Anatomy (Pectoral And Axillary Regions)

Front 1

what are the three components of the sternum?

Back 1

manubrium
body
xiphoid process

Front 2

what is the sternal angle?

Back 2

angle of Louis

angle between manubrium and body of sternum

Front 3

with what does the sternum articulate?

Back 3

clavicle (sternoclavicular joint)
7 ribs

Front 4

what allows the clavicle to hold the scapula away from the trunk?

Back 4

coracoclavicular ligament

Front 5

what prevents superior dislocation of the humerus?

Back 5

the acromion and coracoacromial ligament

Front 6

what is the name for the part of the scapula that articulates with the humerus?

Back 6

glenoid cavity

Front 7

which of the bones of the forearm is larger at the elbow?

Back 7

ulna

Front 8

which of the bones of the forearm is larger at the wrist?

Back 8

radius

Front 9

what forms the anterior wall of the axilla?

Back 9

mammary gland
pectoralis major
pectoralis minor
subclavius muscle

Front 10

what forms the posterior wall of the axilla?

Back 10

scapula
subscapularis
teres major
latissimus dorsi

Front 11

what forms the medial wall of the axilla?

Back 11

ribs 2-6
serratus anterior muscle

Front 12

what forms the lateral wall of the axilla?

Back 12

intertubercular sulcus
tendon of long head of biceps brachii

Front 13

what forms the base of the axilla?

Back 13

skin and fascia of the armpit

Front 14

what is the apex of the axilla?

Back 14

triangular space, bounded by clavicle, upper border of scapula, and rib 1

Front 15

what are the attachments of the pectoralis major muscle?

Back 15

clavicle (clavicular head)
sternum (sternal head)
lateral lip of bicipital groove

Front 16

what are the actions of the pectoralis major?

Back 16

adducts humerus
medially rotates humerus
flexes humerus

Front 17

what innervates the pectoralis major muscle?

Back 17

medial pectoral nerve
lateral pectoral nerve

Front 18

what are the attachments of the pectoralis minor muscle?

Back 18

ribs 2-6 (usually 3-5)
coracoid process of scapula

Front 19

what are the actions of the pectoralis minor?

Back 19

protracts the scapula

Front 20

what innervates the pectoralis minor muscle?

Back 20

medial pectoral nerve

Front 21

what forms the borders of the deltopectoral triangle?

Back 21

pectoralis major (inferior)
deltoid (superolateral)
clavicle (superomedial)

Front 22

what is transmitted through the deltopectoral triangle?

Back 22

cephalic vein

Front 23

through what does the cephalic vein pierce to join with the axillary vein?

Back 23

deltopectoral triangle
costocoracoid membrane

Front 24

into what vein does the cephalic vein drain?

Back 24

axillary vein

Front 25

of what fascia is the costocoracoid membrane a part?

Back 25

clavipectoral fascia

Front 26

what is enclosed within the clavipectoral fascia?

Back 26

subclavius muscle
pectoralis minor muscle

Front 27

what does the clavipectoral fascia become below the pectoralis minor?

Back 27

suspensory ligament

Front 28

to what does the suspensory ligament of the clavipectoral fascia attach?

Back 28

base of the axilla

Front 29

what produces the axillary fossa?

Back 29

suspensory ligament from the clavipectoral fascia

Front 30

what forms the borders of the medial triangular space?

Back 30

subscapularis (superomedial)
teres major (inferior)
long head of triceps brachii (superolateral)

Front 31

what forms the borders of the lateral quadrangular space?

Back 31

surgical neck of the humerus (superolateral)
subscapularis (superomedial)
teres major (inferolateral)
long head of triceps brachii (inferomedial)

Front 32

what are the attachments of the serratus anterior?

Back 32

ribs 1-8
medial border of scapula

Front 33

what are the actions of the serratus anterior?

Back 33

protracts scapula
assists in rotation of scapula

Front 34

what innervates the serratus anterior?

Back 34

long thoracic nerve (C5, C6, C7)

Front 35

what causes winged scapula?

Back 35

lesion of long thoracic nerve and paralysis of serratus anterior muscle

Front 36

when does the subclavian artery become the axillary artery?

Back 36

inferior border of rib 1

Front 37

when does the axillary artery become the brachial artery?

Back 37

lower border of teres major muscle

Front 38

with what fascia is the axillary sheath continuous?

Back 38

prevertebral fascia of the neck

Front 39

what are the attachments of the subclavius muscle?

