The Axilla & Breast (Exam IV) Flashcards
1
Q
Deep compartment of armpit
A
Axilla
2
Q
Region where the upper arm connects to the torso
A
Axilla
3
Q
What major bones connect in the axilla
A
Humerus connects to the scapula & clavicle
4
Q
What borders does the axilla contain
A
Anterior, posterior, medial, lateral
5
Q
Two major significances of the locations of the axilla
A
1- major vessels of the heart pass through here
2- nerves of cervical & brachial plexus go into thoracic region & upper limb
6
Q
Importance of a swollen axillary lymph node
A
May be indication of something pathological going on elsewhere
7
Q
Axillary fossa is inferior to the
A
Glenohumeral joint
8
Q
Location in which the humerus attaches to the scapula
A
Glenohumeral joint
9
Q
Another name for the shoulder joint
A
Glenohumeral joint
10
Q
Axilla is a important passageway for
A
Neuromuscular structures of the upper limb
11
Q
The axilla is a space invested in
A
Layers of fascia
12
Q
Some of the fascial layers of the scapula are continuous with
A
The thorax and upper limb
13
Q
What makes up the pectoral/shoulder girdle
A
Clavicle & scapula
14
Q
Describe superficial fascia
A
Loose areolar connective tissue, subcutaneous, fatty
15
Q
Functions of the deep fascia
A
1- encases muscles
2- compartmentalization
3- attaches muscle to bone
16
Q
The contributions that contribute to the axillary compartmentalization come from:
A
Pectoral fascia & clavipectoral fascia
17
Q
The pectoralis major is wrapped in _____, while the pectoralis minor is wrapped in ______
A
Pectoral fascia
Clavipectoral fascia
18
Q
Muscle over lower mandible, neck & upper thoracic/shoulder region
A
Platysma
19
Q
Describe the platysma muscle (3)
A
Skeletal muscle
Very superficial
Mostly subcutaneous
20
Q
The subclavicular nerves are _____ branches from _____ spinal nerves _____ & _____
A
Cutaneous
Cervical
C3 & C4
21
Q
The supercalvicular nerves provide cutaneous innervation over
A
The skin of the neck & upper pectoral region
22
Q
Nerve branches responsible for pain to the left limb during a heart attack (be specific)
A
Anterior & lateral branches of T2 intercostal nerve
23
Q
What forms the suspensory ligament of the axilla
A
Where the clavipectoral and pectoral fascia connect
24
Q
Two roles of pectoral fascia
A
1- attaches clavicle & sternum
2- invests pectoralis major muscle
25
The pectoralis fascia is continuous with
Scarpas fascia of anterior abdominal wall
26
Pectoral fascia will eventually become
Axillary fascia
27
Forms the floor of the axilla
Axillary fascia
28
Clavipectoral fascia is deep to the
Pectoralis major muscle
29
Functions of the clavipectoral fascia
1- surrounds subclavius muscle
2- surrounds pectoralis minor muscle
3- attaches to clavicle
30
Deep fascial membranous structure that transmits nerves and vessels from deep in shoulder to subcutaneous in chest
Costocorocoid membrane
31
Connects subcalvius to pectoralis minor
Costocorocoid membrane
32
What does the deltoid fascia attach to
Clavicle, acromium & spine of scapula
33
What is the deltoid fascia continuous with
Pectoralis fascia
34
What does the deltoid fascia compartmentalize
Scapular muscles
35
Allows passage of neuromuscular structures between the axilla and pectoral region
Clavipectoral triangle
36
Borders of the clavipectoral triangle
Deltoid, pectoralis major, middle 1/3 of clavicle
37
The clavipectoral triangle contains (3):
Cephalic veins
Deltopectoral lymph nodes
Deltoid branch of thoracoacromial artery
38
Makes up the floor of the clavipectoral triangle
Corocoid membrane
39
Importance of the suspensory ligament of the axilla
Its keeping all of the tissue tucked up into the axilla & not hanging down
40
The skin covering the base of the axilla is continuous with
Axillary fascia
41
Border of the anterior wall of axilla
Anterior axillary fold
42
Border of the posterior wall of the axilla
Posterior axillary fold
43
What muscle is the anterior axillary fold made up of
Mostly pectoralis major
44
What makes up the posterior axillary fold
Latissimus dorsi & lateral border of there scapula
45
Top opening of the axilla coming from the neck
Apex
46
Anterior, posterior & medial borders of the apex
Anterior- clavicle
Posterior- scapula
Medial- first rib
47
Passageway for neurovascular structures traveling from the neck to the upper limb
Cervoaxillary canal
48
Important passageway contained within the axilla
Cervicoaxillary canal
49
The cervicoaxillary canal provides a passageway for
Axillary vessels & brachial plexus components
50
The base of the axilla is invested in
Superficial axillary fascia
51
What components comprise the base of the axilla (5)
1- Skin
2- Superficial fascia
3- Anterior axillary fold
4- Posterior axillary fold
5- Chest wall
52
List four structures that can be associated with the anterior wall of the axillary pyramid
Clavicle, Subclavius muscle, Pectoralis major muscle, Pectoralis minor muscle
53
List four structures that can be associated with the posterior wall of the axillary pyramid
