis major
C: pectoralis minor
79
What components make up the posterior wall of the axilla? (4)
Scapula, subscapularis muscle, latissimus dorsi muscle, teres major muscle
80
Label:
A- posterior wall
B- latissiumus dorsi
C- teres major
D- scapula
E- subscapularis
81
What components make up the lateral wall of the axilla?
Intertubercular sulcus
Tendon of long head of biceps
Coracobrachialis tendon
82
The lateral wall of the axilla is associated with the ____ and the muscles and tendons that go with it.
Humerus
83
The anterior medial aspect of the humerus has a groove called the intertubercular sulcus which can also be called:
Bicipital groove
84
Label:
A: coracobrachialis tendon
B: tendon of long head of biceps
85
What tendon sits in side the intertubercular sulcus (or bicipital groove of sulcus)?
Tendon of long head of biceps brachii
86
Within the axilla is a separate facial compartment called the:
Axillary sheath
87
The axillary sheath is an extension of the _______ into the ______ of the axilla
Extensions of prevertebral layer of deep cervical fascia into the cervicoaxillary canal (apex)
88
The contents of the axillary sheath include what 3 things (basic)
Vascular, neurological, and lymphatic
89
The vascular component of the axillary sheath includes:
Arteries and veins
90
The neurological components of the axillary sheath include:
Cord of the brachial plexus
91
The lymphatic components of the axillary sheath include:
Axillary lymph nodes
92
The axillary sheath is found in the:
Cervicoaxillary canal
93
The axillary sheath surrounds what 3 things? What is also sometimes there but most of the time are located AROUND the axillary sheath and not in it?
Axillary vein, axillary artery, & parts of brachial plexus
Lymph nodes
94
When discussing the vasculature of the axilla, the axilla contains what vein and what artery?
Axillary artery, axillary vein
95
The axillary artery is a continuation of the:
Subclavian artery
96
The axillary artery is a continuation of the subclavian artery and has tributaries that provide blood to the: (3)
Shoulder, thorax, and axillary region
97
The axillary artery continues into the arm as the:
Brachial artery
98
The axillary vein is formed by the joining of the:
Brachial veins and basilic vein
99
The brachial veins and basilic veins join to form the:
Axillary vein
100
The axillary vein will eventually be joined by the cephalic vein as it becomes the:
Subclavian vein
101
Cephalic =
Lateral/ superior
102
Basilic =
Medial/inferior
103
Both the cephalic and basilic veins are both ____ of the upper limb
Superficial veins
104
Label:
A- axillary artery
B- cephalic vein
C- subclavian vein
D- axillary vein
E- brachial veins
F- bacilic vein
105
A network of spinal nerves C5-T1 that emerge from the neck and travel into the axilla
Brachial plexus
106
The brachial plexus of the axilla involves the spinal nerves:
C5-T1
107
The ______ of the brachial plexus are within the axillary sheath
Cords
108
The cords of the brachial plexus that are within the axillary sheath are also accompanied by:
The axillary artery and vein
109
The brachial plexus of the axilla provides innervation to the: (4)
1. Shoulder
2. Pectoral region
3. Scapular region
4. Upper limb
110
What cervical nerves are involved with the brachial plexus? What thoracic nerves?
C5-C8; T1
111
Within the fibrocartilage connective tissue of the axilla there are numerous:
Axillary lymph nodes
112
The axillary lymph nodes can be grouped together based on :
Their location within pyramid
113
Anterior axillary lymph nodes:
Pectoral lymph nodes
114
Posterior axillary lymph nodes
Subscapular lymph nodes
115
Lateral axillary lymph nodes:
Humeral lymph nodes
116
Center/base axillary lymph nodes:
Central lymph nodes
117
The apex axillary lymph nodes:
Apical lymph nodes
118
Axillary lymph nodes (3-5) located near the medial wall of the axilla & also cluster around the lateral thoracic vein.
Pectoral (anterior) lymph nodes
119
The axillary lymph nodes (6-7) that are located near the posterior axillary fold and cluster around the subscapular vessels
Subscapular (posterior) lymph nodes
120
The axillary lymph nodes ( 4-6) located in the lateral wall of the axilla near the axillary vein:
Humeral (lateral) lymph nodes
121
The axillary lymph nodes (3-4) located at the base of the axilla near the axillary vein:
Central (center/base) lymph nodes
122
The axillary lymph nodes located near the apex (cervicoaxillary canal), and near the axillary vein
Apical (apex) lymph nodes
123
Describe the structure of the breast:
Bilateral glandular structures
124
In females, the breast is much more developed and capable of:
Producing nourishment for the young
125
What type of glands are mammary glands?
Modified sweat glands
126
The cutaneous structure (breast itself) sits on top of:
Pectoral fascia (deep fascia)
127
What are the glands that produce the milk in the glandular breast tissue:
Lactiferous glands
128
From the lactiferous glands, we have a lot of ducts that converge on the:
Nipple
129
List the order of deep to superficial when describing the breast:
1. Ribs
2. Pectoralis minor muscle (covered in clavipectoral fascia)
3. Pectoralis major muscle (covered in pectoral fascia)
4. Retromammary space
5. Superficial fascia of chest wall & breast?
130
The retromammary space can also be called the:
Retromammary bursa
131
The Retromammary space (bursa) is a potential space between the:
Breast and pectoral fascia
132
The breast is innervated by:
Intercostal nerves (4-6)
133
The 4th-6th intercostal nerves provide ___ & ____ to breast tissue.
