Breast Anatomy and Muscles of the Arm and Shoulder
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Questions and Answers

What type of connective tissue acts as the attachment point for the suspensory ligaments of Cooper?

  • Dermis
  • Retromammary tissue
  • Pectoral fascia (correct)
  • Adipose tissue

    • Which artery supplies the medial aspect of the breast?

  • Internal thoracic artery (correct)
  • Mammary branch artery
  • Lateral thoracic artery
  • Posterior intercostal artery

    • What is the primary route for lymphatic drainage from the breast?

  • Renal nodes
  • Axillary nodes (correct)
  • Cervical nodes
  • Parasternal nodes

    • Which percentage of lymph from the breast drains to the parasternal nodes?

    <p>20%</p> Signup and view all the answers

    From which artery do the lateral mammary branches originate?

    <p>Aorta</p> Signup and view all the answers

    What is the retromammary space primarily composed of?

    <p>Loose connective tissue</p> Signup and view all the answers

    What is the role of lymphatic drainage in relation to breast cancer?

    <p>It aids in the metastasis of cancer cells</p> Signup and view all the answers

    What is the primary artery that supplies the lateral part of the breast?

    <p>Lateral thoracic artery</p> Signup and view all the answers

    What is the primary function of the lymphatic system?

    <p>To drain tissue fluid, plasma proteins, and cellular debris back into the bloodstream</p> Signup and view all the answers

    Where do the superficial lymphatic vessels originating from the hand primarily travel?

    <p>In close proximity to major superficial veins</p> Signup and view all the answers

    What is the final destination of the lymphatic vessels that follow the basilic vein?

    <p>Cubital lymph nodes</p> Signup and view all the answers

    Which group of lymph nodes in the axilla receives lymph from the majority of the upper limb?

    <p>Humeral nodes</p> Signup and view all the answers

    What type of lymphatic vessels are associated with joint capsules and muscles?

    <p>Deep lymphatic vessels</p> Signup and view all the answers

    What do the subscapular lymph nodes primarily collect lymph from?

    <p>Scapular region</p> Signup and view all the answers

    What anatomical group of lymph nodes collects lymph from the anterior thoracic wall, including most of the breast?

    <p>Pectoral nodes</p> Signup and view all the answers

    In which lymphatic route do the vessels following the cephalic vein typically lead?

    <p>To the apical axillary lymph nodes</p> Signup and view all the answers

    What is the primary function of the apical axillary lymph nodes?

    <p>To receive lymph from central axillary nodes and the cephalic vein</p> Signup and view all the answers

    Which lymphatic structures converge to form the right lymphatic duct?

    <p>Right subclavian trunk</p> Signup and view all the answers

    Which of the following is NOT part of the anterior wall of the axilla?

    <p>Teres major muscle</p> Signup and view all the answers

    Which muscles are included in the medial wall of the axilla?

    <p>Serratus anterior and thoracic wall</p> Signup and view all the answers

    Which structure forms the apex of the axilla?

    <p>Axillary inlet</p> Signup and view all the answers

    What is the shape of the axilla described in the content?

    <p>Pyramidal</p> Signup and view all the answers

    Which axillary lymph node group receives lymph from the pectoral, subscapular, and humeral axillary lymph node groups?

    <p>Central nodes</p> Signup and view all the answers

    Which of the following borders contributes to the lateral wall of the axilla?

    <p>Intertubercular groove of humerus</p> Signup and view all the answers

    What is the main artery supplying the upper limb?

    <p>Axillary artery</p> Signup and view all the answers

    How many parts does the axillary artery have?

    <p>Three parts</p> Signup and view all the answers

    Which muscle tendon does NOT travel through the axilla?

    <p>Triceps brachii (long head)</p> Signup and view all the answers

    What is a potential consequence of the apex of the axilla decreasing in size when the arm is fully abducted?

    <p>Increased risk of compression of axillary contents</p> Signup and view all the answers

    Which of these structures passes through the quadrangular space?

    <p>Axillary nerve</p> Signup and view all the answers

    What type of condition is an enlargement of the axillary lymph nodes often considered a non-specific indicator of?

    <p>Breast cancer</p> Signup and view all the answers

    What is the main route through which the majority of contents leave the axilla?

    <p>Inferiorly and laterally into the upper limb</p> Signup and view all the answers

    Which vein is NOT considered a major tributary of the axillary vein?

    <p>Subclavian vein</p> Signup and view all the answers

    Which muscles are classified as extrinsic muscles of the shoulder?

