thoracic wall muscles, mammary glands, cross-section
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THORACIC WALLTHORACIC WALL
MUSCLES, MAMMARY GLANDS, MUSCLES, MAMMARY GLANDS, CROSS-SECTIONCROSS-SECTION
Surface Muscles (Anterior)Surface Muscles (Anterior)
PlatysmaPlatysmaPectoralis majorPectoralis majorPectoralis minorPectoralis minorSubclaviusSubclaviusSerratus anteriorSerratus anteriorRefer in syllabus:Refer in syllabus:
Table 1, pp 47-49Table 1, pp 47-49Figure 13, p 50Figure 13, p 50
Surface Muscles (Posterior)Surface Muscles (Posterior)
Latissimus dorsiLatissimus dorsiTrapezius Trapezius Rhomboideus majorRhomboideus majorRhomboideus minorRhomboideus minorRefer in syllabus:Refer in syllabus:
Table I; pp 47-9Table I; pp 47-9
Deltopectoral TriangleDeltopectoral Triangle
Boundaries:Boundaries:Anterior border of the deltoid.Anterior border of the deltoid.
Superior border of the pectoralis major.Superior border of the pectoralis major.
Middle third of the clavicle.Middle third of the clavicle.
Deltopectoral TriangleDeltopectoral Triangle
Contents:Contents:Cephalic vein.Cephalic vein.
Deltopectoral lymph nodes.Deltopectoral lymph nodes.
Deltoid branch of the thoracoacromial Deltoid branch of the thoracoacromial artery.artery.
Clavipectoral FasciaClavipectoral Fascia
Invests subclavius and pectoralis minor.Invests subclavius and pectoralis minor.Attached to clavicle and anterior thoracic Attached to clavicle and anterior thoracic
wall.wall.Pierced by:Pierced by:
Cephalic veinCephalic vein
Thoracoacromial arteryThoracoacromial artery
Lateral pectoral nerveLateral pectoral nerveBecome suspensory ligament of the axilla.Become suspensory ligament of the axilla.
THORACIC WALL THORACIC WALL STRUCTURESTRUCTURE
(x.s.) (x.s.)
Refer to Figure 15, p. 60 in Refer to Figure 15, p. 60 in syllabus as well as background syllabus as well as background
material on pp 58-59.material on pp 58-59.
Mammary GlandsMammary Glands
Modified sweat glandsModified sweat glands15-20 lobes15-20 lobesLobes separated by fibrous septaLobes separated by fibrous septaLactiferous duct (1 per lobe)Lactiferous duct (1 per lobe)Lactiferous sinus (ampulla):Lactiferous sinus (ampulla):
Dilation as duct enters nippleDilation as duct enters nipple
Mammary GlandsMammary Glands
Fibrous tela subcutanea:Fibrous tela subcutanea:Connective tissue layer surrounding the Connective tissue layer surrounding the
entire gland.entire gland.Fatty tela subcutanea:Fatty tela subcutanea:
Adipose tissue deep to fibrous layer.Adipose tissue deep to fibrous layer.Suspensory ligament of Cooper:Suspensory ligament of Cooper:
Bundles of collagen fibers in dermis and Bundles of collagen fibers in dermis and hypodermis.hypodermis.
Mammary GlandsMammary Glands
Breast extends from 2Breast extends from 2ndnd-3-3rdrd rib superiorly to rib superiorly to 66thth-7-7thth costal cartilage inferiorly. costal cartilage inferiorly.
Extends from lateral border of sternum to Extends from lateral border of sternum to beyond the anterior axillary fold.beyond the anterior axillary fold.
Mammary GlandsMammary Glands
Retromammary space:Retromammary space:Space between the gland and the Space between the gland and the
pectoralis pectoralis major muscle.major muscle.Sinus mammarumis:Sinus mammarumis:
Space between the two glands.Space between the two glands.