Scapula, Subscapularis muscle, Latissimus dorsi muscle, Teres major muscle
54
Groove that houses the tendon of long head of biceps brachii
Intertubicular sulcus
55
Two structures associated with the lateral border of the axillary pyramid
Intertubicular sulcus with long tendon of biceps brachii inside & coracobrachialis tendon
56
The axillary sheath contains (3)
Axillary artery
Axillary vein
Brachial plexus
57
Vascular contents of the axillary sheath
Axillary artery & vein
58
Neurological contents of the axillary sheath
Cords of the brachial plexus
59
Lymphatic contents of the axillary sheath
Axillary lymph nodes
60
Where does the axillary sheath begin
Cervicoaxillary canal
61
The axillary sheath is an extension of the _____ layer of _____ into the cervicoaxillary canal
Prevertebral layer
Deep cervical fascia
62
Arteries come from ____ & go ______
Heart
Rest of body
63
Vasculature contained within the axilla
Axillary artery & vein
64
The axillary artery is a continuation of the
Subclavian artery
65
Tributaries of the axillary artery provide blood to (3)
1- shoulder
2- thorax
3- axillary region
66
The axillary artery & vein continues into the arm as the
Brachial artery
67
The axillary vein is formed by the coming together of
The brachial veins & basilica vein
68
The axillary vein will eventually be joined by the ____ vein as it becomes the ____ vein
Cephalic vein
Subclavian vein
69
Superficial contribution to the axillary vein
Basilic vein
70
The axillary vein goes back towards the
Superior vena cava
71
Superficial vein of the upper limb that dumps right into the axillary vein
Basilic vein
72
Network of spinal cord nerves that emerge from the neck & travel into the axilla
Brachial plexus
73
What spinal nerves does the brachial plexus involve
C5-T1
74
Component of the brachial plexus that runs with the axillary artery & vein in the axillary sheath
Cords of the brachial plexus
75
The brachial plexus provides innervation to (4)
1- shoulder
2- pectoral region
3- scapular region
4- upper limb
76
What type of rami are involved in spinal nerves of the brachial plexus
Ventral rami
77
Most axillary lymph nodes are found ____ but some can potentially be located _____
Around the axillary region
Within the axillary sheath
78
List the five groups of axillary lymph nodes
1- pectoral lymph nodes
2- sub scapular lymph nodes
3- humeral lymph nodes
4- cervical lymph nodes
5- apical lymph nodes
79
Pectoral lymph nodes are considered anterior & are located in (2)
Medial wall of axilla
Cluster around thoracic vein
80
Subscapular lymph nodes are considered posterior & are located (2)
Posterior axillary fold
Cluster around subscapular vessels
81
Humerus lymph nodes are considered lateral & are located (2)
Lateral wall of axilla
Near axillary vein
82
Central lymph nodes are located (2)
Base of axilla
Near axillary vein
83
Apical lymph nodes are found (2)
Apex @ cervoaxillary canal
Near axillary vein
84
What axillary lymphatics may be found near the axillary vein
Humeral, central, apical
85
Describe human breasts
B/L glandular structures
86
What makes female breasts unique in comparison to males
Female breasts are more well-developed & capable for producing nourishment for young
87
Mammary glands are modified
Sweat glands
88
The breast itself sits onto of
Pectoralis fascia
89
Covers the breasts
Skin & superficial fascia of the pectoral region
90
Type of tissue found in large quantities around the regions of the breast
Adipose tissue
91
Within the breast tissue there is
Glandular tissue
92
The glandular tissue of the breast is where _______ are located
Lactiferous glands
93
Lactiferous glands function in the production of
Milk
94
Within the glands of the breasts, there are _____ which converge on the ____
Ducts
Nipples
95
Location in which milk can be expressed
Nipples
96
If an individual presents to the clinic with breast tissue that does not move freely along the chest wall- why might this be of concern
This can be indicative of some sort of infiltrate in the retromammary space, causing adherence of breast tissue to the chest & is often caused by a pathological abnormality
97
Breasts are cutaneous structures that rest on the
Pectoral fascia
98
Potential space between breast & pectoral fascia that allow breast to move freely over the chest wall
Retromammary space
99
How do the breasts receive their blood supply
From tributaries of subclavian & axillary arteries & veins
100
Where do breasts receive their innervation from
Intercostal nerves 4-6 & some supraclavicular nerves
101
What type of innervation of the lactiferous lobules/mammary glandes receive
Sympathetic & parasympathetic
102
Where do mammary gland lobules converge
On nipple
103
Describe the position of the mammary glands/lactiferous lobules
Lateral & superior
104
What do suspensory ligaments do
Tack breast to dermis & give breast its shape
105
Lactiferous ducts drain into
Lactiferous sinuses
106
Lactiferous sinuses are located in the