    <p>Pectoralis major</p> Signup and view all the answers

    What is the primary nerve that innervates the biceps brachii?

    <p>Musculocutaneous nerve</p> Signup and view all the answers

    Which muscle is responsible for flexing the elbow joint?

    <p>Brachialis</p> Signup and view all the answers

    Which structure is formed by the anterior rami of cervical spinal nerves C5 to T1?

    <p>Brachial plexus</p> Signup and view all the answers

    What separates the two layers of extrinsic muscles in the shoulder region?

    <p>Tendon of the rotator cuff</p> Signup and view all the answers

    Which of the following muscles is located in the posterior compartment of the upper arm?

    <p>Triceps brachii</p> Signup and view all the answers

    Which nerve runs through the axilla and supplies the skin and musculature of the upper limb?

    <p>Radial nerve</p> Signup and view all the answers

    The cephalic vein enters the axilla via which anatomical structure?

    <p>Clavipectoral triangle</p> Signup and view all the answers

    Which of the following nerves innervates the biceps brachii muscle?

    <p>Musculocutaneous Nerve</p> Signup and view all the answers

    Which nerve is responsible for innervating the thenar muscles?

    <p>Median Nerve</p> Signup and view all the answers

    What muscles are innervated by the Axillary Nerve?

    <p>Teres minor and deltoid</p> Signup and view all the answers

    Which nerve predominantly innervates the extensors of the wrist and fingers?

    <p>Radial Nerve</p> Signup and view all the answers

    The Ulnar Nerve is responsible for innervating which of the following?

    <p>Medial one and a half fingers and associated palm area</p> Signup and view all the answers

    Which branch of the Median Nerve innervates the lateral part of the palm?

    <p>Palmar cutaneous branch</p> Signup and view all the answers

    Which of the following nerves arises from the roots C5 and C6?

    <p>Axillary Nerve</p> Signup and view all the answers

    The digital cutaneous branch of the Median Nerve innervates which part of the hand?

    <p>Lateral three and a half fingers on the anterior surface</p> Signup and view all the answers

    Study Notes

    Breast, Axilla, and Muscles of the Arm and Shoulder

    • The breasts are paired structures located on the anterior thoracic wall in the pectoral region.
    • They are more prominent in females after puberty.
    • Breasts contain mammary glands, an accessory gland of the female reproductive system, involved in lactation.

    Surface Anatomy of the Breast

    • Extends horizontally from the sternum's lateral border to the mid-axillary line.
    • Vertically, it spans from the 2nd to 6th costal cartilages.
    • It's superficial to the fascia covering the pectoralis major and serratus anterior muscles.
    • The breast has two regions: a larger circular body and a smaller axillary tail.

    Breast Anatomy

    • The nipple is centrally located and contains mainly smooth muscle fibers.
    • The areola surrounds the nipple, containing sebaceous glands.
    • These glands enlarge during pregnancy and secrete an oily substance as a protective lubricant.
    • Milk production and secretion are regulated by the hormones prolactin and oxytocin, secreted by the pituitary gland.
    • Breasts are composed of mammary glands surrounded by connective tissue stroma.
    • Mammary glands are modified sweat glands with ducts and 15-20 secretory lobules.
    • Each lobule has alveoli drained by a single lactiferous duct. These ducts converge at the nipple.

    Connective Tissue Stroma

    • The fibrous stroma forms suspensory ligaments ("Cooper's ligaments").
    • Ligaments attach the breast to the dermis and underlying pectoral fascia.
    • They separate the secretory lobules of the breast.
    • The base of the breast lies on the pectoral fascia. This fascia acts as an attachment point for Cooper's ligaments.
    • Retromammary space is a layer of loose connective tissue between the breast and pectoral fascia, often used in reconstructive plastic surgery.

    Arterial Supply and Venous Drainage of the Breasts

    • Arterial supply to the medial breast is via the internal thoracic artery (internal mammary artery).
    • This artery branches from the subclavian artery.
    • The lateral part of the breast receives blood from lateral thoracic and thoracoacromial branches of the axillary artery.
    • These branches come from the posterior intercostal arteries (from the aorta) and supply the breast in the 2nd, 3rd, and 4th intercostal spaces.
    • Venous drainage occurs into the axillary and internal thoracic veins, corresponding to the arteries.

