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Clinical Anatomy > Thorax 1 - Breast Anatomy > Flashcards

Thorax 1 - Breast Anatomy Flashcards

1
Q

what three muscles is the breast anatomically related/ close to? how?

A

pectoralis major - 2/3 of the breast rests on the pec major
serratus anterior - 1/3 of breast
rectus abdominus - lower medial edge overlaps with the upper part of the rectus sheath

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2
Q

what three muscles is the breast anatomically related/ close to?

A

pectoralis major
serratus anterior
rectus abdominus

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3
Q

what ribs does the breast overlie vertically?

A

2nd to 6th ribs

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4
Q

what are the two main types of tissue in breast tissue?

A

connective tissue
glandular tissue

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5
Q

what is the primary component of the breast tissue during lactation?

A

glandular tissue - composition increases in lactating women

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6
Q

in non-lactating women, what is the predominant composition of breast tissue?

A

fatty connective tissue

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7
Q

what role do the glandular tissue and ducts play in the breast?

A

glandular tissue in the breast contains ducts & secretory lobules - converge into 15-20 lactiferous ducts around the nipple that open independently

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8
Q

what happens to the breast tissue composition during lactation?

A

increase in proportion of glandular tissue compared to non-lactating women

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9
Q

what key ligament does the connective tissue of the breast? why is it important?

A

suspensory ligament of Cooper - separates the breast lobules & is continuous with the skin and deep fascia

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10
Q

what happens when the suspensory ligaments of Cooper are shortened or tethered? what conditions might this indicate?

A

shortened/tethered = leads to dimpling of the breast

indicative of breast carcinoma or lymphatic obstruction

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11
Q

role of the areola in the breast?

A

pigmented area surrounding the nipple - provides lubrication during lactation

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12
Q

what is the primary tissue type in the breast during lactation?
a) Glandular tissue
b) Fatty connective tissue
c) Cartilage
d) Muscle tissue

A

A: glandular tissue

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13
Q

which structure in the breast separates the lobes and is continuous with the skin and deep fascia?
a) Suspensory ligament of Cooper
b) Lactiferous duct
c) Mammary gland
d) Areola

A

A: suspensory ligament of Cooper

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14
Q

what does dimpling of the breast usually indicate?
a) Increased glandular tissue
b) Shortening or tethering of the suspensory ligaments of Cooper
c) Lactation
d) A decrease in fatty connective tissue

A

B: shortening or tethering of the suspensory ligaments of Cooper

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15
Q

what artery supplies the medial part of the breast? what artery does it arise from?

A

supplied by the medial mammary & perforating branches of the internal thoracic/ mammary artery

arises from the subclavian artery

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16
Q

what arteries supply the lateral part of the breast? what artery do these arise from?

A

mammary branches of the lateral thoracic & thoracoacromial trunk - branches of the axillary artery

lateral mammary branches of the posterior intercostal arteries - arises from the thoracic aorta

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17
Q

which arteries provide mammary branches to the anterior part of the breast? what artery does it arise from?

A

anterior intercostal arteries - arise from the internal thoracic artery

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18
Q

what role do the posterior intercostal arteries play in supplying the breast? what artery does this arise from?

A

give rise to lateral mammary branches that supply the lateral part of the breast - arises from the thoracic aorta

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19
Q

what artery do the anterior intercostal arteries arise from? what does it supply?

A

internal thoracic artery - supply the anterior part of the breast via its mammary branches

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20
Q

which artery gives medial mammary and perforating branches to the medial part of the breast?

A

internal thoracic/ mammary artery

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21
Q

TRUE/FALSE: the medial part of the breast is supplied by the axillary artery

A

FALSE - it’s supplied by the internal thoracic artery (branch of the subclavian artery)

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22
Q

TRUE/FALSE: the lateral thoracic artery provides mammary branches to the lateral part of the breast

A

TRUE

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23
Q

TRUE/FALSE: the posterior posterior intercostal arteries arise from the thoracic aorta and give rise to lateral mammary branches

A

TRUE - go on to supply the lateral part of the breast

24
Q

which artery supplies the medial part of the breast?
a) Lateral thoracic artery
b) Internal thoracic (mammary) artery
c) Axillary artery
d) Subcostal artery

A

B: internal thoracic/mammary artery - its medial mammary & perforating branches

25
Q

from where do the lateral mammary branches of the breast arise?
a) Internal thoracic artery
b) Lateral thoracic artery and thoracoacromial arteries
c) Posterior intercostal arteries
d) Subclavian artery

A

B: lateral thoracic artery & thoracoacromial arteries - supply lateral part of breast

26
Q

which of the following arteries primarily supplies the lateral mammary branches of the breast?
a) Internal thoracic artery
b) Lateral thoracic artery
c) Thoracoacromial artery
d) Subcostal artery

A

B: lateral thoracic artery

27
Q

describe the arterial supply to the different parts of the breast (medial, lateral & anterior) and where these arteries arise from

A

medial part of breast: supplied by medial mammary & perforating branches of the internal thoracic artery - arise from the subclavian artery

lateral part of breast: supplied by
- mammary branches of lateral thoracic artery & thoracoacromial branches - arise from axillary artery
- lateral mammary branches of posterior intercostal arteries - arise from thoracic aorta

anterior part of breast: supplied by mammary branches of anterior intercostal artery - arises from internal thoracic artery

28
Q

TRUE/FALSE: the anterior intercostal artery arises from the thoracic aorta

A

FALSE - arises from the internal thoracic artery (the posterior intercostal arteries arise from the thoracic aorta)

29
Q

where is the circular venous plexus found? what does it drain into?

