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Questions and Answers
The breast contains 10 to 15 lobules of glandular tissue.
The breast contains 10 to 15 lobules of glandular tissue.
False
The lactiferous duct drains each lobule and opens independently on the nipple.
The lactiferous duct drains each lobule and opens independently on the nipple.
True
The retro-mammary space is located between the breast and the deep pectoral fascia.
The retro-mammary space is located between the breast and the deep pectoral fascia.
True
The suspensory ligaments of Cooper connect the mammary glands to the fascia.
The suspensory ligaments of Cooper connect the mammary glands to the fascia.
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The areola is a prominent part of the mammary glands.
The areola is a prominent part of the mammary glands.
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Most lymph (75%) from the breast will drain to axillary lymph nodes.
Most lymph (75%) from the breast will drain to axillary lymph nodes.
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Male breasts and pre-pubertal female breasts are distinctly different.
Male breasts and pre-pubertal female breasts are distinctly different.
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Breast tissue proliferates during pregnancy due to the stimulation of hormones like oestrogen and progesterone.
Breast tissue proliferates during pregnancy due to the stimulation of hormones like oestrogen and progesterone.
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Post-menopausal breasts typically increase in size due to fat deposition.
Post-menopausal breasts typically increase in size due to fat deposition.
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Breast cancer can spread exclusively through direct invasion.
Breast cancer can spread exclusively through direct invasion.
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Mammary glands are modified sweat glands.
Mammary glands are modified sweat glands.
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The circular base of the female breast extends from the sternum to the posterior axillary line muscle.
The circular base of the female breast extends from the sternum to the posterior axillary line muscle.
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Subcutaneous fat gives the contour and volume of the breasts.
Subcutaneous fat gives the contour and volume of the breasts.
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Mammary glands do not change in size except during pregnancy.
Mammary glands do not change in size except during pregnancy.
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The vertical extension of the breast is from the 2nd to 6th ribs.
The vertical extension of the breast is from the 2nd to 6th ribs.
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The anatomy of the axilla includes both an artery and a vein.
The anatomy of the axilla includes both an artery and a vein.
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The pectoral girdle does not have any associated muscles.
The pectoral girdle does not have any associated muscles.
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The brachial plexus has no branches.
The brachial plexus has no branches.
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Men can get breast cancer, but it is less common than in women.
Men can get breast cancer, but it is less common than in women.
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The axilla is described as a regular cube.
The axilla is described as a regular cube.
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The anterior wall of the axilla includes the pectoralis major and minor muscles.
The anterior wall of the axilla includes the pectoralis major and minor muscles.
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The floor of the axilla consists of only muscle tissue.
The floor of the axilla consists of only muscle tissue.
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The pectoralis minor muscle pulls the tip of the shoulder up.
The pectoralis minor muscle pulls the tip of the shoulder up.
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The clavicular head is responsible for the extension of a flexed arm.
The clavicular head is responsible for the extension of a flexed arm.
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The serratus anterior muscle is innervated by the lower subscapular nerve.
The serratus anterior muscle is innervated by the lower subscapular nerve.
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The long thoracic nerve is responsible for protraction and rotation of the scapula.
The long thoracic nerve is responsible for protraction and rotation of the scapula.
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The medial border of the scapula moves laterally and posteriorly when the serratus anterior is paralyzed.
The medial border of the scapula moves laterally and posteriorly when the serratus anterior is paralyzed.
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The thoracodorsal nerve innervates the latissimus dorsi muscle.
The thoracodorsal nerve innervates the latissimus dorsi muscle.
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The teres major muscle is involved in abduction of the arm.
The teres major muscle is involved in abduction of the arm.
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Injury to the long thoracic nerve can result in a condition known as winged scapula.
Injury to the long thoracic nerve can result in a condition known as winged scapula.
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The medial and lateral pectoral nerves are involved in the flexion and extension of the arm.
The medial and lateral pectoral nerves are involved in the flexion and extension of the arm.
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The axillary artery starts at the inferior margin of rib 2.
The axillary artery starts at the inferior margin of rib 2.
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The long thoracic nerve innervates the pectoralis major muscle.
The long thoracic nerve innervates the pectoralis major muscle.
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The coracobrachialis passes through the central part of the axilla.
The coracobrachialis passes through the central part of the axilla.
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The posterior circumflex artery is part of the first section of the axillary artery.
The posterior circumflex artery is part of the first section of the axillary artery.
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The brachial plexus is formed by the anterior rami of C4-C8 and T1.
