Block 2 Chest Wall

Front 1

Breast tissue locations

Back 1

Subcutaneous tissue/superficial fascia

Front 2

The breast is a modified ______

Back 2

sweat gland

Front 3

Breast composed of
-15-20 ___

Back 3

-Lobules

Front 4

Lobes contain ____ draining them, ending in a branched glandular pattern

Back 4

Ducts

Front 5

The majority of fat in breast tissue found in:

Back 5

Axillary tail

Front 6

Septa in breast formed by

Back 6

Suspensory ligaments

Front 7

Areola contains _____ glands

Back 7

Montgomery

Front 8

Montgomery glands are a ____ type of gland

Back 8

Sebaceous

Front 9

Montgomery glands secrete

Back 9

Oily substance for lubrication during suckling

Front 10

The nipple serves as

Back 10

An opening for the ducts

Front 11

All breast cancer arises from:

Back 11

Glandular tissue (duct or gland itself)

Front 12

Location of most cancers in the breast

Back 12

upper outer quadrant because this is where most tissue is located

Front 13

Upper outer quadrant drains to which lymph nodes?

Back 13

Axillary

Front 14

Layout (arrangement) of the breast

Back 14

Radially arrayed

Front 15

Breast lobules are supported by:

Back 15

Suspensory ligaments

Front 16

Milk is only produced with:

Back 16

Prolactin

Front 17

Metastasis occurs most commonly to

Back 17

Axillary nodes

Front 18

Peau d'orange

Back 18

Tumor expanding against suspensory ligaments, causing dimpling of skin looking like orange

Front 19

Most common type of breast cancer

Back 19

Ductocarcinoma

Front 20

Leathery skin of breast caused by

Back 20

Cancer interfering with lymph drainage, build up of fluid occurs

Front 21

Cancer is harder to detect in:

Back 21

larger breasts

Front 22

Breast tissue is _____ dependent

Back 22

Estrogen

Front 23

Each lobule has one _____

Back 23

one duct

Front 24

Breast exams should evaluate
-
-

Back 24

Axillary tail
All axillary nodes

Front 25

Duct system goes away after:

Back 25

Menopause

Front 26

2 sources of blood to the breast
-Primary
-

Back 26

-Internal thoracic off subclavian
-Lateral thoracic

Front 27

Venous drainage of breast to

Back 27

Axillary vein

Front 28

Innervation of breast

Back 28

T2-T6

Front 29

____ will be the reverse of arterial supply

Back 29

Lymphatic

Front 30

Lymphatic channels drain

Back 30

Radially

Front 31

Lymph nodes of breast superior to inferior

Back 31

-Apical
-Central
-Lateral
-Medial

Front 32

Bad signs in breasts (4; ONED)

Back 32

1. Peau d'orange
2. New nipple inversion
3. Upper limb edema
4. Dimpling

Front 33

Why are cancers associated with enlarged lymph towards the axilla

Back 33

Primary drainage is to the axillary nodes

Front 34

Upper limb lymph drainage

Back 34

Lateral nodes

Front 35

All nodes are draining toward ___-node

Back 35

apical

Front 36

Swollen lymph above clavicle

Back 36

Lung cancer

Front 37

peau d'orange found:

Back 37

Wherever the lymph drainage is coming from

Front 38

Enclosed in the thoracic wall is the:

Back 38

Thoracic cavity

Front 39

Thoracic cavity has 2 divisions

Back 39

1. Pleural cavity
2. Mediastinum

Front 40

Sternal notch

Back 40

Junction of manubrium and clavicle

Front 41

Sternal notch around ____ vertebral level

Back 41

T2

Front 42

Sternal angle around ____ vertebral level

Back 42

T5

Front 43

Dome of diaphragm around ____ vertebral level

Back 43

T9

Front 44

___ fills the inferior thoracic aperature

Back 44

Diaphragm

Front 45

Axillary lines
-
-
-

Back 45

-Anterior
-Mediclavicular
-Median/Midsternal

Front 46

Thoracic outlet location

Back 46

Between 1st rib and manubrium

Front 47

The only bony attachment of the upper extremity is:

Back 47

Sternoclavicular joint

Front 48

The sternal angle is important because

Back 48

this is where the 2nd rib attaches to the sternum

Front 49

What forms the costal arch?

Back 49

Cartilage of ribs 8-10

Front 50

Intercostal spaces are found:

Back 50

Under their their named rib

Front 51

____ of a rib articulates with the transverse process of a vertebra

Back 51

Tubercle

Front 52

Ribs/vertebra relationship

Back 52

Rib named for transverse process it articulates with

Front 53

What's located in the costal groove

Back 53

Intercostal V. A. N.

