The Breast

Question 1

What does the breast contain

Answer 1

Fat- variable amounts
Glandular/secretory tissue arranged in lobules
Ducts which converge on nipple
Connective tissue and ligaments
Blood vessels and lymphatics

Question 2

Axillary tail

Answer 2

Breast tissue extended towards the anterior axilla (armpit)

Question 3

Areola

Answer 3

Region of pigmented skin surrounding the nipple

Question 4

Primary blood supply to breast

Answer 4

branches from the internal thoracic artery (which arises from the subclavian artery) and axillary artery (lateral thoracic and thoracoacromial branches), mammary branch, lateral mammary branches

Question 5

Where does venous blood return in breast

Answer 5

Axillary and internal thoracic vein

Question 6

What nerves innervate the breast

Answer 6

somatic sensory fibres innervate the skin of breast
• sympathetic fibres innervate smooth muscle in blood vessel walls and nipple
As well as the intercostal nerves

Question 7

5 groups of lymph nodes in the axilla

Answer 7

central, pectoral, humeral, subscapular and apical

Question 8

Which node receives lymph from all other nodes

Answer 8

apical nodes receive lymph from all other necks in axilla- often involved in spread of breast cancer

Question 9

Nipple

Answer 9

point at which lactiferous ducts emerge

Question 10

Which nerves are skin of thoracic wall innervated by

Answer 10

T1-T12

Question 11

Dermatome

Answer 11

area of skin innervated by a single spinal nerve (each pair of thoracic spinal nerves supply a strip of skin around the chest wall)

Question 12

Which nerves innervate the skin of the thoracic wall

Answer 12

Somatic motor fibres innervated the skeletal muscles and sympathetic fibres innervated sweat glands and smooth muscle of blood vessels and hair follicles in skin (arrector pili)

Question 13

Upper chest muscles

Answer 13

pectoralis major - most superficial muscle of anterior chest. Attaches to upper humerus, clavicle and upper 6 ribs. Adducts humerus
• pectoralis minor - smaller muscle deep to pectoralis major. Attaches to scapula and ribs 3-5. Protract scapula
• serratus anterior - superficial muscle that sweeps around lateral aspect of thoracic cage. Attaches to scopula and upper 8 ribs. Protract scapula

Question 14

Hormones that control production and secretion of milk

Answer 14

Prolactin and oxytocin secreted from pituitary gland

Question 15

The umbilicus lies at approximately which dermatomal level?

Answer 15

T10

Question 16

Which group of lymph nodes receives the majority of lymph drainage from the breast?

Answer 16

Approximately 75% of lymph from the breast drains to the axillary lymph nodes.

The hilar, mediastinal and paraaortic lymph nodes are deep structures and drain lymph from deep organs such as the lungs and gastrointestinal tract.

The supraclavicular nodes are located more superiorly in the torso and may be enlarged in certain gastrointestinal cancers, most commonly stomach cancer.

Question 17

What does the long thoracic nerve supply

Answer 17

Serratus anterior muscle

Question 18

What do the medial and lateral pectoral nerves supply

Answer 18

Pectoralis major muscle

Question 19

What does the phrenic nerve supply

Answer 19

Diaphragm and part of parietal pleura in contact with diaphragm and mediastinum

Question 20

What does the vagus nerve supply

Answer 20

many structures in the neck and torso (heart, lungs, oesophagus, pharynx and larynx).

Question 21

What does the sternocleidomastoid attach to

Answer 21

Sternum
Clavicle
Mastoid bone

Question 22

Which artery supplies the medial aspect of the breast

Answer 22

Internal thoracic artery