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35 Cards in this Set

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Axilla
-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
Breast
-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)
Cooper's Ligaments
dense connective tissue strands in breast that separate the lobes
Tail of Spence
-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
Foramen of Langer
-Space where Tail of Spence of breast inserts in axilla
Lactating Glands of Breast
-15-20 of these
-congerge upon nipple
Position of breast
-primarily over pectoralis major and over the pectoral fascia
Blood Supply of Breast
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
What two skin areas have fibers directly connecting to hypothalamus?
-Nipple
-Perineum (labia minora and scrotum)
Borders of Axilla
*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
Cervicoaxillary canal
-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
Subscapularis muscle
-only muscle that inserts on the lesser tubercle of humerus
-the primary internal rotator of scapula
-one of rotator cuff muscles
Serratus Anterior
-huge muscle covering of first 8 ribs
-"Boxers' Muscle"
-Primary protractor of scapula
-innervated by Long Thoracic Nerve
-helps form medial portion of axilla
Three Portions of Axillary Artery
1st portion- medial to pectoralis minor
2nd portion-deep to pectoralis minor
3rd portion-lateral to pectoralis minor
Branches of Axillary Artery (moving distally)
-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
Superior Thoracic Artery
-first branch of axillary artery
-usually very small
-runs to the anterior part of the first two intercostal spaces
Lateral Thoracic Artery
-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
Subscapular Artery
-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
Posterior Circumflex Humeral Artery
-one of last two branches of axillary artery
-forms ring around humerus along with anterior circumflex humeral artery
-found in quadrangular space
Anterior Circumflex Humeral Artery
-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
Veins of Axilla (those that don't have the same names as the arteries)
1. Cephalic vein
2. Basilic vein
3. Median Cubital vein
Basilic Vein
-as traced cephalad, fuses with two accompanying veins (venae comitantes) to become the axillary vein
Axillary Lymph Nodes
-common drainage site for upper limb
-very important in lymphatic drainage of breast
-30-40 axillary lymph nodes
Types of Axillary Lymph Nodes
1. Anterior nodes
2. Central nodes
3. Lateral nodes
4. Apical nodes
5. Posterior (subscapular) nodes
6. Parasternal nodes
Anterior nodes
-also kalled Pectoral Nodes
-like posterior to pectoralis major
-associated w/ lateral thoracic vessels
-3-5 of these
Central nodes
-on central portion of axillary vein
-3-4 of these
Apical nodes
-on medial side of central nodes
-3-4 of these
Posterior nodes
-also called Subscapular nodes
-collected around subscapular vessels
-6-7 of these
Parasternal nodes
-not much drainage here
-circle formed by these connects right and left breasts
Level 1 Nodes
-lateral to pectoralis major
-not usually involved in mammary gland tumor
Level 2 Nodes
-posterior to pectoralis minor
-more likely to be involved in cancer
Level 3 Nodes
-medial to pectoralis minor
-more likely to be involved in cancer
"Pre-fixed Plexus"
-when a brachial plexus has a lot of C4 contribution and little or no T1 contribution
"Post-fixed Plexus"
-when a brachial plexus has a lot of T2 contribution and little or not C5
Crutch Palsy
-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