The brachial plexus is formed by the anterior rami of C4-C8 and T1.
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The medial cord of the brachial plexus includes the ulnar nerve.
The medial cord of the brachial plexus includes the ulnar nerve.
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The lateral thoracic artery arises from the second part of the axillary artery.
The lateral thoracic artery arises from the second part of the axillary artery.
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The axillary nerve innervates the deltoid muscle.
The axillary nerve innervates the deltoid muscle.
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Five groups of lymph nodes are present in the axilla.
Five groups of lymph nodes are present in the axilla.
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The subscapular nerve primarily innervates the biceps brachii muscle.
The subscapular nerve primarily innervates the biceps brachii muscle.
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The suprascapular foramen allows passage for the axillary nerve.
The suprascapular foramen allows passage for the axillary nerve.
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The medial cutaneous nerve of the forearm originates from the medial cord.
The medial cutaneous nerve of the forearm originates from the medial cord.
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The axillary artery is divided into four parts.
The axillary artery is divided into four parts.
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The radial nerve is found in the posterior cord of the brachial plexus.
The radial nerve is found in the posterior cord of the brachial plexus.
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The breast contains 15 to 20 glacial lobules of glandular tissue.
The breast contains 15 to 20 glacial lobules of glandular tissue.
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The lactiferous duct includes a section known as the lactiferous sinus.
The lactiferous duct includes a section known as the lactiferous sinus.
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The axillary process extends toward the pectoralis major muscle from the rib 6 area.
The axillary process extends toward the pectoralis major muscle from the rib 6 area.
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Suspensory ligaments of Cooper enhance the connection between mammary glands and the dermis.
Suspensory ligaments of Cooper enhance the connection between mammary glands and the dermis.
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The areola is the non-pigmented area surrounding the nipple.
The areola is the non-pigmented area surrounding the nipple.
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Lymph from the breast can drain to abdominal lymph nodes.
Lymph from the breast can drain to abdominal lymph nodes.
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In post-menopausal women, breasts often increase in size due to hormonal changes.
In post-menopausal women, breasts often increase in size due to hormonal changes.
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Carcinoma of the breast can spread through lymphatics and veins.
Carcinoma of the breast can spread through lymphatics and veins.
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Male and pre-pubertal female breasts contain fully developed glandular tissue.
Male and pre-pubertal female breasts contain fully developed glandular tissue.
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Pectoral lymph nodes are part of the central lymph nodes in breast lymphatic drainage.
Pectoral lymph nodes are part of the central lymph nodes in breast lymphatic drainage.
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The floor of the axilla is made up of only fascia and skin.
The floor of the axilla is made up of only fascia and skin.
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The axilla is shaped like a regular cube.
The axilla is shaped like a regular cube.
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Pectoralis major and minor, along with the subclavius, form the anterior wall of the axilla.
Pectoralis major and minor, along with the subclavius, form the anterior wall of the axilla.
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The medial pectoral nerve is responsible for the extension of the arm.
The medial pectoral nerve is responsible for the extension of the arm.
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Men have a higher incidence of breast cancer than women.
Men have a higher incidence of breast cancer than women.
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The clavicular head of the pectoralis major is responsible for extension of an extended arm.
The clavicular head of the pectoralis major is responsible for extension of an extended arm.
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The long thoracic nerve is crucial for the medial rotation of the arm.
The long thoracic nerve is crucial for the medial rotation of the arm.
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The medial border of the scapula moves laterally and posteriorly when the serratus anterior is functioning normally.
The medial border of the scapula moves laterally and posteriorly when the serratus anterior is functioning normally.
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The subscapularis muscle is involved in medial rotation of the arm.
The subscapularis muscle is involved in medial rotation of the arm.
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Teres major assists in both extension and lateral rotation of the arm.
Teres major assists in both extension and lateral rotation of the arm.
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Injury to the long thoracic nerve can lead to a condition known as winged scapula.
Injury to the long thoracic nerve can lead to a condition known as winged scapula.
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The thoracoacromial artery supplies blood to the pectoral muscles.
The thoracoacromial artery supplies blood to the pectoral muscles.
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The medial and lateral pectoral nerves are solely responsible for the adduction of the arm.
The medial and lateral pectoral nerves are solely responsible for the adduction of the arm.
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Klumpke palsy results from injury to the superior parts of the brachial plexus.
Klumpke palsy results from injury to the superior parts of the brachial plexus.
