Week 4

Description:	10/02
Category:	Medical
Created by:	GrossAnatomy1 on 2007-10-06

Question	Answer
Q Where are mammary glands located? Do they have a capsule?	A Mammary glands are located in the subcutaneous tissue, and they do NOT have a capsule
Q Where is the areola located in relation to underlying structures?	A At the level of the 4th intercostal space
Q The female breast extends roughly from the lateral border of the sternum to what point laterally?	A There is a "tail" of the breast tissue that extends to the mid-axillary line underneath the arm.
Q The vertical borders of the breast are roughly ribs 2 and 6, depending on age and structure (so really those numbers mean nothing). What else is located at the rib 2 level?	A The angle of Louie
Q 2/3 of the breast lays over the pec major. Where does the other 1/3 rest?	A Don't forget the tail of the breast that extends under the arm. The lat 1/3 of the breast rests on the serratus ant.
Q Internal to the female breast there is a potential space made up of CT to allow some movement. What is this space called?	A Retromammary space/bursa
Q What supports the lobules in the female breast? Where are these most developed?	A suspensory ligaments of Cooper, which are skin ligaments. These are more developed in the sup portion of the breast.
Q What kind of glands are the female mammary glands? What other glands are present in the female breast?	A They are modified sweat glands. Also present are sebaceous glands of montgomery that secrete oil for lubrication.
Q There are 15-20 lobules per gland in the female breast. What drains each lobule?	A Each lobule drains into a lactiferous duct
Q What is the wide spot in the lactferous duct called, and where is it found?	A LActiferous sinus, found just beneath the surface. Note: There is one sinus per duct
Q What is the nipple composed of? Are any other structures or marks present on the nipple?	A The nipple is circular smooth m., and there is no fat, hair, or sweat glands present here; only small fissures to mark the openings of the lactiferous ducts.
Q The breasts are supplied blood by which arteries? Which is larger?	A medial mammary branches of the internal thoracic artery, and lateral mammary branches of the lateral thoracic artery (this is 2-3 times larger)
Q If for some reason blood supply to the breast from the medial mammary branches was cut off, how would blood have to arrive?	A The pos. intercostal arteries supply blood to the lateral thoracic wall. These have lateral mammary branches that reach the breast.
Q If blood supply to the breast from the lateral mammary branches were cut off, through what pathway would blood travel to reach the breast?	A The internal thoracic artery branches into ant intercostal arteries. These have perforating branches called "medial mammary branches" which supply blood to the breast.
Q What is the major blood supply to the serratus ant m.?	A lateral thoracic artery. This is where the lateral mammary branches split off on their way to the breast.
Q The internal thoracic artery is important for blood supply to the breast. Where does this vessel come from, and where else does it go?	A The int. thoracic artery is a branch of the subclavian artery, which travels parallel to the sternum, pos. to the ribs.
Q Once the int. thoracic artery arrives at the rib 6-7 level, it continues inf. into the rectus sheath as what artery? What branches off laterally from this artery?	A IT becomes the sup. epigastric artery, and branches laterally into the musculophrenic artery.
Q Internal thoracic veins may be referred to as "vena communicantes". Why is this? What may be the reason for this structure?	A Vena communicantes are 2-3 veins that wrap around an artery in web-like formation. This may be to take advantage of the constriction/dilation of the artery to promote flow through the vein as well.
Q Breast cancer almost always becomes proliferative where?	A In the ducts.
Q The innervation of the breast is from intercostal/segmental nn, easily enough. Do you know what specific levels though?	A intercostal nn. 4-6
Q The pec major has a clavicular head,, which originates from the medial half of the clavicle. Where does the sternocostal head originate?	A on the ant sternum, sup 6 costal cartilages, and the aponeurosis of the ext oblique m.
Q What is the innervation of the pec major? What about the pec minor?	A major = lat/med pectoral n., minor = medial pectoral n.
Q What is significant about the medial pectoral n.?	A It travels through the pec minor m.
Q The sternocostal head of the pec major by itself would extend the humerous from a flexed position. What would the clavicular head accomplish on its own?	A flexion of the humerous.
Q To what mm. does the thoracoacromial artery supply blood?	A To the pec major/minor
Q What is the origin of the pec minor?	A Ribs 3-5 near costal cartilage
Q What mm. draws the scapula anterior AND inferior?	A pec minor
Q What mm. acts as an antagonist to the traps/scm on the clavicle?	A subclavius
Q This m. originates from the junction of rib 1/costal cartilage and inserts on the inf middle 1/3 of the clavicle.	A subclavius
Q Is blood supply to the subclavius the same as to the pec major/minor?	A Yes, it is from the thoracoacromial artery, BUT it comes from the clavicular branch as opposed to the pectoral branch.
Q The origin of this m spans from ribs 1-8	A serr. ant.
Q What is the innervation of the serr. ant.? What is unusual about the travel of this n.?	A The long thoracic n. travels on top of the serr. ant (though covered by the lats for the most part), whereas most nn. travel underneath the mm. they innervate.
Q This m. protracts the scapula, AND holds it against the thorax	A serr. ant.
Q What is the blood supply to the serr. ant?	A lat. thoracic artery
Q What mm. were found on the internal surface of the lower sternum when you cut through to the thoracic cavity in gross lab?	A transverse thoracic mm/transversus thoracis
Q The innervation of the transversus thoracis m is from intercostal/segmental nn. What is the action of this m.?	A depress the ribs for forced exhalation
Q The pericardium is a double walled "fibroserous" sac. What are the two ligaments coming off of this sac?	A The pericardiacophrenic ligament to the central tendon (?) and the sternopericardial ligament to the sternum
Q How/where does the pericardium attach to the heart?	A It is fused with the tunica adventitia of the great vessels
Q What are the two parts of the pericardium?	A The serous pericardium which decreases friction during beating, and the fibrous pericardium which is for protection.
Q The serous pericardium has a parietal layer fused with the firbrous pericardium, and a visceral layer. What is another name for the visceral layer?	A The epicardium
Q What is the function of the fibrous pericardium?	A it limits overfilling
Q Where are the phrenic nn. and the pericardiacophrenic vessels found in relation to the heart?	A They are inside the fibrous pericardium
Q Where is the transverse pericardial sinus located? Specifically, what structures is it behind/in front of?	A ***Pos. to aorta/pulmonary trunk, and ant. to sup ven cav
QTher oblique pericardial sinus was palpated in gross lab, from the apex of the heart medial and superior. What are the borders of this sinus medially/laterally?	A Medial = R sup/inf pulmonary veins, Lateral = L sup/inf pulmonary veins.