Thoracic Lecture

Question 1

Structural components of the breast

Answer 1

1) 15-20 lobes
2) lactiferous ducts
3) Cooper’s (suspensory) ligaments attach to skin/separate lobes

*Divided into 4 quadrants

Question 2

Breast Lymphatics

Answer 2

• drainage to the axillary lymph nodes

- medial quadrants also drain to the parasternal lymph nodes

Question 3

Breast cancer (adenocarcinomas)

Answer 3

• usually painless lumps in the lactiferous ducts
• Dimpling is caused by invasion to the cooper’s ligaments
• Can metastasize to the lymphs and the the abdominal wall

Question 4

Radical mastectomy

Answer 4

• Breast removed
• pectoralis major/minor removed
• lymphs and vessels removed
• long thoracic nerve can be damaged, leads to upward scapula

Question 5

Three layers of Intercostal muscle

Answer 5

1) External intercostal muscle
2) Internal
3) innermost

Question 6

Primary source of blood to the chest

Answer 6

direct branches from the aorta (posterior intercostal artery)

Question 7

Secondary source of blood to the chest

Answer 7

anterior intercostal artery

Question 8

Site of potential collateral circulation

Answer 8

Blocking one source of the blood to the chest won’t kill you because there is the secondary (anterior) artery

Question 9

Layers of the abdominal wall

Answer 9

1) skin
2) superficial/deep fascia
3) External oblique
4) Internal oblique
5) transversus abdominus
6) transversalis fascia
7) Extraperitoneal fat/fascia
8) peritoneum

Question 10

Peritoneum

Answer 10

• friction reducing mesothelium
• simple cuboidal
• secretes serous fluid

Question 11

Inguinal ligament

Answer 11

• rolled inferior extension of external oblique aponeurosis (tendon)
• band that runs from pubic tubercle to anterior superior iliac spine

Question 12

Inguinal canal

Answer 12

-Just above the inguinal ligament

MALE: site where gonad protruded from the abdominal wall, contains the spermatic cord (ductus deferens/muscles/veins), gubernaculum

FEMALE: round ligament, smaller than male and only the gubernaculum goes through this (unlike males)

• “fault” in the external obliques of both sexes (each sex has one on each side)
• forms path for hernias

Question 13

Aponeurosis

Answer 13

Dense, regular connective tissue (tendon)

Question 14

Extraperitoneal tissue

Answer 14

• layer 7 of abdominal wall
• where gonads develop
• posterior and lateral to inguinal canal

Question 15

Gubernaculum

Answer 15

• fibrous core that makes up attachment to the gonads
• contains skeletal muscle
• forges a path through the anterolateral abdominal wall during development

MALES: contractile structure that shortens and pulls the testis

FEMALES: ovarian ligament and round ligament of the uterus

Question 16

Inguinal ring

Answer 16

• forms the posterior opening of the canal

- made by a fault in the transversalis fascia

Question 17

Superficial inguinal ring

Answer 17

• aponeurosis of the external oblique

- anterior opening of canal

Question 18

Processus vaginalis

Answer 18

• pouch of the peritoneum pulled through the inguinal canal
• covers testis on one side
• thermoregulates

Question 19

Testis layers

Answer 19

1) Internal spermatic fascia: from transversalis fascia
2) Cremasteric Fascia: from internal oblique
3) External spermatic fascia: from external oblique