thoracic wall - INCOMPLETE Flashcards
breast: describe the anatomy of the breast including its neurovascular supply; explain the lymphatic drainage of the breast and its clinical relevance to the spread of metastases
breast embryology
5th week - development of mammary bud, >5th week, 5-12th week, 12th week, >12th week
surface landmarks
2nd-6th rib spaces, lateral border sternum, mid axillary line
gland
15-20 ductal-libular units draining into main duct; fat interspersed; divided by
innervation of breast
dominant innervation to nipple is from lateral cutaneous branch from T4
lymphatic drainage
from axilla; 5 groups of axillary lymph nodes; anterior, posterior, medial, lateral, apical; cutaneous nerves, motor nerves, arteries and veins
lymph node levels
level I, II and III lymph nodes in relation to pec minor (MORE, posterior, medial)
long thoracic nerve
injury leads to X of scapula; injury to vein - paralysis of letisimus dorsi
lymphoedema
caused by removal of lymph nodes; reduction in lymphatic transport capacity and increase in lymphatic node, so accumulation of protein-rich interstitial fluid; fat accumulation and scarring
reducing lymphoedema
less axillary surgery, axillary reverse mapping (only drain those that drain breast not arm), LYMPHA
characteristics of the breast
overlies muscles of anterior chest wall between ribs 2 and 6; comm-shaped; 12-16 lobes arranged radially around nipple; contains little glandular tissue until last weeks of gestation; most bulk is adipose tissue
surrounding nipple
pigmented thin skin areola - deep lie lactiferous sinuses that are squeezed during suckling
support
radial interlobar fibrous partitious between skin and muscles to deep breast
blood supply
branches of axillary and internal thoracic arteries - same pathway as lymphatic drainage
drainage
fine lymphatic vessels form subareolar plexus and submammary plexus between breast and pectoralis major - drain to 5 groups of lymph nodes in axilla and to parasternal nodes (along thoracic artery)