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Erb-Duchenne palsy is characterized by an adducted and internally rotated arm.
Erb-Duchenne palsy is characterized by an adducted and internally rotated arm.
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A supinated forearm is a common symptom of Erb-Duchenne palsy.
A supinated forearm is a common symptom of Erb-Duchenne palsy.
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The rotator cuff muscles are primarily responsible for stabilizing the shoulder joint.
The rotator cuff muscles are primarily responsible for stabilizing the shoulder joint.
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Klumpke palsy primarily affects muscles in the upper arm.
Klumpke palsy primarily affects muscles in the upper arm.
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The supraspinatus muscle abducts the arm at an angle of 90˚.
The supraspinatus muscle abducts the arm at an angle of 90˚.
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The axillary nerve mainly innervates the infraspinatus muscle.
The axillary nerve mainly innervates the infraspinatus muscle.
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Diminished sensation from the medial arm and forearm is a symptom of Klumpke palsy.
Diminished sensation from the medial arm and forearm is a symptom of Klumpke palsy.
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The brachial plexus is formed by the anterior rami of C5, C6, C7, C8, and T2.
The brachial plexus is formed by the anterior rami of C5, C6, C7, C8, and T2.
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The axillary artery begins at the inferior margin of rib 1.
The axillary artery begins at the inferior margin of rib 1.
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The lateral pectoral nerve innervates the pectoralis minor muscle.
The lateral pectoral nerve innervates the pectoralis minor muscle.
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The thoracodorsal nerve innervates the supraspinatus muscle.
The thoracodorsal nerve innervates the supraspinatus muscle.
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The medial cord of the brachial plexus contains the ulnar nerve.
The medial cord of the brachial plexus contains the ulnar nerve.
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The axillary nerve has motor functions for the teres major muscle.
The axillary nerve has motor functions for the teres major muscle.
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The long thoracic nerve innervates the serratus anterior muscle.
The long thoracic nerve innervates the serratus anterior muscle.
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The inferior margin of the teres major separates the axillary artery into three parts.
The inferior margin of the teres major separates the axillary artery into three parts.
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The angular artery branches from the third part of the axillary artery.
The angular artery branches from the third part of the axillary artery.
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The dorsal scapular nerve arises from C6.
The dorsal scapular nerve arises from C6.
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The pectoralis major muscle is innervated by the medial pectoral nerve.
The pectoralis major muscle is innervated by the medial pectoral nerve.
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The medial cutaneous nerve of the arm is part of the lateral cord.
The medial cutaneous nerve of the arm is part of the lateral cord.
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The axillary artery is not connected to any veins.
The axillary artery is not connected to any veins.
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The suprascapular foramen allows passage for the supraclavicular nerve.
The suprascapular foramen allows passage for the supraclavicular nerve.
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The radial nerve is found in the medial cord of the brachial plexus.
The radial nerve is found in the medial cord of the brachial plexus.
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The axilla is shaped like an irregular pyramid with a floor and walls.
The axilla is shaped like an irregular pyramid with a floor and walls.
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The axillary artery is only associated with the first section of the brachial plexus.
The axillary artery is only associated with the first section of the brachial plexus.
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Pectoralis minor muscle functions to pull the tip of the shoulder up.
Pectoralis minor muscle functions to pull the tip of the shoulder up.
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Men have a higher incidence of breast cancer compared to women.
Men have a higher incidence of breast cancer compared to women.
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The anterior wall of the axilla is made up of the subclavius and major pectoralis muscles.
The anterior wall of the axilla is made up of the subclavius and major pectoralis muscles.
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The suspensory ligaments of Cooper connect the mammary glands to the epidermis.
The suspensory ligaments of Cooper connect the mammary glands to the epidermis.
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The breast contains 15 to 20 lobules of glandular tissue, each draining through a common lactiferous duct.
The breast contains 15 to 20 lobules of glandular tissue, each draining through a common lactiferous duct.
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The retro-mammary space is located under the pectoralis minor muscle.
The retro-mammary space is located under the pectoralis minor muscle.
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The areola is typically composed of a circular pigmented region surrounding the breast's duct openings.
The areola is typically composed of a circular pigmented region surrounding the breast's duct openings.
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Lactiferous ducts are exclusively found in mammalian females.
Lactiferous ducts are exclusively found in mammalian females.
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The long thoracic nerve is predominantly involved in the medial rotation of the arm.
The long thoracic nerve is predominantly involved in the medial rotation of the arm.
