Plating 3 (Part 2)

Covers: breast and back anatomy

Breast

Most superficial structure in anterior thoracic wall

Areola

Circular pigmented area of skin in breast

Contains numerous sebaceous glands, giving a protective lubricant

Subcutaneous tissue

In what type of tissue are mammary glands in

2nd-6th ribs

The ribs covered by the circular female breast

4th

The nipple is situated on the __ intercostal space

Axillary tail of spence

Small part of the mammary gland that extends from p. major ms to axilla

2/3

What fraction of the breast lies on deep fascia related to the p. major ms

1/3

What fraction of the breast rests on the fascial, covering the serratus anterior ms

Retromammary space

Layer of loose connective tissue that separates breast from deep fascia and provides movement over underlying structures

Suspensory ligaments (of Cooper)

The mammary gland is firmly attached to dermis of skin by these skin ligaments

8-15

At what age do breasts normally grow because of glandular development and increased fat desposition

15-20

How many lobules of grandular tissue forms through the lactiferous ducts?

Nipple

Cornical/cylindrical prominence in center of areola with no fat, hair, or sweat gland

T4

Dermatome of the nipple

Lateral thoracic

Posterior intercostal

Major blood supply of breast

Axillary vein, internal thoracic vein

Major veinous drainage of breast

Axillary

Superclavicular

Internal mammary group of lymph nodes

The superficial lymphatics from skin over breast drain into

Anterior and lateral cutaneous branches - 4th-6th intercostal nerves

Nerve supply of the breast

Polymastia

Condition when there is an extra number of breast

Polythelia

Condition when there is an extra number of nipples

Amastia

Condition with the absence of breast or presence of nipple but no glandular tissue

Gynaecomastia

Enlargement of the male breast which commonly occurs in puberty

Klinefelter’s syndrome

~40% of post-pubertal males with this syndrome exhibits gynaecomastia

Diethylstibesterol

After treatment of prostate cancer with this drug could lead to gynaecomastia

Breast cancer

Most common malignancy in women

Surgery

Radiotherapy

Chemotherapy

Curative treatments of breast cancer

True

Breast tumors spread via lymphatic veins

Peau d’orange

Appearance of an orange peel texture on surface of breast

Cancer en cuirasse

Rare manifestation of breast cancer; hard woody texture to the skin

Palpable lump

Most common breast symptom

Lactiferous sinus

Dilated part of the lactiferous duct

Spinal accessory nerve

Anterior rami C3-C4

Nerve supply of trapezius

Elevates

Adducts

Depresses scapula

Action of trapezius

Thoracodorsal nerve

Nerve supply of latissmus dorsi

Shoulder extension

Shoulder medial rotation

Shoulder adduction

Action of latissmus dorsi

Cervical plexus C3-C4

Dorsal scapular nerve C5

Nerve supply of levator scapulae

Scapula elevation

Downward rotation

Action of levator scapulae

Dorsal scapular nerve C4-C5

Nerve supply of rhomboid minor and major

Splenius

Superficial interinsic layer of deep back muscle

Erector spinae

Intermediate interinsic layer of deep back ms

Extension of vertebral column

Action of erector spinae

Spinalis

Most medial ms of erector spinae

Longissimus

Middlemost ms of erector spinae

Illiocostalis

Most lateral ms of erector spinae

Semispinalis

Deep interinsic layer of deep back ms

Rotate head and neck contralaterally

Action of semispinalis unilaterally

Extend head and thoracic cervical regions

Action of semispinalis bilaterally

Posterior rami of intercostal nerves

Nerve supply of multifidus

Posterior rami of spinal nerves

Nerve supply of rotatores

Inspiratory muscle

Minor deep interinsic layer

True

Veins in back muscles have free venous blood flow

Posterior rami

Major nerve supply of the back