    Lymphatic Drainage of the Breasts

    • Lymphatic drainage is crucial in breast cancer metastasis.
    • Lymphatic drainage from breast tissue is collected by three groups of lymph nodes:
      • Axillary nodes (75%)
      • Parasternal nodes (20%)
      • Posterior intercostal nodes (5%)
    • All axillary lymph nodes drain into apical nodes.

    Innervation of the Breasts

    • Innervation of the breast is provided by the anterior and lateral cutaneous branches of the 4th-6th intercostal nerves (contain both sensory and autonomic nerve fibers)
    • Autonomic fibers regulate smooth muscle and blood vessel tone.
    • Nerves do not control milk production and secretion.

    Clinical Relevance: Breast Cancer

    • Breast cancer is the most common cancer in the UK.
    • It's the second highest cause of cancer death in UK women after lung cancer.
    • It is more common in women than men.

    Clinical Presentation and Causes of Breast Cancer

    • Blockages in lymphatic drainage can cause excess lymph build-up in subcutaneous tissue.
    • Common clinical features may include nipple deviation or retraction, prominent skin between dimpled pores (peau d'orange), and larger dimples from cancerous invasions and fibrosis.

    Diagnosis of Breast Cancer

    • A triple assessment, including clinical examination, imaging (mammogram and ultrasound), and biopsy, is used to diagnose a suspected breast cancer.

    Treatment of Breast Cancer

    • Surgical treatment with adjuvant radiotherapy is the recommended treatment approach.
    • Often aims to remove only the affected tissue.
    • Mastectomy is considered an option for cases where local intervention is not sufficient
    • Adjuvant chemotherapy is used to improve survival rates.

    Lymphatic Drainage of the Upper Limb

    • The lymphatic system drains tissue fluid, plasma proteins, and cellular debris into the bloodstream, supporting immune defense.
    • Lymph is filtered through lymph nodes before returning to the venous system.
    • Superficial lymphatic vessels accompany superficial veins, moving proximally towards the lymph nodes in the axilla.
    • Deep lymphatic vessels follow deep veins and terminate in humeral axillary lymph nodes, draining lymph from the joint capsules, periosteum, tendons, and muscles.
    • The majority of upper extremity lymph nodes are in the axilla.

    Borders of the Axilla

    • The axilla is a pyramidal-shaped region with an apex, base, and four walls (anterior, posterior, medial, and lateral).

    Contents of the Axilla

    • The axilla contains important structures such as nerves, blood vessels, and lymphatics, including the axillary artery (and branches—medial, posterior, and lateral to the pectoralis minor), axillary vein, and brachial plexus.

    Passageways Exiting the Axilla

    • Three main routes for structures exiting the axilla: the main route moving inferiorly and laterally into the upper limb; the quadrangular space through the posterior wall to the posterior arm and shoulder; and a section associated with the clavipectoral triangle.

    Muscles of the Shoulder and Upper Arm

    • Shoulder muscles are divided into extrinsic (originate from the torso, attaching to shoulder bones) and intrinsic (originate from scapula/clavicle, attaching to humerus)

    • The extrinsic muscles are primarily superficial back muscles and are grouped into two layers

    • extrinsic superficial muscles include: Trapezius, Latissimus dorsi, Levator scapulae, Rhomboids major and minor

    • Extrinsic deep muscles include: Subclavius

    • The intrinsic muscles of the shoulder (rotator cuff) are: Supraspinatus, Infraspinatus, Teres minor, Subscapularis

    • Upper Arm Muscles: Biceps brachii, Brachialis, Coracobrachialis, Triceps brachii

    Muscles of the Pectoral Region

    • The pectoral region has four key muscles: Pectoralis major, Pectoralis minor, Serratus anterior, and Subclavius
    • Each muscle has specific attachment points, actions, and innervation to facilitate upper limb movements.

    Brachial Plexus

    • The brachial plexus is a network of nerves that supplies the skin and musculature of the upper limb.
    • Roots: derived from the ventral rami of spinal nerves (C5-T1).
    • Trunks: formed by the division of the roots (upper, middle, and lower).
    • Divisions: further subdivision of the trunks (anterior and posterior).
    • Cords: formed by the division of the trunks (lateral, medial, and posterior).
    • Branches: the terminal nerves emerging from the cords (musculocutaneous, axillary, radial, median, and ulnar)

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    Breast, Axilla & Arm Muscles Anatomy PDF

    Description

    This quiz covers the anatomy of the breast, including its structure, location, and functions. It also addresses the associated muscles of the arm and shoulder, highlighting their significance in the anatomical context. Test your knowledge on these critical components of human anatomy.

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