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The serratus anterior is innervated by the thoracodorsal nerve.
The serratus anterior is innervated by the thoracodorsal nerve.
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Teres major is innervated by the lower subscapular nerve and is involved in extension and medial rotation of the arm.
Teres major is innervated by the lower subscapular nerve and is involved in extension and medial rotation of the arm.
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The medial border of the scapula remains aligned with the thoracic wall even when the serratus anterior is paralyzed.
The medial border of the scapula remains aligned with the thoracic wall even when the serratus anterior is paralyzed.
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The medial and lateral pectoral nerves are responsible for protraction and rotation of the scapula.
The medial and lateral pectoral nerves are responsible for protraction and rotation of the scapula.
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The thoraco-acromial artery branches contribute to the vascular supply of the shoulder region.
The thoraco-acromial artery branches contribute to the vascular supply of the shoulder region.
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Injury to the long thoracic nerve can lead to conditions affecting the medial pectoral nerve.
Injury to the long thoracic nerve can lead to conditions affecting the medial pectoral nerve.
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Klumpke palsy primarily affects the superior parts of the brachial plexus.
Klumpke palsy primarily affects the superior parts of the brachial plexus.
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Erb-Duchenne palsy is characterized by a forearm that is supinated and an adducted arm.
Erb-Duchenne palsy is characterized by a forearm that is supinated and an adducted arm.
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The teres minor muscle acts as a medial rotator of the arm.
The teres minor muscle acts as a medial rotator of the arm.
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Damage to the C5-C6 roots can result in a characteristic 'waiter’s tip position.'
Damage to the C5-C6 roots can result in a characteristic 'waiter’s tip position.'
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Supraspinatus is responsible for the abduction of the arm beyond 15˚.
Supraspinatus is responsible for the abduction of the arm beyond 15˚.
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Diminished sensation from the medial aspect of the arm is associated with Erb-Duchenne palsy.
Diminished sensation from the medial aspect of the arm is associated with Erb-Duchenne palsy.
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The trapezius muscle originates from the spinous processes of T1-T12.
The trapezius muscle originates from the spinous processes of T1-T12.
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The axillary nerve innervates the supraspinatus muscle.
The axillary nerve innervates the supraspinatus muscle.
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The circular base of the female breast extends from the lateral border of Pectoralis major to the anterior axillary line muscle.
The circular base of the female breast extends from the lateral border of Pectoralis major to the anterior axillary line muscle.
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Mammary glands only change in size during pregnancy due to hormonal stimulation.
Mammary glands only change in size during pregnancy due to hormonal stimulation.
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The axilla is commonly described as a regular cube shape.
The axilla is commonly described as a regular cube shape.
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The medial border of the scapula moves laterally and posteriorly when the serratus anterior muscle is functioning normally.
The medial border of the scapula moves laterally and posteriorly when the serratus anterior muscle is functioning normally.
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The axillary nerve innervates predominantly the biceps brachii muscle.
The axillary nerve innervates predominantly the biceps brachii muscle.
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The latissimus dorsi muscle is innervated by the thoracodorsal nerve.
The latissimus dorsi muscle is innervated by the thoracodorsal nerve.
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The axillary nerve is responsible for the motor innervation of the deltoid and teres major muscles.
The axillary nerve is responsible for the motor innervation of the deltoid and teres major muscles.
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The long thoracic nerve is responsible for innervating the serratus anterior muscle.
The long thoracic nerve is responsible for innervating the serratus anterior muscle.
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The superior thoracic artery is found in the third part of the axillary artery.
The superior thoracic artery is found in the third part of the axillary artery.
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The medial pectoral nerve innervates the pectoralis major and minor muscles.
The medial pectoral nerve innervates the pectoralis major and minor muscles.
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The teres minor muscle is innervated by the radial nerve.
The teres minor muscle is innervated by the radial nerve.
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The five groups of lymph nodes in the axilla include lateral, anterior, and special nodes.
The five groups of lymph nodes in the axilla include lateral, anterior, and special nodes.
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The lateral thoracic artery arises from the first part of the axillary artery.
The lateral thoracic artery arises from the first part of the axillary artery.
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The posterior circumflex artery is associated with the third part of the axillary artery.
The posterior circumflex artery is associated with the third part of the axillary artery.
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The medial cutaneous nerve of the arm originates from the lateral cord.
The medial cutaneous nerve of the arm originates from the lateral cord.
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The axillary artery is separated into three parts by the pectoralis minor muscle.