Mammary Gland ArteriesMammary Gland Arteries
Anterior perforating arteries:Anterior perforating arteries:From internal thoracic arteryFrom internal thoracic artery
To medial part of glandTo medial part of glandMedial mammary rami:Medial mammary rami:
From 2From 2nd nd - 4- 4thth anterior perforating arteries anterior perforating arteries
To deep medial part of glandTo deep medial part of gland
Mammary Gland ArteriesMammary Gland Arteries
Lateral mammary artery:Lateral mammary artery:From lateral thoracic artery.From lateral thoracic artery.
To inferior part of gland.To inferior part of gland.Lateral mammary rami:Lateral mammary rami:
From lateral cutaneous branches of From lateral cutaneous branches of intercostal arteries.intercostal arteries.
To lateral part of the gland.To lateral part of the gland.
Mammary Gland VeinsMammary Gland Veins
Superficial and deep venous plexuses Superficial and deep venous plexuses drain into internal thoracic, lateral thoracic, drain into internal thoracic, lateral thoracic, and intercostal veins.and intercostal veins.
Mammary Gland NervesMammary Gland Nerves
Lateral mammary nerve:Lateral mammary nerve:T2-T6T2-T6
Anterior branch of lateral cutaneous Anterior branch of lateral cutaneous branch of intercostal nerves.branch of intercostal nerves.
Medial mammary nerve:Medial mammary nerve:T2-T6T2-T6
Lateral branch of anterior cutaneous Lateral branch of anterior cutaneous branch of intercostal nerves.branch of intercostal nerves.
Mammary Gland LymphaticsMammary Gland Lymphatics
Perilobular and interlobular lymphatic Perilobular and interlobular lymphatic vessels:vessels:
Into:Into:Subareolar plexus:Subareolar plexus:
Into:Into:Lateral lymphatic trunk:Lateral lymphatic trunk:
From lateral and superior glandFrom lateral and superior glandMedial lymphatic trunk:Medial lymphatic trunk:
From medial and inferior glandFrom medial and inferior gland
Mammary Gland LymphaticsMammary Gland Lymphatics
Lateral lymphatic trunk and Medial Lateral lymphatic trunk and Medial lymphatic trunk:lymphatic trunk:
Into:Into:Pectoral group of axillary lymph nodes:Pectoral group of axillary lymph nodes:
Into:Into:Subclavian lymphatic channelsSubclavian lymphatic channels
Mammary Gland LymphaticsMammary Gland Lymphatics
Accessory lymphatic drainage:Accessory lymphatic drainage:Periphery of gland drains into apical group Periphery of gland drains into apical group
of of axillary nodes and follows thoracoacromial axillary nodes and follows thoracoacromial trunk.trunk.
Circumareolar channels drain into sternal Circumareolar channels drain into sternal chain.chain.
Lymphatic DrainageLymphatic Drainage
Subareolar plexus of nodesSubareolar plexus of nodesAxillary lymph nodes:Axillary lymph nodes:
Receive from:Receive from:Superficial tissues, skin, breast, extrinsic limb Superficial tissues, skin, breast, extrinsic limb
muscles.muscles.
Include:Include:Pectoral groupPectoral group
Lateral groupLateral group
Apical groupApical group
Subscapular groupSubscapular group
Lymphatic DrainageLymphatic Drainage
Infraclavicular nodesInfraclavicular nodesParasternal nodesParasternal nodesAbdominal nodesAbdominal nodes
Inspiration: “Bucket Handle”Inspiration: “Bucket Handle”
Involves contraction of intercostal musclesInvolves contraction of intercostal musclesResults in raising of ribsResults in raising of ribsResults in an increase in the lateral Results in an increase in the lateral
dimensions of the thoracic cage.dimensions of the thoracic cage.
Inspiration: “Pump Handle”Inspiration: “Pump Handle”
Results from raising of sternumResults from raising of sternumResults in increase in anteroposterior Results in increase in anteroposterior
dimensions of thoracic cagedimensions of thoracic cage
Abdominal BreathingAbdominal Breathing
Results from lowering of diaphragm:Results from lowering of diaphragm:Phrenic nervePhrenic nerve
Necessary when:Necessary when:InfantInfant
Costal cartilages are calcifiedCostal cartilages are calcified
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