Breast Anatomy PDF

( UPPER LIMB ) “ Breast “ ‫ثدي‬ ‫الغدة اللبنية‬ ‫متخصصة‬ The female breast (mamma) is formed by the mammary gland (specialized ‫ غدة اضافية‬accessory gland) secr...

( UPPER LIMB ) “ Breast “ ‫ثدي‬ ‫الغدة اللبنية‬ ‫متخصصة‬ The female breast (mamma) is formed by the mammary gland (specialized ‫ غدة اضافية‬accessory gland) secreting milk. ‫املوقع‬ ‫تفرز‬ ‫الشكل‬ Shape & position: ‫قاعدته‬ The breast is conical in shape with its base extending from the second to the sixth ribs and from sternum (lateral border) to the midaxillary line. ‫الضلع‬ ‫االبطي‬ ‫تخترق‬ It presents in superficial fasola, except axillary tail (which pierces deep fascia at lower border of pectoralis major and enters axilla). (‫العضلة السرير ) يعني الي حتت الثدي‬ Muscle bed of breast (muscles under it) are pectoralis major the main muscle bed) with serratus anterior & external oblique. ‫فصوص‬ ‫مفصولة‬ It consists of 15-20 lobes separated by fibrous septa which is more developed in upper part near skin forming the suspensory ligament (Cooper's ligament). ‫الرباط‬ Breast is separated from the deep fascia under it by it by a layer of loose arcolar tissue called retromammary space.  ‫متكون من‬ ‫تنقل‬ Each lobe is formed of acini (secreting milk) and transmits the milk by a ‫ قناة لبنية‬lactiferous duct that opens into the nipple and before its enc forms lactiferous sinus (ampulla). Each lobe has one duct so there is 15-20 ducts in breast. ‫قناة‬ Nip ple & Areola: ‫مقابل‬ ‫الفراغ بي االضالع الرابع‬ Nipple: lies opposite to 4th intercostal space, but if the breast is large, the nipple will be lower. It has 15-20 openings. ‫وردي داكن‬ ‫دائرية‬ ‫حتيط‬ Areola: is dark pink-brownish circular area ‫احلمل‬ surrounding the nipple, it changes to dark brown by melanin at first pregnancy and still for ever. Arcola contains areolar sebaceous glands which is so large forming visible cutaneous tubercles. ‫غدد دهنية‬ ‫حتدبان‬ Both nipple & arcola have no fat under its skin. Blood supply: 1. Internal thoracic a. (perforating branches of it). 2. Lateral thoracic a. 3. Intercostal arteries. 4. Thoraco-acromial a Note: Veins corresponds to arteries. ( Lymph drainage ) ‫اجلانبي‬ ‫الربع‬ ‫املركزي‬ Lateral quadrant & central part: drain into anterior (pectoral) group. ‫العلري‬ ‫قمي‬ Upper quadrant: drain into apical group of lymph nodes Lower quadrant: into lymph plexus of rectus sheath & subphrenic plexus. ‫الوسطي‬ Medial quadrant: into internal thoracic (parasternal) nodes. Some lymphatics of medial part cross opposite breast (intermammary lymphatics). ‫مقابل‬  Clinical notes : ‫يتضخم‬ Male breast may enlarge in some diseases (gynecomastia). ‫يُهاجم‬ ‫سرطان الثدي‬ Suspensory (Cooper's) ligament may be invaded by breast cancer causing ‫ ندب‬dimpling of skin (peau d'orange) by their shrinkage. Breast cancer may invade retromammary space into the muscle causing fixation of breast ‫تثبيت‬ ‫يعني يصبح كتلة صلدة‬  ‫سن البلوغ‬ ‫شبه االسطواني‬ ‫تأثير‬ Breasts at puberty assume their hemispherical shape under the influence of ovarian hormones, and their size increase by fat deposition. ‫الهورمونات املبيضية‬ ‫تراكم الدهون‬ ( AXILLA ) Definition: ‫االبط‬ Axilla (armpit) is a pyramidal space between upper part of arm & the side of he chest. It has an apex, base & 4 walls. ‫قمة‬ Apex of axilla: (upper end) Anteriorly: clavicle. Posteriorly: upper end of scapula. Medially: outer border of 1" rib. ‫ القاعدة‬Base of axilla: (lower end) ‫طية‬ Anteriorly: anterior axillary fold (pectoralis major). Posteriorly: posterior axillary fold (teres major & latissimus dorsi tendons). Medially: chest wall. ‫جدار الصدر‬ Note: Base of axilla is formed by skin & fascia that connect the anterior & posterior axillary walls.  ‫جداران‬ Walls of axilla: (4 walls) Anterior wall: pectoralis major, pectoralis minor, subclavius & clavipectoral fascia. Posterior wall: teres major, latissimus dorsi & subscapularis. Lateral wall: bicipital groove of humerus, biceps brachii & coracobrachialis. Medial wall: upper 4-5 ribs, intercostal spaces & serratus anterior. Contents of axilla: 1. Brachial plexus (cords & branches). 2. Axillary a. (and its branches). 3. Axillary v. (and its tributaries). 4. Axillary lymph nodes (and lymph vessels). 5. Axillary fat. 6. Axillary tail of breast. 7. Axillary sheath.  ‫استمرار‬ Axillary sheath: is a continuation of prevertebral layer of deep fascia of neck. It contains: (1) axillary a. (2) cords of brachial plexus. Clavipectoral fascia: ‫صفيحة‬ Strong fibrous sheet between clavicle (above) (enclosing the subclavius m.) & pectoralis minor (below). Its lower part (after pectoralis minor) forms suspensory ligament of axilla. Its upper border forms costocoracoid ligament (between 1 rib & coracoids process). It is pierced by : (1) lateral pectoral n. (supplies pectorals major). (2) thoraco-acromial a. (from 2nd part of axillary a.). (3) cephalic v. (drains into axillary v.). (4) lymph vessels (drain into apical lymph nodes). Deltopectoral groove: Groove between deltoid & pectoralis major. It contains: (1) deltoid branch of thoraco-acromial a. (2) uppermost part cephalic v. (3) deltopectoral lymph node. Written by : Mohammed Wael