A

found at the base of the nipple - drains into the axillary and internal thoracic veins

30
Q

TRUE/FALSE: venous drainage of the breast goes into the subclavian vein

A

FALSE - goes from the circular venous plexus around the nipple to the axillary & internal thoracic veins

31
Q

which nerve provides sensory innervation to the nipple and areola?

A

4th intercostal nerve mainly (variations from 3rd to 5th intercostal nerves)

32
Q

what area of the breast do the 2nd-6th intercostal nerves supply?

A

anterior skin of breast

33
Q

which lymph nodes receive the majority of the breast’s lymphatic drainage? how much?

A

axillary lymph nodes - 75% of drainage

34
Q

where are the parasternal lymph nodes located and what do they drain?

A

deep to the anterior thoracic wall - drain the medial portions of the breast & anterior thoracic wall

35
Q

what artery are the parasternal lymph nodes located aling?

A

internal thoracic artery

36
Q

how much lymphatic drainage of the breast do the parasternal nodes receive?

A

20%

37
Q

what nodes receive 5% of breast lymphatic drainage?

A

posterior intercostal nodes

38
Q

what are the 5 groups of axillary lymph nodes?

A

pectoral/anterior
subscapular/posterior
brachial/lateral
central
apical

39
Q

which group of axillary lymph nodes drains the upper limb?

A

brachial/lateral group

40
Q

where are the central lymph nodes located in the axilla? what do they collect lymph from?

A

in the centre of the axilla/near the base - collect lymph from pectoral, subscapular, and brachial groups

41
Q

what happens when lymphatic drainage from the breast is blocked due to breast cancer?

A

skin dimpling or breast tissue tethering

42
Q

which axillary lymph nodes are located near the lower border of the subscapularis muscle? where do they collect lymph from?

A

subscapular/posterior group - lymph from the posterior thoracic wall

43
Q

the axillary lymph nodes consist of 5 groups - what are they? where do they each collect lymph from?

A
  1. pectoral/anterior - from anterior thoracic wall & most of breast
  2. subscapular/posterior - from posterior thoracic wall
  3. brachial/lateral - from upper limb
  4. central - collects lymph from pectoral, subscapular & brachial groups
  5. apical - collects lymph from central nodes & other groups, drain ultimately into the subclavian lymph trunk
44
Q

TRUE/FALSE: The majority of breast lymphatic drainage drains into the parasternal lymph nodes

A

FALSE - 75% to the axillary LNs; 20% to parasternal nodes

45
Q

which lymph node group drains the anterior thoracic wall and most of the breast?
a) Pectoral (anterior) group
b) Subscapular (posterior) group
c) Brachial (lateral) group
d) Apical group

A

A: pectoral/anterior group

46
Q

which lymphatic drainage pathway is most likely to be blocked in breast cancer, leading to skin dimpling?
a) Parasternal lymph nodes
b) Abdominal lymph nodes
c) Axillary lymph nodes
d) Posterior intercostal nodes

A

C: axillary LNs

47
Q

which of the following lymph node groups primarily drains the medial aspect of the breast and anterior thoracic wall?
a) Axillary lymph nodes
b) Parasternal lymph nodes
c) Posterior intercostal nodes
d) Subscapular lymph nodes

A

B: parasternal LNs

48
Q

the apical lymph nodes of the axilla ultimately drain lymph into which major lymphatic structure?
a) Subclavian lymph trunk
b) Thoracic lymphatic duct
c) Right lymphatic duct
d) Internal thoracic vein

A

A: subclavian lymph trunk - apical LN collects lymph from all the other axilla groups first

49
Q

what happens during direct infiltration by breast cancer?

A

cancer invades underlying muscles - e.g. pec major - or skin

muscle invasion makes the skin appear fixed/ immobile; skin invasion causes dimpling or tethering

50
Q

what symptom is commonly caused by skin invasion in breast cancer? why?

A

dimpling/tethering of the skin due to involvement of the suspensory ligaments (of Cooper)

51
Q

which lymph node group is the most common route for breast cancer metastasis?

A

axillary LNs

52
Q

in advanced breast cancer, where can metastases spread via the bloodstream?

A

lungs, bones, liver, brain

53
Q

TRUE/FALSE: the primary lymphatic route for breast cancer metastasis is through the brachial lymph nodes

A

FALSE - it’s through the axillary LNs

54
Q

TRUE/FALSE: skin dimpling caused by breast cancer is due to the invasion of subcutaneous tissues

A

TRUE

55
Q

which of the following is a common sign of breast cancer skin invasion?
a) Enlargement of the lymph nodes in the axilla
b) Fixed or immobile breast due to muscle invasion
c) Dimpling or tethering of the skin
d) Protrusion of the nipple

A

C: dimpling or tethering of the skin

56
Q

breast cancer can spread through the bloodstream to all of the following organs EXCEPT:
a) Lungs
b) Bones
c) Liver
d) Spleen

A

D: spleen

Clinical Anatomy (27 decks)

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