Mkgrady8 Breast And Thoracic Cage

Front 1

sensory innervation of the breast

Back 1

anterior and lateral cutaneous branches of the 4th-6th intercostal nerves (ventral rami of T4-T6)

Front 2

sympathetic innervation of the breast

Back 2

reach the blood vessels, glandular tissue, and smooth muscles by way of 2nd -6th intercostal nerves

Front 3

fetal development of breasts

Back 3

mammary ridges on either side of the body from the arms to the legs; starting in the 6th week there is the formation of a primary bud which grows secondary buds and then a mammary pit forms and lactiferous ducts are formed

Front 4

amastia

Back 4

lack of breasts (if the mammary ridges disappear)

Front 5

polymastia

Back 5

many breasts; if the mammary ridge forms an accessory breast at an additional location on the mammary ridges

Front 6

athelia

Back 6

one nipple; if one less nipple forms

Front 7

polythelia

Back 7

many nipples; if an additional nipple forms along the line of the mammary ridge

Front 8

unilateral hypoplasia

Back 8

if one breast is a lot smaller (15% less or more) than the other (may impede function in that breast)

Front 9

gynecomastia

Back 9

breasts in a man; associated with obesity; can lead to breast cancer in men; can be due to hormonal imbalances due to testicular cancer, suprarenal cancer, or cirrhosis

Front 10

the breasts at puberty

Back 10

ovarian hormones induce growth; the ductile system grows primarily from estrogen and the lobular system grows primarily from progesterone

Front 11

at the end of puberty the brest is

Back 11

1/3 mammary gland, 1/3 fat, and 1/3 connective tissue

Front 12

the breasts during pregnancy

Back 12

additional growth of breast under influence of pituitary, ovarian/placental hormones; ductile system grows due to prolactin and estrogen; progesterone at this stage inhibits lactation

Front 13

at the end of pregnancy the breast is

Back 13

40-50% ductile system

Front 14

lactation in the breast

Back 14

estrogen and progesterone levels decrease rapidly; progesterone is no longer inhibiting lactation; with suckling (or thoughts of baby) prolactin levels (milk production) and oxytocin levels (letdown) temporarily spike

Front 15

menopause on the breast

Back 15

estrogen and progesterone levels drop, leading to delimitation of the entire ductile system, causing the remnants to resemble connective tissue; testosterone (ovarian) levels increase; endogenous aromatase in the breast can convert testosterone to estrogen in the breast- an uptick in hormone sensitive cancer in the elderly and use of estrogen receptor blockers or aromatase inhibitors with active research ongoing as regarding side effects

Front 16

symptoms of breast cancer

Back 16

lumps within tissue (andenocarcinomas), peau d'orange (edema of the skin), dimpled skin/inverted nipple, elevation of breast with exercise (signaling something (cancer) connecting the breast with the pec muscle

Front 17

risk factors for breast cancer

Back 17

heredity, age, environmental factors, and age

Front 18

heredity on breast cancer

Back 18

BRCA1 and BRCA2 are the most well-known factors; at least a dozen other genes have been identified (many of which can co-occur as gene complexes) (with as yet poorly understood interactions); gene screening is expensive and often uncovered

Front 19

age on breast cancer

Back 19

by 30 1 in 2500, by 40 1 in 250, by 70 1 in 25; ultimately 1 out of 8

Front 20

environmental facts and breast cancer

Back 20

estrogen mimics, general risks

Front 21

hormone replacement therapy on breast cancer

Back 21

estrogen mimics

Front 22

treatment of breast cancer

Back 22

ranges from lumpectomy (localized excision followed by drug and radiation therapy to prevent redevelopment of cancer) to simple single or simple double mastectomy followed by drug and radiation therapy to radical single or double mastectomy followed by extremely aggressive drug and radiation therapy (extremely rare)

Front 23

clinical examination of thorax

Back 23

inspection- visual, look for abnormalities, asymmetries; palpation- feel for bumps, areas of tenderness; percussion- listen for dullness (lack of tympanic sounds) over lungs; auscultation- listen for breathing sounds and to the heart

Front 24

classification of ribs

Back 24

by type- true (1-7), false (8-10), or floating(11-12); by form- typical (3-10) or atypical (1, 2, 11, 12); by clinically- normal or anomalous (extra rib)

Front 25

a dislocated rib versus a separated rib

Back 25

dislocated= costal cartilage from sternum; separated= rib from costal cartilage

Front 26

the danger of an extra cerc=vical rib

Back 26

can compress rivers of inferior trunk of brachial plexus leading to pain in upper limb (one example of thoracic outlet syndrome)

Front 27

the danger of an extra lumbar rib

Back 27

can be mistaken for a fractured rib or lead to mistakes in counting vertebra

Front 28

muscles of the thorax that aid in protection of the thorax and inspiration

Back 28

serratus posterior superior, serratus posterior inferior, levatores costarum, intercostals, subcostals, and transversus thoracis

Front 29

muscles not truly of the thoracic cage but do serve a protective role OR air in forced inspiration

Back 29

trapezius, lat dorsi, rhomboid major and minor, pectorals major and minor, serratus anterior, subclavius, scalenes

Front 30

blood supply to the thorax

Back 30

subclavian artery via supreme intercostal to posterior intercostals 1 and 2; thoracic aorta to posterior intercostals 3-11 and subcostal; internal thoracic artery to anterior intercostals 1-6 and, via musculophrenic, to anterior intercostals 7-9; axillary artery to superior thoracic and lateral thoracic

Front 31

innervation of thoracic cage

Back 31

intercostal nerves (ventral rami of T1-T11 spina lnerves); subcostal nerve (ventral rami of T12 spinal nere); typically run inferior to their associated rib- inferior to the associated artery which is, in turn, inferior to the associated vein (VAN)

Front 32

the intercostal/subcostal nerves

Back 32

typically provide sensory innervation, along with associated dorsal rami, from a dermatome that rings the body - above and below a line defined by the nerve in question, there is overlap and a need to deaden adjacent intercostal nerves in order to deaden any given intercostal space; provide muscular branches of the thoracic cage; provide, by way of fibers from the sympathetic trunk, sympathetic innervation to the blood levels, glands, and smooth muscles of the thoracic cage

Front 33

the VAN positioning

Back 33

initially centered in the intercostal space as they exit the spinal column; soon move to a position in the costal groove along the lower edge of the superior rib (so enter just superior to a rib when doing surgery)

Front 34

during a mastectomy what do you have to watch out for

Back 34

the long thoracic nerve (which you want to avoid) and the lateral thoracic artery (which you have no choice but to remove)