Back 39

costochondral junction of rib 1
subclavian groove

Front 40

what are the actions of the subclavius muscle?

Back 40

stabilizes clavicle during movements of distal portions of upper limb

prevents subclavian artery from being compressed between clavicle and rib 1

Front 41

what innervates the subclavius muscle?

Back 41

nerve to subclavius (C5, C6)

Front 42

what are the branches (from proximal to distal) of the axillary artery?

Back 42

supreme thoracic artery
thoracoacromial artery
lateral thoracic artery
subscapular artery
posterior humeral circumflex artery
anterior humeral circumflex artery

Front 43

what branches from the first part of the axillary artery?

Back 43

1st part is between rib 1 and pec minor

supreme thoracic artery

Front 44

what branches from the second part of the axillary artery?

Back 44

2nd part is posterior to the pec minor

thoracoacromial artery
lateral thoracic artery

Front 45

what branches from the third part of the axillary artery?

Back 45

3rd part is between pec minor and lower border of teres major

subscapular artery
posterior humeral circumflex artery
anterior humeral circumflex artery

Front 46

why is only the first part of the axillary vein enclosed in the axillary sheath?

Back 46

so that the remaining part can expand

Front 47

in relation to the axillary artery, where does the axillary vein lie?

Back 47

medial to the axillary artery

Front 48

what is the continuation of the basilic vein?

Back 48

axillary vein

Front 49

where does the axillary vein become the subclavian vein?

Back 49

at the level of rib 1

Front 50

what veins from brachial and axillary arteries join the axillary vein?

Back 50

venae comitantes

Front 51

for what is a subclavian venipuncture performed?

Back 51

central venous access

Front 52

what is punctured in subclavian venipuncture?

Back 52

terminal part of the axillary vein
(medial to rib 1)

Front 53

where is the cephalic vein located?

Back 53

superficially on the lateral side of the arm

Front 54

where is the basilic vein located?

Back 54

superficial on the medial side of the arm

Front 55

what is the order of organization of the brachial plexus?

Back 55

Remember To Drink Cold Beer

Rami
Trunks
Divisions
Cords
Branches

Front 56

how many rami are in the brachial plexus? where are they located?

Back 56

5 ventral nerve rami

located in the neck

Front 57

how many trunks are in the brachial plexus? where are they located?

Back 57

3 trunks

upper (C5, C6)
middle (C7)
lower (C8, T1)

located in the neck

Front 58

how many divisions are in the brachial plexus? where are they located?

Back 58

6 divisions (3 anterior and 3 posterior)

posterior to the clavicle

Front 59

how many cords are in the brachial plexus? where are they located?

Back 59

3 cords (lateral, posterior, medial)

posterior to pectoralis minor

Front 60

how many terminal branches come from the brachial plexus? where are they located?

Back 60

6 terminal branches

distal to the pectoralis minor

Front 61

from what is the posterior cord of the brachial plexus formed?

Back 61

posterior divisions from all three trunks

Front 62

from what is the lateral cord formed?

Back 62

anterior divisions from superior and middle trunk

Front 63

from what is the medial cord formed?

Back 63

continuation of the anterior division of the inferior trunk

Front 64

which branches of the brachial plexus are supraclavicular?

Back 64

dorsal scapular nerve (C5)
nerve to subclavius (C5, C6)
long thoracic nerve (C5, C6, C7)
suprascapular nerve (C5, C6)

Front 65

what branches from the lateral cord of the brachial plexus are infraclavicular?

Back 65

lateral pectoral nerve
musculocutaneous nerve (C5, C6, C7)
lateral head of median nerve

Front 66

what branches from the medial cord of the brachial plexus are infraclavicular?

Back 66

medial pectoral nerve
medial head of median nerve (C5, C6, C7, C8, T1)
ulnar nerve (C7, C8, T1)
medial brachial cutaneous nerve
medial antebrachial cutaneous nerve

Front 67

what branches from the posterior cord of the brachial plexus are infraclavicular?

Back 67

upper subscapular nerve
lower subscapular nerve
thoracodorsal nerve
axillary nerve (C5, C6)
radial nerve (C5-T1)

Front 68

which root of a typical spinal nerve carries efferent fibers?

Back 68

ventral root

Front 69

which root of a typical spinal nerve carries afferent fibers?

Back 69

dorsal root

Front 70

what type of fibers are carried in spinal nerves?

Back 70

afferent fibers
efferent fibers

Front 71

what are the divisions of a spinal nerve?