The axillary artery is separated into three parts by the pectoralis minor muscle.
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The inferior margin of the teres major defines the end of the axillary artery.
The inferior margin of the teres major defines the end of the axillary artery.
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Study Notes
Axilla and Brachial Plexus
- The axilla is a gateway to the upper limb, an irregular pyramid
- It has four sides, an inlet, and a floor
- The brachial plexus is formed by the anterior rami of C5-C8 and T1
- It passes into the posterior triangle between anterior and middle scalene muscles
- The brachial plexus contains five roots, three trunks, six divisions, and three cords.
- The brachial plexus is named after its position around the axillary artery
- It has five terminal branches (nerves)
- The roots (C5-T1) originate from the spinal cord and contribute to nerves that innervate muscles and skin of the upper limb
- The roots are: Dorsal scapular (C5), long thoracic (C5,6,7), phrenic (C5)
- Specific nerves innervate specific regions (e.g., lateral pectoral nerve innervates pectoralis major)
- The brachial plexus also contains associated arteries
- The supraspinatus, infraspinatus, teres minor, and subscapularis, collectively known as the rotator cuff, muscles that stabilise the shoulder joint
- The rotator cuff muscles are further defined by particular origins and actions
Breast
- Mammary glands are modified sweat glands
- Subcutaneous fat contributes to breast contour and volume.
- The breast contains 15-20 lobules of glandular tissue
- Each lobule drains into a lactiferous duct that opens on the nipple
- Each duct has a dilated portion called the lactiferous sinus
- The circular base extends transversely from the sternum to the anterior axillary line, and vertically from the second to sixth ribs
- The breast extends to the inferolateral edge of the pectoralis major
- The retro-mammary space (bursa) is between the breast and deep pectoral fascia
- Breast structure changes with gender, age, or disease
- Breast contains vascular and lymphatic components, these components relate to ageing and disease
Axillary Artery
- The axillary artery is a continuation of the subclavian artery and passes through the axilla.
- It's located near the inferior margin of teres major muscle, and is separated into 3 parts by the pectoralis minor muscle
- These parts are: Superior thoracic artery, Thoracoacromial artery, Lateral thoracic artery.
- Third part: Subscapular artery, Anterior circumflex humeral artery, Posterior circumflex humeral artery,
Axilla-Content
- Passing through the axilla are the proximal parts of the biceps brachii and coracobrachialis muscles
- Contents include the axillary artery and vein, the brachial plexus, and lymphatic tissue
- Five groups of lymph nodes are found in the axilla (anterior/pectoral, posterior/subscapular, lateral/humeral, central, apical)
Injuries to the Brachial Plexus
- Injuries to the brachial plexus affect the movements (muscle paralysis) and cutaneous sensations (anaesthesia) of the upper limb
- Examples of injuries include Erb-Duchenne palsy and Klumpke palsy
- Erb-Duchenne palsy: affects axillary, suprascapular, subscapular, musculocutaneous, and radial nerves; characterised by an adducted, internally rotated arm, extended elbow, pronated forearm, and flexed wrist.
- Klumpke palsy: occurs when the inferior parts of the brachial plexus (C8-T1) are affected; it typically results in hand paralysis, a claw hand, and reduced sensation in the medial arm and forearm.
Gateways in the Posterior Wall
- Major structures passing through include the Suprascapular foramen (supra and teres suprascapularis nerve), quadrangular space (axillary nerve and posterior circumflex humeral artery), triangular space (circumflex scapular artery), triangular interval (radial nerve and profunda brachii artery)
Winged Scapula
- Occurs when the serratus anterior muscle is paralysed (damage to the long thoracic nerve C5-7)
- The medial border of the scapula moves laterally and posteriorly, away from the thoracic wall.
Learning Outcomes
- Describe the structure and function of the muscles of the pectoral girdle and the back.
- Identify the axilla and its contents (artery and vein).
- Discuss the structure and function of the brachial plexus and its branches.
- Demonstrate clinically relevant anatomical landmarks on clinical or radiographic examination.
- Identify the structure and function of the breast and the underlying muscles and fascia.
- Describe changes in the breast with gender, age, or disease.
- Discuss the vascular and lymphatic components of the breast and their relationship to ageing and disease.
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Description
Explore the intricate anatomy of the axilla and the brachial plexus in this quiz. Understand the structure, components, and branches of the brachial plexus that innervate the upper limb. Test your knowledge on the relationships and functions of the nerves and associated muscles.