Front 54

Why is the intercostal n. susceptible to damage?

Back 54

It is not as protected by the costal groove as the a. and v.

Front 55

Posterior ribs on X ray are ______ (direction)

Back 55

Horizontal/perpendicular to vertebrae

Front 56

Anterior ribs are ______

Back 56

Pointed anteriorly/ inferiorly

Front 57

Articulation of the 7th rib to the sternum is at:

Back 57

Body/xiphoid junction

Front 58

Vertebral body level of sternal angle

Back 58

T4/T5

Front 59

Superior limits of what organ are found at the line of the sternal angle

Back 59

Heart

Front 60

Below sternal angle:
Above sternal angle:

Back 60

Heart
Aorta, branches, etc

Front 61

What separates the internal intercostals and innermost intercostals?

Back 61

Intercostal v. a. n.

Front 62

Innermost intercostals in relation to transversus thoracis

Back 62

Innermost - lateral
Transversus - medial

Front 63

Muscles that are a common cause of faux chest pain

Back 63

Transversus thoracis

Front 64

Most quiet inspiration done via _____ muscle

Back 64

Diaphragm

Front 65

Levator costarum
-Longus crosses ___ spaces
-Brevis

Back 65

2
1

Front 66

inspiratory muscles

Back 66

External, innermost intercostals
Subcostal
Levator costarum
Serratus posterior superior

Front 67

Expiratory muscles

Back 67

Internal intercostal
Transversus thoracis
Serratus posterior inferior

Front 68

Key to inspiration is:

Back 68

Increasing intrathoracic volume

Front 69

Most respiration occurs by depressing ____ to gain intrathoracic volume

Back 69

Diaphragm

Front 70

Any muscle attached to the rib can be used to:

Back 70

Inspire

Front 71

Usual job of intercostal muscles

Back 71

Keep a stiff intercostal space allowing rigid thoracic wall that can expand as a unit

Front 72

Internal thoracic a. arises from

Back 72

Subclavian

Front 73

Branches of internal thoracic
(5 total, 2 main)

Back 73

Pericardiophrenic
Anterior intercostal
Anterior perforating branch
(Musculophrenic)
(Superior epigastric)

Front 74

Skin near sternum supplied by what artery

Back 74

Anterior perforating branches

Front 75

Intercostal spaces supplied by what a.

Back 75

Anterior intercostal

Front 76

A. traveling with the phrenic n. supplying the diaphragm

Back 76

Pericardiophrenic

Front 77

2 terminal branches of the internal thoracic a.

Back 77

Musculophrenic
Superior epigastric

Front 78

Musculophrenic a. course & branches

Back 78

Along costal arch, has anterior intercostal branches for ribs 7-10

Front 79

Superior epigastric course

Back 79

Enters the abdomen next to xiphoid process

Front 80

Intercostal arteries arise from
(4)

Back 80

1. Intercostal a of costocervical trunk
2. Superior thoracic a.
3. Aorta
4. Internal thoracic

Front 81

Internal thoracic a. braches from:
Lateral thoracic branches from:

Back 81

Subclavian
Axilarry

Front 82

Anterior intercostal a. come from ____

Back 82

Internal thoracic a.

Front 83

Posterior intercostal a. come from

Back 83

Posterior intercostal a.

Front 84

Thoracoepigastric v. communicates between ___ & ___ veins

Back 84

Lateral thoracic
Superficial epigastric

Front 85

Intercostal veins drain to

Back 85

Superior intercostal v.
Azygos
Hemiazygos
Accessory hemiazygos

Front 86

Epigastric vein communicates with

Back 86

Internal thoracic v.

Front 87

Intercostal n. are VPR of

Back 87

T1-T11

Front 88

Subcostal n. is VPR of

Back 88

T12

Front 89

Parietal pleura is next to:

Back 89

Chest wall

Front 90

Visceral pleur in contact with

Back 90

Viscera (lung)

Front 91

What holds the plural cavity open

Back 91

Vacuum

Front 92

Best place for thoracocentesis is done where?

Back 92

Costodiaphragmatic recess

Front 93

Costodiaphragmatic recess found near what rib level

Back 93

Rib 8, posteriorly

Front 94

Which line is this?

Back 94

Axillary

Front 95

Which line is this?

Back 95

Midclavicular

Front 96

Which line is this?

Back 96

Median/midclavicular