Back 71

dorsal ramus
ventral ramus

Front 72

what is innervated by a dorsal ramus?

Back 72

muscles acting on spinal column and overlying skin

Front 73

what is innervated by a ventral ramus?

Back 73

muscles and skin of anterior 3/4 of body wall

Front 74

in what fascia does the mammary gland lie?

Back 74

superficial pectoral fascia

Front 75

where does the mammary gland extend (vertical and horizontal limits)?

Back 75

ribs 2-6

side of sternum to midaxillary line

Front 76

what connects the glandular tissue of the breast to the skin?

Back 76

suspensory ligaments (of Cooper)

Front 77

what causes drooping of breasts?

Back 77

atrophy of suspensory ligaments of Cooper

Front 78

what causes dimpling of breasts?

Back 78

contraction of suspensory ligaments of Cooper from fibrosis around a carcinoma

Front 79

what is polymastia?

Back 79

supernumerary breasts

Front 80

what is polythelia?

Back 80

accessory nipples

Front 81

where do polymastia and polythelia occur?

Back 81

along the embryonic mammary ridge
(the milk line)

Front 82

what is amastia?

Back 82

absence of a breast

Front 83

what innervates the mammary gland?

Back 83

intercostal nerves 2-6 via lateral and anterior cutaneous branches

sympathetic: innervation via intercostal nerves or vessels

Front 84

what vascularizes the mammary gland?

Back 84

2-3 branches of the internal thoracic artery (internal mammary artery)
2 branches from lateral thoracic artery
small branches from intercostal arteries
pectoral branch of thoracoacromial artery

Front 85

where do main lymph vessels of the mammary gland converge?

Back 85

converge on the nipple

Front 86

where do the lymph vessels from the superficial portion of the breast drain?

Back 86

subareolar plexus

Front 87

where do the lymph vessels from the deep portion of the breast drain?

Back 87

submammary plexus

Front 88

what are the clusters of axillary lymph nodes?

Back 88

apical nodes
central nodes
lateral (brachial or humeral) nodes
pectoral nodes (anterior)
subscapular nodes (posterior)
deltopectoral nodes (infraclavicular)

Front 89

where are the low nodes of the axillary region?

Back 89

below the level of the pectoralis minor

Front 90

where are middle nodes of the axillary region?

Back 90

deep to the level of the pectoralis minor

Front 91

where are the upper (apical) nodes of the axillary region?

Back 91

between the upper border of pectoralis minor and lower border of clavicle

Front 92

where are Rotter's nodes?

Back 92

between pectoralis minor and pectoralis major

Front 93

what is peau d'orange sign?

Back 93

skin of the breast resembles the skin of an orange (has prominent pores due to edema of the skin)

Front 94

what muscles can be used for breast reconstruction surgery to hold the implant in place?

Back 94

latissimus dorsi flap

transverse rectus abdominal muscle (TRAM) flap

Front 95

what is included in the nuchal area?

Back 95

parietal bones
occipital bone
temporal bones

Front 96

what is the inion?

Back 96

external occipital protuberance
(bony prominence in the center of the superior nuchal line)

Front 97

what is the external occipital crest?

Back 97

median nuchal line
(prominent bony line down the median line of the occipital bone to the foramen magnum)

Front 98

what is on the posterior aspect of C1?

Back 98

posterior tubercle

Front 99

what is another name for C1?

Back 99

atlas

Front 100

which vertebrae have bifid spines?

Back 100

C2-C6

Front 101

which vertebra is the vertebra prominens?

Back 101

C7

(though it has a less prominent spinous process than T1)

Front 102

which vertebral spines are palpable?

Back 102

C6 to L5

Front 103

what is another name for C2?

Back 103

axis

Front 104

what is another name for the ligamentum nuchae?

Back 104

supraspinal ligament

Front 105

to what does the supraspinal ligament (ligamentum nuchae) attach?

Back 105

cervical spines
inion
external occipital crest

Front 106

what are the two sufaces of the scapula?

Back 106

costal (ventral)
dorsal

Front 107

what are the three borders of the scapula?

Back 107

superior
medial (vertebral)
lateral (axillary)

Front 108

what are the three angles of the scapula?

Back 108

superior
inferior
lateral

Front 109

what are the two processes of the scapula?

Back 109

coracoid process
spine of scapula

Front 110

what are the 3 fossae of the scapula?

