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35 Cards in this Set
- Front
- Back
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Axilla
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-a crossroads between areas from neck, structures leaving and entering thoracic cavity and arm
-things emanating to and from axilla stem from neck and thorax--> must come superior to first rib and under clavicle so there is potential for compromise or compression |
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Breast
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-superficial structure associated w/ axilla
-male and female breast distinguished by size and amount of glandular tissue -modified sweat gland -15-20 lobes separated by Cooper's ligaments -nipple ~4th intercostal space (thus innervated by T4) |
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Cooper's Ligaments
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dense connective tissue strands in breast that separate the lobes
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Tail of Spence
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-an extension of the breast that travels towards the axilla
-inserts into Foramen of Langer -important to remember to examine this area in breast exam b/c can also develop breast cancer |
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Foramen of Langer
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-Space where Tail of Spence of breast inserts in axilla
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Lactating Glands of Breast
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-15-20 of these
-congerge upon nipple |
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Position of breast
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-primarily over pectoralis major and over the pectoral fascia
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Blood Supply of Breast
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1. Internal Thoracic Artery-some lateral branches
2. Lateral Thoracic Artery-supplies lateral margin 3. Intercostal Arteries- perforating branches supply breast 4. Thoracoacromial Artery (pectoral branch)- continuing branches |
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What two skin areas have fibers directly connecting to hypothalamus?
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-Nipple
-Perineum (labia minora and scrotum) |
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Borders of Axilla
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*Apex-first rib, clavicle, superior angle of scapula (known as cervicoaxillary canal- where subclavian vein leaves axilla)
*Medial Border-serratus anterior, intercostal muscle *Anterior Border-pectoralis major, pectoralis minor, clavipectoral fascia *Base/Inferior Border- skin of axilla and fascia of region *Lateral Border- intertubercular groove *Posterior Border- subscapularis, teres major, latissimus dorsi |
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Cervicoaxillary canal
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-Apex of axilla
-formed by the point where the first rib, clavicle, and superior angle of scapula come together -subclavian vein leaves axilla through this canal |
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Subscapularis muscle
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-only muscle that inserts on the lesser tubercle of humerus
-the primary internal rotator of scapula -one of rotator cuff muscles |
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Serratus Anterior
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-huge muscle covering of first 8 ribs
-"Boxers' Muscle" -Primary protractor of scapula -innervated by Long Thoracic Nerve -helps form medial portion of axilla |
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Three Portions of Axillary Artery
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1st portion- medial to pectoralis minor
2nd portion-deep to pectoralis minor 3rd portion-lateral to pectoralis minor |
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Branches of Axillary Artery (moving distally)
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-First Branch = superior thoracic artery
-Second Branch (inferiorly) = thoracoacromial artery (w/ 4 associated branches) -Third Branch = Lateral Thoracic Artery -Fourth Branch = Subscapular Artery -5th and 6th branches = posterior and anterior circumflex humeral arteries |
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Superior Thoracic Artery
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-first branch of axillary artery
-usually very small -runs to the anterior part of the first two intercostal spaces |
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Lateral Thoracic Artery
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-third branch of axillary artery
-runs right on lateral part of thoracic wall on superficial surface of serratus anterior -runs somewhat parallel to the long thoracic nerve |
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Subscapular Artery
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-4th and largest branch of axillary artery
-quickly gives off scapular circumflex artery which is visible in triangular SPACE on back of scapula -distally it changes name to THORACODORSAL ARTERY which runs with thoracodorsal nerve to latissumus dorsi |
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Posterior Circumflex Humeral Artery
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-one of last two branches of axillary artery
-forms ring around humerus along with anterior circumflex humeral artery -found in quadrangular space |
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Anterior Circumflex Humeral Artery
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-one of last two branches of axillary artery
-anastamoses with posterior circumflex humeral artery to form ring around humerus -runs laterally just deep to tendon of long head of biceps |
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Veins of Axilla (those that don't have the same names as the arteries)
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1. Cephalic vein
2. Basilic vein 3. Median Cubital vein |
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Basilic Vein
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-as traced cephalad, fuses with two accompanying veins (venae comitantes) to become the axillary vein
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Axillary Lymph Nodes
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-common drainage site for upper limb
-very important in lymphatic drainage of breast -30-40 axillary lymph nodes |
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Types of Axillary Lymph Nodes
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1. Anterior nodes
2. Central nodes 3. Lateral nodes 4. Apical nodes 5. Posterior (subscapular) nodes 6. Parasternal nodes |
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Anterior nodes
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-also kalled Pectoral Nodes
-like posterior to pectoralis major -associated w/ lateral thoracic vessels -3-5 of these |
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Central nodes
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-on central portion of axillary vein
-3-4 of these |
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Apical nodes
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-on medial side of central nodes
-3-4 of these |
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Posterior nodes
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-also called Subscapular nodes
-collected around subscapular vessels -6-7 of these |
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Parasternal nodes
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-not much drainage here
-circle formed by these connects right and left breasts |
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Level 1 Nodes
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-lateral to pectoralis major
-not usually involved in mammary gland tumor |
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Level 2 Nodes
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-posterior to pectoralis minor
-more likely to be involved in cancer |
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Level 3 Nodes
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-medial to pectoralis minor
-more likely to be involved in cancer |
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"Pre-fixed Plexus"
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-when a brachial plexus has a lot of C4 contribution and little or no T1 contribution
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"Post-fixed Plexus"
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-when a brachial plexus has a lot of T2 contribution and little or not C5
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Crutch Palsy
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-lesion involving posterior cord of brachial plexus
-involves radial nerve -results in poor function of triceps and wrist extensors -also called Saturday Night Palsy -can result in transient loss of function of radial nerve |