Sensation and autonomics
134
The lactiferous lobules (glandular structures) receive:
Sympathetic and parasympathetic innervation
135
Blood supply and innervation of the breast is coming rom surrounding vessels and nerves such as:
Tributaries from sublcavian and axillary arteries and the corresponding veins
136
Structures within the breast tissue that actually tack some of the loose tissue to the skin:
Suspensory ligaments of the breast
137
Typically the adipose loose areolar connective fascia of the breast is NOT stuck to the breast wall. However when attachment occurs or infiltrates into the retromammary space occurs this is indicative of:
A pathological process (probs cancer)
138
Mammary gland lobules converge on the:
Nipple
139
_____ drain into _____ which open at the nipple
Lactiferous ducts ; lactiferous sinuses
140
What allows milk to pool prior to expression?
Lactiferous sinuses
141
The nipple is surrounded by a pigmented:
Areola
142
The innervation of the breast is mainly from:
Anterior and lateral branches of the 4th -6th intercostal nerves
143
In addition to the 4th-6th intercostal nerves, the breast may also receive innervation from :
Supraclacivular nerve branches & and other intercostal nerve branches
144
What type of innervation occurs for the skin of the breast?
Somatosensory
145
What type of innervation occurs with the blood vessels and smooth muscle of the breast?
Autonomic
146
We have ___ & ____ mammary branches that will come from the ____ & _____ intercostal branches (for breast innervation)
Medial and lateral mammary branches; anterior and lateral intercostal branches
147
The primary blood supply of the breast breaks down into what two branches?
Medial mammary branches & Lateral mammary branches
148
The medial mammary branches come from the _____ which comes from the ____.
From internal thoracic artery which comes from subclavian artery
149
The lateral mammary branches come from the ____ which comes from the ______.
Lateral thoracic artery which comes from the axillary artery
150
What is the primary blood supply to the breast?
A- axillary artery
B- subclavian artery
C- Both
C- Both
151
Label:
A- intercostal nerve- lateral mammary branches
B- Supraclavicular nerves
C- Intercostal nerve- medial mammary branches
152
Label
A- axillary artery and vein
B- lateral thoracic artery and vein
C- medial mammary branches
D- lateral mammary branches
E- Subclavian artery and vein
F- Internal thoracic artery and vein
G- perforating branches
H- mammary branches
153
The primary venous drainage of the breast is mainly to the ____ via lateral thoracic veins and medial mammary veins via the _____.
Axillary vein; internal thoracic vein
154
The venous drainage of the breast is mainly to the axillary vein via the ____ , and then the ______ via the internal thoracic vein.
Lateral thoracic veins ; medial mammary veins
155
Lymphatic drainage of the breast is especially important due to its role in :
Metastasis of cancer cells
156
More than 75% of lymph drainage of the breast goes into:
Axillary lymph nodes
157
What are the groups of axillary lymph nodes that most commonly receive lymph drainage:
Pectoral, central, apical
158
The nipple, areolar and lactiferous lobules drain into the:
Subareolar lymph nodes
159
Additional breast lymph may be drained into the:
Parasternal and abdominal lymph nodes
160
Developmental region in which along this line in development breast tissue can develop anywhere, and may or may not include glandular tissue:
Mammary ridge
161
Accessory nipple (___)and or breast tissue (____) can occur in males & females
Polythelia; polymastia
162
Arise from glandular tissue, epithelial cells of lactiferous ducts:
Adenocarcinomas
163
Most metastasis of breast involves:
Axillary lymph nodes
164
Excess subcutaneous fluid involved in cancer process:
Lymphedema
165
Dimpling of the skin of the breast:
Peau D’orange sign
166
Invasion of the retromammary space and pectoral fascia will cause the breast to: (a clinical sign of advanced cancer)
Elevate when pectoral muscles contract
167
List common signs of carcinoma of breast: (5)
1. Skin dimpling
2. Retracted signs
3. Edema of skin (Peau D’ Orange)
4. Nipple retraction and deviation
5. Abnormal contours
168
Metastatic cancer Carnell from breast tissue can also spread via:
Parasternal lymph node communication with internal thoracic veins
169
Metastatic cancer from breast tissue can also spread via Parasternal lymph node communication ninth internal thoracic (internal mammary) veins, which drain to:
Intercostal veins
170
The intercostal veins eventually drain to the _____ in the posterior thorax
Azygous venous system
171
The drainage of the intercostal veins to the azygous venous system in teh posterior thorax can provide the route by which cancers of the breast can spread to:
Thoracic and skeletal structures
172
During metastasis, involvement of vertebral venous pelxus also provides a route for cancer cells to spread to the:
Brain and cranium
173
What are the 4 most common areas breast cancer can metastasize to?
Lung, pleura, liver, and bone