Nipple
107
Dark pigmented region surrounding the nipple
Areola
108
Lactiferous sinuses allow
Milk to pool before expression
109
Where do the breasts main source of innervation come from
Anterior & lateral branches of the 4th-6th intercostal nerves
110
Aside from the anterior & lateral branches of the 4th-6th intercostal nerves, where else might breast tissue receive its innervation from
Supraclavicular nerve branches
111
Laterally the intercostal nerves will give off branches _____
Cutaneously
112
Anteriorly the intercostal nerves will give off branches that go to the
Sternal region
113
Lateral & anterior intercostal nerves give rise to (2)
1- Medial mammary branches
2- Lateral mammary branches
114
What type of innervation is received by the blood vessels & smooth muscle of the breasts
Autonomic
115
Primary blood supply to breasts
Axillary artery & subclavian artery
116
Medial mammary branches come from the _____ which comes from the _____
Internal thoracic artery
Subclavian artery
117
Lateral mammary branches come from the _____ which comes from the _____
Lateral thoracic artery
Axillary artery
118
Venous drainage of the breasts is mainly to the _____ via the _______ & _______ veins, via the ______ vein
Axillary vein
Lateral thoracic & medial mammary veins
Internal thoracic vein
119
Some of the anterior intercostal veins drain into the _____
Internal thoracic vein & subclavian vein
120
Part of the breast tissue that tucks up into the axillary region
Axillary tail of the breast tissue
121
Predominant form of lymph drainage in breast
Axillary lymph nodes
122
How much of the lymph drainage of breast is accomplished via the axillary lymph nodes
75%
123
Which of the five categories of axillary lymph nodes are responsible for the lymphatic drainage of the breast
Pectoral, central, apical
124
What are some sources of lymphatic drainage of the breast other than the axillary lymph nodes
Subareolar lymph nodes
Parasternal lymph nodes
Abdominal lymph nodes
125
The subareolar lymph nodes are responsible for lymphatic drainage of the
Nipple, areola, lactiferous lobules
126
Line of development where breast tissue may form - characteristic of mammals
Mammary ridge
127
Accessory nipple
Polythelia
128
Accessory nipple + glandular tissue
Polymastia
129
Accessory nipples (if present) occur along the
Embryonic mammary crest
130
Some of the most dangerous carcinomas of the breast typically involve
The ductile system
131
Why is lymphatic drainage of importance when considering carcinomas of the breast
Root of metastasis
132
When there is a suspected carcinoma of the breast, what is often biopsied
Axillary lymph nodes
133
Skin dimpling, edema of skin of the breasts, nipple retraction & deviation, & abnormal contours of the breast are all considered
Refraction sign
134
Edema of the skin of the breast is a refraction sign often caused by
Blockage of lymphatics in the areolar region
135
Excess subcutaneous fluid due to blocking flow of lymph that is often due to some sort of breast cancer
lymphedema
136
Invasion of ____ &____ will cause the breast to elevate when the pectoral muscles contract & this is a sign of _____
Retromammary space & pectoral fascia
Advanced cancer
137
Common sites of breast cancer metastasis
Lung, bone, liver, pleura, brain & cranium
138
Metastatic cancer cells from breast tissue commonly spread via ____ & ____ lymph nodes
Parasternal & Axillary
139
The internal thoracic vein drains into _____ veins which eventually drain into _____ in the posterior thorax
Intercostal veins
Azygous venous system
140
Venous drainage routes in which cancer of the breast metastasize to the thorax and skeletal structures
Internal thoracic vein ---> Intercostal veins ---> Azygous vein
141
Involvement of the ____ in breast cancer provides a route for cancer cells to spread to the brain & cranium
Venous plexus
142
Label the following image
A- Subclavian artery & vein
B- Internal thoracic artery & vein
C- Perforating branches
D- Mammory branches
E- Lateral mammary branches
F- Medial mammary branches
G- Lateral thoracic artery & vein
H- Axillary artery & vein
143
Label the following nerves & the branches that they give rise to (for 2 & 3)
1- Supraclavicular nerve
2- Intercostal nerve —> medial mammary branches
3- Intercostal nerve —> lateral mammary branches
144
Label the following image
1- Suspensory ligaments
2- Lobe
3- Lactiferous sinus
4- Alveoli
5- Lactiferous ducts
6-Lobule
7- Areolar gland
8- Nipple
9- Areola
145
Label the following image
1- Sternum
2- Axillary tail of breast
3- Axilla
4- Lobules of fat
5- Nipple
6- Areola
7- Serratus anterior
146
Label the following image
A- Axillary artery
B- Cephalic vein
C- Subclavian vein
D- Axillary artery
E- Brachial veins
F- Basilic vein
147
Label the following image
1- Skin & subcutaneous fat
2- Platysma
3- Subclavicular nerves
4- Reflected pectoral & deltoid fascia (deep)
5- Anterior & Lateral branches of intercostal nerves
6- Pectoral & deltoid fascia (deep)