Back 110

supraspinous
infraspinous
subscapular

Front 111

at what structure do the supraspinous and infraspinous fossae communicate?

Back 111

spinoglenoid notch

Front 112

what closes off the suprascapular notch superiorly?

Back 112

transverse scapular (suprascapular) ligament

Front 113

what passes inferior to the suprascapular ligament?

Back 113

suprascapular nerve (for protection)

Front 114

what passes superior to the suprascapular ligament?

Back 114

suprascapular artery and vein
(able to expand with increased blood volume)

Front 115

where is the iliocostalis muscle attached to the ribs?

Back 115

at the angles of each of the ribs

Front 116

what is the inferior attachment of the erector spinae (sacrospinalis) muscles?

Back 116

iliac crest

Front 117

what is a dermatome?

Back 117

the area of skin supplied by sensory terminal branches of both dorsal and ventral rami of a single dorsal nerve root

Front 118

into what does the dorsal ramus of the typical spinal nerve divide?

Back 118

medial branch
lateral branch

(both supply muscles and then one or the other becomes cutaneous for the back)

Front 119

where do medial branches of the dorsal ramus of a spinal nerve become cutaneous?

Back 119

above the mid-thoracic region (T1-T9)

Front 120

where do the lateral branches of the dorsal rami of spinal nerves become cutaneous for the back?

Back 120

below mid thoracic region (T10 down)

Front 121

what is the longus dorsal ramus?

Back 121

cutaneous (lateral) branch of T12

(extends to shoulder area)

Front 122

what muscles compose the superficial muscles of the back?

Back 122

latissimus dorsi
trapezius
levator scapulae
rhomboidei (major and minor)

Front 123

what is the function of superficial muscles of the back?

Back 123

act on upper limb

Front 124

what are the attachments of the latissimus dorsi?

Back 124

thoracolumbar fascia of inferior 6 thoracic vertebrae, all lumbar and all sacral spines
outer lip of iliac crest
ribs 9-12

floor of bicipital groove (intertubercular sulcus)

Front 125

what innervates the latissimus dorsi?

Back 125

thoracodorsal nerve (C6, C7, C8)

Front 126

from where does the thoracodorsal nerve branch?

Back 126

posterior cord of the brachial plexus

Front 127

what are the actions of the latissimus dorsi?

Back 127

extends humerus
adducts humerus
medially rotates humerus

Front 128

what are the attachments of the trapezius?

Back 128

skull
all spines of cervical vertebrae (ligamentum nuchae)
all spines of thoracic vertebrae

lateral 1/3 of clavicle
acromion
crest of spine of scapula
tubercle on inferior lip of crest of spine of scapula

Front 129

what innervates the trapezius?

Back 129

motor = accessory nerve (CN XI)
sensory = C3, C4 ventral rami

Front 130

what are the actions of the trapezius?

Back 130

adducts scapula (elevates shoulder)
suspensory muscle of shoulder girdle

inferior fibers assist superior fibers in rotation of scapula

Front 131

what are the attachments of the levator scapulae?

Back 131

posterior tubercles of transverse processes of C1-C4

medial border of scapula

Front 132

what innervates the levator scapulae?

Back 132

C3, C4, (C5)

Front 133

what are the actions of the levator scapulae?

Back 133

elevates scapula

Front 134

what are the attachments of the rhomboid major?

Back 134

spinous processes of T1-T5
medial border of scapula

rhomboid major is inferior to rhomboid minor

Front 135

what are the attachments of the rhomboid minor?

Back 135

nuchal ligament
spinous process of C7-T1
medial border of scapula

rhomboid minor is superior to rhomboid major

Front 136

what innervates the rhomboidei (both major and minor)?

Back 136

dorsal scapular nerve (C5)

Front 137

what forms the borders of the triangle of auscultation?

Back 137

lat-scap-trap

vertebral (medial) border of scapula (superolaterally)
superior border of latissimus dorsi (inferiorly)
lateral border of trapezius (superomedially)

Front 138

what is covered by the triangle of auscultation?

Back 138

6th intercostal space (btwn 6 & 7)
rib 7

Front 139

what visceral structure is deep to the triangle of auscultation on the left side?

Back 139

cardiac orifice of the stomach

Front 140

what forms the borders of the lumbar triangle?

Back 140

posterior border of external oblique (laterally)
latissimus dorsi (medially)
iliac crest (inferiorly)

floor = internal obliques

Front 141

what is the clinical significance of the lumbar triangle?

Back 141

site of herniations